Ahmed Alaa
Zhaozhi Qian
Mihaela van der Schaar
Nick MaxfieldA paper on COVID-19 authored by Mihaela van der Schaar, Ahmed Alaa, and Zhaozhi Qian, alongside a number of the van der Schaar Lab’s clinical collaborators, has been accepted for publication in BMJ Open (editor-in-chief: Adrian Aldcroft).
The paper, entitled “Retrospective cohort study of admission timing and mortality following COVID-19 infection in England,” was published online on November 23, and was co-authored by Dr. Jem Rashbass and Prof. Jonathan Benger, both from NHS Digital.
In their study, the authors investigate whether the timing of hospital admission is associated with the risk of mortality for patients with COVID-19 in England, and the factors associated with a longer interval between symptom onset and hospital admission. Key findings include the discovery that timing of hospital admission is an independent predictor of mortality following adjustment for age, sex, comorbidities, ethnicity and obesity. Additionally, healthcare workers were found to be most likely to have an increased interval between symptom onset and hospital admission, as were people from Black, Asian and minority ethnic (BAME) backgrounds, and patients with obesity.
Retrospective cohort study of admission timing and mortality following COVID-19 infection in England
Ahmed Alaa, Zhaozhi Qian, Jem Rashbass, Jonathan Benger, Mihaela van der Schaar
Abstract
Objectives
We investigated whether the timing of hospital admission is associated with the risk of mortality for patients with COVID-19 in England, and the factors associated with a longer interval between symptom onset and hospital admission.
Design
Retrospective observational cohort study of data collected by the COVID-19 Hospitalisation in England Surveillance System (CHESS). Data were analysed using multivariate regression analysis. Setting Acute hospital trusts in England that submit data to CHESS routinely.
Participants
Of 14 150 patients included in CHESS until 13 May 2020, 401 lacked a confirmed diagnosis of COVID-19 and 7666 lacked a recorded date of symptom onset. This left 6083 individuals, of whom 15 were excluded because the time between symptom onset and hospital admission exceeded 3 months. The study cohort therefore comprised 6068 unique individuals.
Main outcome measures
All-cause mortality during the study period.
Results
Timing of hospital admission was an independent predictor of mortality following adjustment for age, sex, comorbidities, ethnicity and obesity. Each additional day between symptom onset and hospital admission was associated with a 1% increase in mortality risk (HR 1.01; p<0.005). Healthcare workers were most likely to have an increased interval between symptom onset and hospital admission, as were people from Black, Asian and minority ethnic (BAME) backgrounds, and patients with obesity.
Conclusion
The timing of hospital admission is associated with mortality in patients with COVID-19. Healthcare workers and individuals from a BAME background are at greater risk of later admission, which may contribute to reports of poorer outcomes in these groups. Strategies to identify and admit patients with high-risk and those showing signs of deterioration in a timely way may reduce the consequent mortality from COVID-19, and should be explored.
For a full list of the van der Schaar Lab’s publications, click here.
To find out more about the van der Schaar Lab’s work related to the COVID-19 pandemic, visit our dedicated page here.
Evgeny Saveliev
Nabeel Seedat
Andreas Bedorf
