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The Barts Health NHS Trust COVID-19 cohort: characteristics, outcomes and risk scoring of patients in East London
METHODS: Patients with confirmed polymerase chain reaction (PCR) test results admitted between 1 March and 1 August 2020 were included, alongwith clinician‐diagnosed suspected cases. Prognostic factors from the 4C Mortality score and 4C Deterioration scores were extracted from electronic health records and logistic regression was used to quantify the strength of association with 28‐day mortality and clinical deterioration using national death registry linkage.
RESULTS: Of 2783 patients, 1621 had a confirmed diagnosis, of whom 61% were male and 54% were from Black and Minority Ethnic groups; 26% died within 28 days of admission. Mortality was strongly associated with older age. The 4C mortality score had good stratification of risk with a calibration slope of 1.14 (95% CI 1.01–1.27). It may have under‐estimated mortality risk in those with a high respiratory rate or requiring oxygen.
CONCLUSION: Patients in this diverse patient cohort had similar mortality associated with prognostic factors to the 4C score derivation sample, but survival might be poorer in those with respiratory failure.
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Keywords: COVID-19; SARS-CoV-2; clinical risk; cohort study; mortality
Document Type: Research Article
Affiliations: 1: The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK 2: Wolfson Institute of Preventive Medicine, Queen Mary University of London, Mile End Road, London, UK 3: Wolfson Institute of Preventive Medicine, Queen Mary University of London, Mile End Road, London, UK, Barts Clinical Trials Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Mile End Road, London, UK 4: The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, The William Harvey Research Institute, Queen Mary University of London Charterhouse Square, London, UK 5: The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK 6: Centre for Global Public Health, Queen Mary University of London, Mile End Road, London, UK 7: The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, Whipps Cross University Hospital, Barts Health NHS Trust, Leytonstone, London, UK 8: Whipps Cross University Hospital, Barts Health NHS Trust, Leytonstone, London, UK 9: The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, The William Harvey Research Institute, Queen Mary University of London Charterhouse Square, London, UK, St Bartholomew´s Hospital, Barts Health NHS Trust, West Smithfield, London, UK 10: Newham University Hospital, Barts Health NHS Trust, London, UK 11: Barts Clinical Trials Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Mile End Road, London, UK, The William Harvey Research Institute, Queen Mary University of London Charterhouse Square, London, UK 12: The William Harvey Research Institute, Queen Mary University of London Charterhouse Square, London, UK 13: The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK, Newham University Hospital, Barts Health NHS Trust, London, UK
Publication date: 01 May 2021
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