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. 2020 Oct 6;11(1):5009.
doi: 10.1038/s41467-020-18849-z.

Deep phenotyping of 34,128 adult patients hospitalised with COVID-19 in an international network study

Edward Burn #  1   2 Seng Chan You #  3 Anthony G Sena  4   5 Kristin Kostka  6 Hamed Abedtash  7 Maria Tereza F Abrahão  8 Amanda Alberga  9 Heba Alghoul  10 Osaid Alser  11 Thamir M Alshammari  12 Maria Aragon  1 Carlos Areia  13 Juan M Banda  14 Jaehyeong Cho  3 Aedin C Culhane  15 Alexander Davydov  16   17 Frank J DeFalco  4 Talita Duarte-Salles  1 Scott DuVall  18   19 Thomas Falconer  20 Sergio Fernandez-Bertolin  1 Weihua Gao  21 Asieh Golozar  22   23 Jill Hardin  4 George Hripcsak  20   24 Vojtech Huser  25 Hokyun Jeon  26 Yonghua Jing  21 Chi Young Jung  27 Benjamin Skov Kaas-Hansen  28   29 Denys Kaduk  16   30 Seamus Kent  31 Yeesuk Kim  32 Spyros Kolovos  33 Jennifer C E Lane  33 Hyejin Lee  34 Kristine E Lynch  18   19 Rupa Makadia  4 Michael E Matheny  35   36 Paras P Mehta  37 Daniel R Morales  38 Karthik Natarajan  20   24 Fredrik Nyberg  39 Anna Ostropolets  20 Rae Woong Park  3   26 Jimyung Park  26 Jose D Posada  40 Albert Prats-Uribe  2 Gowtham Rao  4 Christian Reich  6 Yeunsook Rho  33 Peter Rijnbeek  5 Lisa M Schilling  41 Martijn Schuemie  4   42 Nigam H Shah  40 Azza Shoaibi  4 Seokyoung Song  43 Matthew Spotnitz  20 Marc A Suchard  42 Joel N Swerdel  4 David Vizcaya  44 Salvatore Volpe  20 Haini Wen  45 Andrew E Williams  46 Belay B Yimer  47 Lin Zhang  48   49 Oleg Zhuk  16 Daniel Prieto-Alhambra  50 Patrick Ryan  4   51
Affiliations

Deep phenotyping of 34,128 adult patients hospitalised with COVID-19 in an international network study

Edward Burn et al. Nat Commun. .

Abstract

Comorbid conditions appear to be common among individuals hospitalised with coronavirus disease 2019 (COVID-19) but estimates of prevalence vary and little is known about the prior medication use of patients. Here, we describe the characteristics of adults hospitalised with COVID-19 and compare them with influenza patients. We include 34,128 (US: 8362, South Korea: 7341, Spain: 18,425) COVID-19 patients, summarising between 4811 and 11,643 unique aggregate characteristics. COVID-19 patients have been majority male in the US and Spain, but predominantly female in South Korea. Age profiles vary across data sources. Compared to 84,585 individuals hospitalised with influenza in 2014-19, COVID-19 patients have more typically been male, younger, and with fewer comorbidities and lower medication use. While protecting groups vulnerable to influenza is likely a useful starting point in the response to COVID-19, strategies will likely need to be broadened to reflect the particular characteristics of individuals being hospitalised with COVID-19.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form, with the following declarations made: D.P.A. reports grants and other from AMGEN, grants, non-financial support and other from UCB Biopharma, grants from Les Laboratoires Servier, outside the submitted work; and Janssen, on behalf of IMI-funded EHDEN and EMIF consortiums, and Synapse Management Partners have supported training programmes organised by DPA’s department and open for external participants. D.V. reports personal fees from Bayer, outside the submitted work, and he is a full-time employee at a pharmaceutical company. DM reports funding support from the Wellcome Trust, NIHR, Scottish CSO and Tenovus Scotland for research unrelated to this work. S.C.Y. reports grants from Korean Ministry of Health & Welfare, grants from Korean Ministry of Trade, Industry & Energy, during the conduct of the study. A.G. reports personal fees from Regeneron Pharmaceuticals, outside the submitted work, and she a full-time employee at Regeneron Pharmaceuticals. This work was not conducted at Regeneron Pharmaceuticals. Y.J. reports employee of AbbVie and owns company stock. A.A. reports that he is currently employed at Alberta Health Services (AHS) as a Data Science Lead redeployed as an epidemiologist to aid in the COVID-19 response. This work was not conducted at AHS, within AHS working hours, or with AHS staff. He contributed and conducted this work as an Independent Epidemiologist, as a member of the Observational Health Data Sciences and Informatics (OHDSI) Network. P.R. reports grants from Innovative Medicines Initiative, grants from Janssen Research and Development, during the conduct of the study. M.S. reports grants from US National Science Foundation, grants from US National Institutes of Health, grants from IQVIA, personal fees from Janssen Research and Development, during the conduct of the study. G.H. reports grants from US NIH National Library of Medicine, during the conduct of the study; grants from Janssen Research, outside the submitted work. A.P.U. reports grants from Fundacion Alfonso Martin Escudero, grants from Medical Research Council, outside the submitted work. H.A. reports personal fees from Eli Lilly and Company, outside the submitted work. A.S. reports personal fees from Janssen Research & Development, during the conduct of the study; personal fees from Janssen Research & Development, outside the submitted work. A.S. is a full-time employee of Janssen and shareholder of Johnson & Johnson. G.R. is a full-time employee of Janssen and shareholder of Johnson & Johnson. F.D. reports personal fees from Janssen Research & Development, during the conduct of the study; personal fees from Janssen Research & Development, outside the submitted work. R.W.P. reports grants from Korean Ministry of Health & Welfare, grants from Korean Ministry of Trade, Industry & Energy, during the conduct of the study. J.P. reports grants from Korean Ministry of Health & Welfare, grants from Korean Ministry of Trade, Industry & Energy, during the conduct of the study. J.C. reports grants from Korean Ministry of Health & Welfare, grants from Korean Ministry of Trade, Industry & Energy, during the conduct of the study. S.D. reports grants from Anolinx, LLC, grants from Astellas Pharma, Inc, grants from AstraZeneca Pharmaceuticals LP, grants from Boehringer Ingelheim International GmbH, grants from Celgene Corporation, grants from Eli Lilly and Company, grants from Genentech Inc., grants from Genomic Health, Inc., grants from Gilead Sciences Inc., grants from GlaxoSmithKline PLC, grants from Innocrin Pharmaceuticals Inc., grants from Janssen Pharmaceuticals, Inc., grants from Kantar Health, grants from Myriad Genetic Laboratories, Inc., grants from Novartis International AG, grants from Parexel International Corporation through the University of Utah or Western Institute for Biomedical Research outside the submitted work. H.J. reports grants from Korean Ministry of Health & Welfare, grants from Korean Ministry of Trade, Industry & Energy, during the conduct of the study. B.S.K.H. reports grants from Innovation Fund Denmark (5153-00002B) and the Novo Nordisk Foundation (NNF14CC0001), outside the submitted work. K.K. reports she is an employee of IQVIA. CR reports he is an employee of IQVIA. J.S. reports other from Janssen R&D, during the conduct of the study; other from Janssen R&D, outside the submitted work; and J.S. was a full-time employee of Johnson & Johnson, or a subsidiary, at the time the study was conducted. J.S. owns stock, stock options, and pension rights from the company. R.M. reports and is an employee of Janssen Research and Development. W.G. is an AbbVie employee. P.R. reports and is an employee of Janssen Research and Development and shareholder of Johnson & Johnson. M.S. is a full-time employee of Janssen R&D, and a shareholder of Johnson & Johnson. J.H. reports other from Janssen Research & Development, during the conduct of the study; other from Janssen Research & Development, outside the submitted work; and full-time employee of Janssen and shareholder of Johnson & Johnson. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Age of patients hospitalised with COVID-19 and of patients hospitalised with influenza.
Individuals hospitalised with COVID-19 between December 2019 and April 2020 compared with those hospitalised with influenza between September 2014 to April 2019 (where available). Proportion of cohorts by 5-year age groups, with groups with counts of <10 omitted. CUIMC: Columbia University Irving Medical Center; HIRA: Health Insurance Review & Assessment; HM: HM Hospitales; PHD: Premier Healthcare Database; SIDIAP: The Information System for Research in Primary Care; UC HDC: University of Colorado Health Data Compass; VA OMOP: Department of Veterans Affairs. Influenza data for SIDIAP was only available from 2014 to 2017.
Fig. 2
Fig. 2. Prevalence of conditions and medication use among COVID-19 patients.
Individuals hospitalised with COVID-19 between December 2019 and April 2020. Conditions from up to a year prior, medication use from day of hospitalisation. Each dot represents one of these covariates with the colour indicating the type of condition/medication. CUIMC: Columbia University Irving Medical Center; HIRA: Health Insurance Review & Assessment; HM: HM Hospitales; PHD: Premier Healthcare Database; SIDIAP: The Information System for Research in Primary Care; UC HDC: University of Colorado Health Data Compass; VA OMOP: Department of Veterans Affairs.
Fig. 3
Fig. 3. Standardised mean difference in conditions (top) and medication use (bottom) among COVID-19 patients compared to 2014–2019 influenza patients.
Individuals hospitalised with COVID-19 between December 2019 and April 2020 compared with those hospitalised with influenza between September 2014 and April 2019. Conditions from up to a year prior, medication use from day of hospitalisation. Each dot represents one of these covariates with the colour indicating the type of condition/medication and the size of the dot reflecting the prevalence of the variable in the COVID-19 study populations. CUIMC: Columbia University Irving Medical Center; PHD: Premier Healthcare Database; SIDIAP: The Information System for Research in Primary Care; VA OMOP: Department of Veterans Affairs.
Fig. 4
Fig. 4. Characteristics of COVID-19 patients compared to 2014–2019 Influenza patients.
The plot compares demographics (age and sex), conditions (recorded over the year prior and up to the day of hospitalisation), and medications (1) from a year prior up to the day of hospitalisation, (2) from 30 days prior up to the day of hospitalisation and (3) on day of hospitalisation). Each dot represents one of these covariates with the colour indicating the absolute value of the standardised mean difference (SMD), with a SMD above 0.1 taken to indicate a difference in the prevalence of a particular covariate. The proportion male, with heart disease, with chronic obstructive pulmonary disease (COPD), and taking immunosuppressants (over the 30 days prior up to hospitalisation) are shown for illustration. CUIMC: Columbia University Irving Medical Center; PHD: Premier Healthcare Database; SIDIAP: The Information System for Research in Primary Care; UC HDC: University of Colorado Health Data Compass; VA OMOP: Department of Veterans Affairs.

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