COVID-19 Clinical Trial
Official title:
Prognostic Factors in Patients Admitted to an Urban Teaching Hospital With COVID-19 Infection
As of 27th May 2020, approximately 5.7 million people worldwide are known to have been
infected with COVID-19 coronavirus and more than 350,000 have died (1). The severity of this
viral disease for an individual is associated with a widespread perturbation of immune,
physiological and metabolic parameters (2, 3). These whole body changes could be considered
characteristic of a systemic inflammatory response to tissue injury and it has been long
recognised that a large and ongoing systemic inflammatory response is associated with the
development of multiple organ failure and infective disease (4, 5).
One of the cardinal signs of severe COVID-19 infection is a marked systemic inflammatory
response (2). This response bears striking similarity to the systemic inflammatory response
experienced by patients undergoing major elective surgical resections for cancer (6, 7).
Indeed, the systemic inflammatory response and the associated metabolic stress has been most
well characterised in major elective surgery, where the relationship between the magnitude of
the post-operative systemic inflammatory response and the development of post-operative
complications is now well recognised, as is the effect of patient comorbidity on this
relationship (8, 9). Such work has informed therapeutic manoeuvres including minimally
invasive surgery, pre-operative optimisation (e.g. anaesthesia, nutrition and steroids) and
enhanced recovery protocols.
The aim of the present study was to examine whether routinely collected clinicopathological
characteristics of patients with COVID-19 on admission were informative on the immune and
metabolic stress experienced by patients with COVID-19 and whether such characteristics were
informative on subsequent outcome.
Electronic patient records for patients who attended the Emergency Department (ED) and Acute Assessment Unit (AAU) at Glasgow Royal Infirmary (GRI), Glasgow, U.K., during the initial 7-week period of the COVID-19 pandemic in Glasgow city (17th March 2020 - 1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. GRI is a university teaching hospital that serves an urban population with a high burden of socio-economic deprivation and offers the full spectrum of adult acute receiving specialties to patients over 16 years old. In line with NHS policy, this study was approved by the NHS Greater Glasgow and Clyde Caldicott guardian. ;
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