Background
Methods
Patients
Data sources and definitions
Assessment of outcomes
Statistical analysis
Results
Patients
All patients (n = 409) | Level 1 (n = 208) | Level 2 (n = 75) | Level 3(n = 126) | p-value | |
---|---|---|---|---|---|
Demographics | |||||
Age (years) | 73·1 ± 15·3 | 81·9 ± 9·4 | 75·4 ± 9·9 | 57·6 ± 12·8 | < 0·001 |
Male sex [n(%)] | 211 (54) | 103 (49·5) | 43 (57·3) | 75 (59·5) | 0·17 |
BMI (kg/m2) | 26·3 (22·1–30·8) | 23·2 (20·5–27·1) | 27·6 (22·0–31·8) | 29·4 (25·8–34·0) | < 0·001 |
BAME [n(%)] | 56 (13·7) | 12 (5·8) | 8 (10·7) | 36 (28·6) | < 0·001 |
Clinical Frailty Scale | 5 (3–6) | 6 (5–7) | 4 (3–5) | 2 (2–3) | < 0·001 |
Co-morbidities | |||||
HFrEF [n(%)] | 51 (12·5) | 34 (16·3) | 13 (17·3) | 4 (3·2) | 0·001 |
IHD [n(%)] | 62 (15·2) | 39 (18·8) | 15 (20·0) | 8 (6·3) | 0·004 |
Hypertension [n(%)] | 191 (46·7) | 99 (47·6) | 44 (58·7) | 48 (38·1) | 0·017 |
AF [n(%)] | 87 (21·3) | 60 (28·8) | 17 (22·7) | 10 (7·9) | < 0·001 |
Diabetes mellitus [n(%)] | 125 (30·6) | 67 (32·2) | 32 (42·7) | 26 (20·6) | 0·004 |
Stroke/TIA [n(%)] | 48 (11·7) | 34 (16·3) | 10 (13·3) | 4 (3·2) | 0·001 |
CKD [n(%)] | 103 (25·2) | 69 (33·2) | 29 (38·7) | 5 (4·0) | < 0·001 |
COPD [n(%)] | 64 (15·6) | 41 (19·7) | 16 (21·3) | 7 (5·6) | 0·001 |
Malignancy [n(%)] | 33 (8·1) | 22 (10·6) | 7 (9·3) | 4 (3·2) | 0·050 |
Medications | |||||
ACEi [n(%)] | 74 (18·1) | 30 (14·4) | 23 (30·7) | 21 (16·7) | 0·007 |
ARB [n(%)] | 32 (7·8) | 10 (4·8) | 8 (10·7) | 14 (11·1) | 0·069 |
BB [n(%)] | 99 (24·2) | 61 (29·3) | 22 (29·3) | 16 (12·7) | 0·001 |
CCB [n(%)] | 68 (16·6) | 27 (13·0) | 20 (26·7) | 21 (16·7) | 0·024 |
Loop diuretic [n(%)] | 64 (15·6) | 50 (24·0) | 12 (16·0) | 2 (1·6) | < 0·001 |
MRA [n(%)] | 16 (3·9) | 11 (5·3) | 3 (4·0) | 2 (1·6) | 0·24 |
Statin [n(%)] | 171 (41·8) | 85 (40·4) | 49 (65·3) | 38 (30·2) | < 0·001 |
Antiplatelet [n(%)] | 105 (25·7) | 57 (27·4) | 23 (30·7) | 25 (19·8) | 0·17 |
Anticoagulant [n(%)] | 57 (13·9) | 42 (20·2) | 11 (14·7) | 4 (3·2) | < 0·001 |
Metformin [n(%)] | 50 (12·2) | 23 (11·1) | 14 (18·7) | 13 (10·3) | 0·17 |
Sulphonylurea [n(%)] | 20 (4·9) | 5 (2·4) | 8 (10·7) | 7 (5·6) | 0·016 |
Corticosteroid [n(%)] | 21 (5·1) | 12 (5·8) | 3 (4·0) | 6 (4·8) | 0·82 |
Immunosuppression [n(%)] | 21 (5·1) | 9 (4·3) | 5 (6·7) | 7 (5·6) | 0·71 |
Ceiling of care and cardiopulmonary resuscitation decisions
Demographics and clinical characteristics
Odds ratio | 95% CI | p-value | |
---|---|---|---|
Age (per year) | 0·89 | 0·86–0·92 | < 0·001 |
Male sex | 1·8 | 0·81–4·0 | 0·15 |
CFS (per nodal point) | 0·47 | 0·37–0·60 | < 0·001 |
Diabetes | 0·49 | 0·20–1·2 | 0·11 |
COPD | 0·60 | 0·19–1·9 | 0·38 |
CKD | 0·31 | 0·093–1·1 | 0·062 |
Stroke/TIA | 1·1 | 0·25–5·1 | 0·88 |
Loop diuretic | 0·27 | 0·031–2·3 | 0·23 |
Statin | 0·68 | 0·30–1·5 | 0·35 |
Odds ratio | 95% CI | p-value | |
---|---|---|---|
Age (per year) | 0·89 | 0·86–0·93 | < 0·001 |
Male sex | 1·75 | 0·79–3·8 | 0·17 |
CFS (per nodal point) | 0·48 | 0·38–0·60 | < 0·001 |
Co-morbidities (per co-morbidity) | 0·72 | 0·52–1·0 | 0·048 |
Loop diuretic | 0·23 | 0·026–2·1 | 0·19 |
Statin | 0·65 | 0·30–1·4 | 0·28 |
Clinical markers of disease severity
All patients (n = 409) | Level 1 (n = 208) | Level 2 (n = 75) | Level 3 (n = 126) | p-value | |
---|---|---|---|---|---|
Laboratory findings | |||||
Hb | 129·2 ± 20·7 | 126·6 ± 21·8 | 125·0 ± 21·6 | 135·9 ± 16·5 | < 0·001 |
WCC | 7·0 (5·4–9·4) | 7·2 (5·4–10·0) | 6·5 (5·0–9·1) | 7·1 (5·6–9·5) | 0·23 |
ANC | 5·4 (4·0–8·0) | 5·7 (4·0–8·9) | 5·1 (3·9–7·8) | 5·6 (4·2–8·3) | 0·38 |
Lymphocyte count | 0·8 (0·5–1·1) | 0·7 (0·5–1·1) | 0·7 (0·5–1·0) | 0·8 (0·6–1·1) | 0·12 |
Na2+ | 138 (136–141) | 140 (136–145) | 137 (135·8–140) | 137 (135–139) | < 0·001 |
K+ | 4·0 (3·7–4·4) | 4·0 (3·7–4·5) | 4·2 (3·7–4·5) | 3·9 (3·7–4·2) | 0·034 |
Creatinine | 81 (63–117) | 95 (68–143) | 86·5 (65·8–129·5) | 74 (60·3–89·8) | < 0·001 |
CRP | 90 (45–169) | 77·5 (34·8–159·8) | 106 (72·3–187·3) | 110 (68–192) | 0·001 |
Ddimer | 467 (258·5–1035·3) | 496 (266–1978) | 671 (387–1042) | 373 (223–924) | 0·068 |
hsTNI | 20·5 (8·1–60) | 40·0 (17·2–94·3) | 25·5 (9·9–70·5) | 8·5 (4·6–22·2) | < 0·001 |
Ferritin | 460 (220–982) | 365 (143·8–671·5) | 510 (261·3–946) | 674 (338·5–1458) | < 0·001 |
Procalcitonin | 0·15 (0·08–0·38) | 0·17 (0·08–0·52) | 0·14 (0·08–0·32) | 0·15 (0·09–0·40) | 0·60 |
Clinical observations | |||||
RR (min−1) | 22 (18–28) | 20 (18–28) | 22·5 (20–28) | 24 (20–29) | 0·026 |
O2 saturations (%) | 94·5 (89–96) | 95 (90–97) | 94 (88–96) | 94 (89–96) | 0·065 |
Heart rate (min−1) | 90 (76–103) | 89 (73–102·8) | 89 (79–101·3) | 96 (86–108·5) | 0·001 |
SBP (mmHg) | 129·2 ± 23·5 | 130·4 ± 25·5 | 131·2 ± 24·4 | 126·2 ± 18·8 | 0·21 |
Temperature (°C) | 37·7 ± 1·1 | 37·4 ± 1·1 | 37·7 ± 1·1 | 38·0 ± 1·0 | < 0·001 |
Chest radiography | |||||
COVID-19 [n(%)] | 190 (47·4) | 61 (29·6) | 40 (55·6) | 89 (72·4) | < 0·001 |
Indeterminate [n(%)] | 125 (31·2) | 79 (38·2) | 22 (30·6) | 24 (19·5) | |
Non-COVID-19 [n(%)] | 86 (21·4) | 66 (32·0) | 10 (13·9) | 10 (8·1) |
Treatments administered during hospitalisation
Clinical outcomes
All patients (n = 485) | Alive (n = 326) | Dead (n = 159) | p-value | |
---|---|---|---|---|
Demographics | ||||
Age (years) | 71·6 ± 16·3 | 68·4 ± 17·4 | 78·1 ± 11·5 | < 0·001 |
Male sex [n(%)] | 259 (53·4) | 168 (51·5) | 91 (57·3) | 0·24 |
BMI (kg/m2) | 26·3 (22·1–30·8) | 26·7 (22·2–31·4) | 25·5 (21·9–29·9) | 0·13 |
BAME [n(%)] | 73 (15·4) | 59 (18·6) | 14 (8·9) | 0·006 |
Clinical Frailty Scale | 5 (3–6) | 3 (2–6) | 6 (3–7) | < 0·001 |
Co-morbidities | ||||
HFrEF [n(%)] | 59 (12·2) | 31 (9·5) | 28 (17·6) | 0·010 |
IHD [n(%)] | 69 (14·2) | 46 (14·1) | 23 (14·5) | 0·92 |
Hypertension [n(%)] | 222 (45·8) | 155 (47·5) | 67 (42·1) | 0·26 |
AF [n(%)] | 97 (20·0) | 52 (16·0) | 45 (28·3) | 0·001 |
Diabetes mellitus [n(%)] | 147 (30·3) | 90 (27·6) | 57 (35·8) | 0·064 |
Stroke/TIA [n(%)] | 53 (10·9) | 32 (9·8) | 21 (13·2) | 0·26 |
CKD [n(%)] | 119 (24·5) | 71 (21·8) | 48 (30·2) | 0·043 |
COPD [n(%)] | 69 (14·2) | 37 (11·3) | 32 (20·1) | 0·009 |
Malignancy [n(%)] | 37 (7·6) | 23 (7·1) | 14 (8·8) | 0·50 |
Medications | ||||
ACEi [n(%)] | 84 (17·3) | 57 (17·5) | 27 (17·0) | 0·89 |
ARB [n(%)] | 41 (8·5) | 31 (9·5) | 10 (6·3) | 0·23 |
BB [n(%)] | 113 (23·3) | 75 (23·0) | 38 (23·9) | 0·83 |
CCB [n(%)] | 80 (16·5) | 57 (17·5) | 23 (14·5) | 0·40 |
Loop diuretic [n(%)] | 74 (15·3) | 47 (14·4) | 27 (17·0) | 0·46 |
MRA [n(%)] | 18 (3·7) | 12 (3·7) | 6 (3·8) | 0·96 |
Statin [n(%)] | 200 (41·2) | 136 (41·7) | 64 (40·3) | 0·76 |
Antiplatelet [n(%)] | 115 (23·7) | 75 (23·0) | 40 (25·2) | 0·60 |
Anticoagulant [n(%)] | 67 (13·8) | 38 (11·7) | 29 (18·2) | 0·049 |
Metformin [n(%)] | 61 (12·6) | 39 (12·0) | 22 (13·8) | 0·56 |
Sulphonylurea [n(%)] | 23 (4·7) | 18 (5·7) | 5 (3·2) | 0·23 |
Corticosteroid [n(%)] | 24 (4·9) | 14 (4·3) | 10 (6·4) | 0·34 |
Immunosuppression [n(%)] | 22 (4·5) | 13 (4·0) | 9 (5·7) | 0·41 |