Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Internal Medicine, St. Maartenskliniek, Nijmegen, The Netherlands.
PLoS One. 2021 Mar 18;16(3):e0248713. doi: 10.1371/journal.pone.0248713. eCollection 2021.
To describe clinical characteristics, disease course and outcomes in a large and well-documented cohort of hospitalized COVID-19 patients in the Netherlands.
We conducted a multicentre retrospective cohort study in The Netherlands including 952 of 1183 consecutively hospitalized patients that were admitted to participating hospitals between March 2nd, 2020, and May 22nd, 2020. Clinical characteristics and laboratory parameters upon admission and during hospitalization were collected until July 1st.
The median age was 69 years (IQR 58-77 years) and 605 (63.6%) were male. Cardiovascular disease was present in 558 (58.6%) patients. The median time of onset of symptoms prior to hospitalization was 7 days (IQR 5-10). A non ICU admission policy was applicable in 312 (32.8%) patients and in 165 (56.3%) of the severely ill patients admitted to the ward. At admission and during hospitalization, severely ill patients had higher values of CRP, LDH, ferritin and D-dimer with higher neutrophil counts and lower lymphocyte counts. Overall in-hospital mortality was 25.1% and 183 (19.1%) patients were admitted to ICU, of whom 56 (30.6%) died. Patients aged ≥70 years had high mortality, both at the ward (52.4%) and ICU (47.4%). The median length of ICU stay was 8 days longer in patients aged ≥70 years compared to patients aged ≤60 years.
Hospitalized COVID-19 patients aged ≥70 years had high mortality and longer ICU stay compared to patients aged ≤60 years. These findings in combination with the patient burden of an ICU admission and possible long term complications after discharge should encourage us to further investigate the benefit of ICU admission in elderly and fragile COVID-19-patients.
描述荷兰大型且记录完备的住院 COVID-19 患者队列中的临床特征、疾病过程和结局。
我们在荷兰进行了一项多中心回顾性队列研究，纳入了 2020 年 3 月 2 日至 5 月 22 日期间连续收治于参与医院的 1183 例住院患者中的 952 例。收集了入院时和住院期间的临床特征和实验室参数，直至 2020 年 7 月 1 日。
中位年龄为 69 岁（IQR 58-77 岁），605 例（63.6%）为男性。558 例（58.6%）患者存在心血管疾病。住院前症状发作的中位时间为 7 天（IQR 5-10）。312 例（32.8%）患者适用非 ICU 入院政策，165 例（56.3%）重症患者入住病房。入院时和住院期间，重症患者的 CRP、LDH、铁蛋白和 D-二聚体值较高，中性粒细胞计数较高，淋巴细胞计数较低。总体住院死亡率为 25.1%，183 例（19.1%）患者入住 ICU，其中 56 例（30.6%）死亡。≥70 岁的患者死亡率较高，在病房（52.4%）和 ICU（47.4%）均如此。与≤60 岁的患者相比，≥70 岁的患者 ICU 住院时间中位数长 8 天。
与≤60 岁的患者相比，≥70 岁的 COVID-19 住院患者死亡率较高，ICU 住院时间较长。这些发现，再加上 ICU 入院的患者负担以及出院后可能出现的长期并发症，应促使我们进一步研究 ICU 入院对老年和脆弱 COVID-19 患者的益处。
