[Clinical course of COVID-19 in the Netherlands: an overview of 2607 patients in hospital during the first wave]

Ned Tijdschr Geneeskd. 2021 Jan 11:165:D5085.
[Article in Dutch]

Abstract

Objective: To systematically collect clinical data from patients with a proven COVID-19 infection in the Netherlands.

Design: Data from 2579 patients with COVID-19 admitted to 10 Dutch centers in the period February to July 2020 are described. The clinical data are based on the WHO COVID case record form (CRF) and supplemented with patient characteristics of which recently an association disease severity has been reported.

Methods: Survival analyses were performed as primary statistical analysis. These Kaplan-Meier curves for time to (early) death (3 weeks) have been determined for pre-morbid patient characteristics and clinical, radiological and laboratory data at hospital admission.

Results: Total in-hospital mortality after 3 weeks was 22.2% (95% CI: 20.7% - 23.9%), hospital mortality within 21 days was significantly higher for elderly patients (> 70 years; 35, 0% (95% CI: 32.4% - 37.8%) and patients who died during the 21 days and were admitted to the intensive care (36.5% (95% CI: 32.1% - 41.3%)). Apart from that, in this Dutch population we also see a risk of early death in patients with co-morbidities (such as chronic neurological, nephrological and cardiac disorders and hypertension), and in patients with more home medication and / or with increased urea and creatinine levels.

Conclusion: Early death due to a COVID-19 infection in the Netherlands appears to be associated with demographic variables (e.g. age), comorbidity (e.g. cardiovascular disease) but also disease char-acteristics at admission.

MeSH terms

  • Age Factors
  • Aged
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • COVID-19* / therapy
  • Cardiovascular Diseases / epidemiology*
  • Comorbidity
  • Critical Care / methods
  • Critical Care / statistics & numerical data
  • Diagnostic Tests, Routine* / methods
  • Diagnostic Tests, Routine* / statistics & numerical data
  • Female
  • Hospital Mortality
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Netherlands / epidemiology
  • Risk Factors
  • SARS-CoV-2 / isolation & purification*
  • Severity of Illness Index