Trends in COVID-19 hospital outcomes in England before and after vaccine introduction, a cohort study

Peter D. Kirwan (), Andre Charlett, Paul Birrell, Suzanne Elgohari, Russell Hope, Sema Mandal, Daniela Angelis and Anne M. Presanis
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Peter D. Kirwan: University of Cambridge
Andre Charlett: UK Health Security Agency
Paul Birrell: University of Cambridge
Suzanne Elgohari: UK Health Security Agency
Russell Hope: UK Health Security Agency
Sema Mandal: UK Health Security Agency
Daniela Angelis: University of Cambridge
Anne M. Presanis: University of Cambridge

Nature Communications, 2022, vol. 13, issue 1, 1-11

Abstract: Abstract Widespread vaccination campaigns have changed the landscape for COVID-19, vastly altering symptoms and reducing morbidity and mortality. We estimate trends in mortality by month of admission and vaccination status among those hospitalised with COVID-19 in England between March 2020 to September 2021, controlling for demographic factors and hospital load. Among 259,727 hospitalised COVID-19 cases, 51,948 (20.0%) experienced mortality in hospital. Hospitalised fatality risk ranged from 40.3% (95% confidence interval 39.4–41.3%) in March 2020 to 8.1% (7.2–9.0%) in June 2021. Older individuals and those with multiple co-morbidities were more likely to die or else experienced longer stays prior to discharge. Compared to unvaccinated people, the hazard of hospitalised mortality was 0.71 (0.67–0.77) with a first vaccine dose, and 0.56 (0.52–0.61) with a second vaccine dose. Compared to hospital load at 0–20% of the busiest week, the hazard of hospitalised mortality during periods of peak load (90–100%), was 1.23 (1.12–1.34). The prognosis for people hospitalised with COVID-19 in England has varied substantially throughout the pandemic and according to case-mix, vaccination, and hospital load. Our estimates provide an indication for demands on hospital resources, and the relationship between hospital burden and outcomes.

Date: 2022
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DOI: 10.1038/s41467-022-32458-y

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