The first consecutive 5000 patients with Coronavirus Disease 2019 from Qatar; a nation-wide cohort study
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Abstract
Background
There are limited data on Coronavirus Disease 2019 (COVID-19) outcomes at a national level, and none after 60 days of follow up. The aim of this study was to describe national, 60-day all-cause mortality associated with COVID-19, and to identify risk factors associated with admission to an intensive care unit (ICU).
Methods
This was a retrospective cohort study including the first consecutive 5000 patients with COVID-19 in Qatar who completed 60 days of follow up by June 17, 2020. The primary outcome was all-cause mortality at 60 days after COVID-19 diagnosis. In addition, we explored risk factors for admission to ICU.
Results
Included patients were diagnosed with COVID-19 between February 28 and April 17, 2020. The majority (4436, 88.7%) were males and the median age was 35 years [interquartile range (IQR) 28–43]. By 60 days after COVID-19 diagnosis, 14 patients (0.28%) had died, 10 (0.2%) were still in hospital, and two (0.04%) were still in ICU. Fatal COVID-19 cases had a median age of 59.5 years (IQR 55.8–68), and were mostly males (13, 92.9%). All included pregnant women (26, 0.5%), children (131, 2.6%), and healthcare workers (135, 2.7%) were alive and not hospitalized at the end of follow up.
A total of 1424 patients (28.5%) required hospitalization, out of which 108 (7.6%) were admitted to ICU. Most frequent co-morbidities in hospitalized adults were diabetes (23.2%), and hypertension (20.7%). Multivariable logistic regression showed that older age [adjusted odds ratio (aOR) 1.041, 95% confidence interval (CI) 1.022–1.061 per year increase; P < 0.001], male sex (aOR 4.375, 95% CI 1.964–9.744; P < 0.001), diabetes (aOR 1.698, 95% CI 1.050–2.746; P 0.031), chronic kidney disease (aOR 3.590, 95% CI 1.596–8.079, P 0.002), and higher BMI (aOR 1.067, 95% CI 1.027–1.108 per unit increase; P 0.001), were all independently associated with increased risk of ICU admission.
Conclusions
In a relatively younger national cohort with a low co-morbidity burden, COVID-19 was associated with low all-cause mortality. Independent risk factors for ICU admission included older age, male sex, higher BMI, and co-existing diabetes or chronic kidney disease.
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SciScore for 10.1101/2020.07.15.20154690: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study was approved by HMC’s Institutional Review Board (MRC0120191), with a waiver of informed consent.
Consent: The study was approved by HMC’s Institutional Review Board (MRC0120191), with a waiver of informed consent.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable The final multivariable logistic regression model included age, male sex, body mass index (BMI), defined as body weight in kilograms divided by squared height in meters, and co-existing diabetes mellitus, systemic hypertension, coronary artery disease, chronic liver disease, and chronic kidney disease. Table 2: Resources
… SciScore for 10.1101/2020.07.15.20154690: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study was approved by HMC’s Institutional Review Board (MRC0120191), with a waiver of informed consent.
Consent: The study was approved by HMC’s Institutional Review Board (MRC0120191), with a waiver of informed consent.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable The final multivariable logistic regression model included age, male sex, body mass index (BMI), defined as body weight in kilograms divided by squared height in meters, and co-existing diabetes mellitus, systemic hypertension, coronary artery disease, chronic liver disease, and chronic kidney disease. Table 2: Resources
Software and Algorithms Sentences Resources 1 (StataCorp LLC, College Station, Texas). StataCorpsuggested: (Stata, RRID:SCR_012763)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The limitations of this study include its observational nature and missing data for some variables. To address those limitations, we used multivariate analyses with multiple imputations to assess independent associations with the outcome. Despite this, our study benefits from being, to the best of our knowledge, the first to report 60-day outcomes of SARS-CoV-2, and to do so at a nationwide level.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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SciScore for 10.1101/2020.07.15.20154690: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement The study was approved by HMC’s Institutional Review Board (MRC0120191), with a waiver of informed consent. 3. Randomization However, recent reports from large cohort and randomized clinical trials do not support the use of hydroxychloroquine, alone or in combination with azithromycin, or lopinavir-ritonavir for patients with COVID-19. [22,23] It is likely that COVID-19 management will continue to evolve as more results from ongoing clinical trials become available [24]. Blinding not detected. Power Analysis not detected. Sex as a biological variable Independent risk factors for ICU admission included older age, male sex, higher BMI, and co-existing … SciScore for 10.1101/2020.07.15.20154690: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement The study was approved by HMC’s Institutional Review Board (MRC0120191), with a waiver of informed consent. 3. Randomization However, recent reports from large cohort and randomized clinical trials do not support the use of hydroxychloroquine, alone or in combination with azithromycin, or lopinavir-ritonavir for patients with COVID-19. [22,23] It is likely that COVID-19 management will continue to evolve as more results from ongoing clinical trials become available [24]. Blinding not detected. Power Analysis not detected. Sex as a biological variable Independent risk factors for ICU admission included older age, male sex, higher BMI, and co-existing diabetes or chronic kidney disease. Table 2: Resources
Antibodies Sentences Resources The latter patient presented with fulminant hepatitis and his hepatitis B serology was positive for surface IgM antibodies. surface IgMsuggested: NoneSoftware and Algorithms Sentences Resources (StataCorp LLC, College Station, Texas). StataCorpsuggested: (Stata, SCR_012763)Data from additional tools added to each annotation on a weekly basis.
About SciScore
SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.
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