Respiratory Department, Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK.
Division of Infection and Immunity, University College London, London, UK.
BMJ Open Respir Res. 2021 Mar;8(1). doi: 10.1136/bmjresp-2020-000813.
Descriptions of clinical characteristics of patients hospitalised withCOVID-19, their clinical course and short-term inpatient and outpatient outcomes in deprived urban populations in the UK are still relatively sparse. We describe the epidemiology, clinical course, experience of non-invasive ventilation and intensive care, mortality and short-term sequelae of patients admitted to two large District General Hospitals across a large East London National Health Service Trust during the first wave of the pandemic.
A retrospective analysis was carried out on a cohort of 1946 patients with a clinical or laboratory diagnosis of COVID-19, including descriptive statistics and survival analysis. A more detailed analysis was undertaken of a subset of patients admitted across three respiratory units in the trust.
Increasing age, male sex and Asian ethnicity were associated with worse outcomes. Increasing severity of chest X-ray abnormalities trended with mortality. Radiological changes persisted in over 50% of cases at early follow-up (6 weeks). Ongoing symptoms including hair loss, memory impairment, breathlessness, cough and fatigue were reported in 70% of survivors, with 39% of patients unable to return to work due to ongoing symptoms.
Understanding the acute clinical features, course of illness and outcomes of COVID-19 will be crucial in understanding the effect of differences in risk, as well as the effectiveness of new interventions and vaccination between the successive waves of the pandemic.
在英国贫困城市人口中，关于因 COVID-19 住院的患者的临床特征、其临床病程以及短期住院和门诊结局的描述仍然相对较少。我们描述了在大伦敦国民保健系统信托的两家大型地区综合医院中，在大流行的第一波期间，在两个大型地区综合医院中接受治疗的患者的流行病学、临床病程、无创通气和重症监护的经验、死亡率和短期后遗症。
对 1946 例临床或实验室诊断为 COVID-19 的患者队列进行了回顾性分析，包括描述性统计和生存分析。对信托中三个呼吸科病房的一组患者进行了更详细的分析。
年龄增长、男性和亚洲种族与较差的结局相关。胸部 X 射线异常的严重程度增加与死亡率呈趋势相关。在早期随访（6 周）时，超过 50%的病例仍存在放射学改变。70%的幸存者报告有持续存在的症状，包括脱发、记忆力减退、呼吸急促、咳嗽和疲劳，由于持续存在的症状，39%的患者无法重返工作岗位。
了解 COVID-19 的急性临床特征、病程和结局对于理解风险差异的影响以及新干预措施和疫苗接种在大流行的连续波中的有效性至关重要。
