Asklepios: Study on 4,700 COVID patients published
• Complete data from 45 Asklepios clinics between Sylt and Lake Constance evaluated for 2020
• Age and certain laboratory values are risk factors for severe and fatal disease progression
• Mortality rates fluctuated strongly seasonally: from 22.4 percent in April to three percent in June
• Study provides risk score for treatment of future COVID patients
Physicians at Asklepios Kliniken, one of the leading private operators of hospitals and healthcare facilities in Germany, have published the results of a comprehensive study („Corona Germany“) in which the disease courses of more than 4,700 COVID patients from 45 Asklepios Clinics in Germany were evaluated over the entire year 2020. The results of the study were published in mid-June in a prestigious US journal ("Clinical outcome, risk assessment, and seasonal variation in hospitalized COVID-19 patients-Results from the CORONA Germany study"). The analysis shows that of the 4,704 COVID patients included in the study, twelve percent (507) were so severely ill that they required mechanical ventilation. A total of 19 percent (890) of the COVID patients died, with ventilated patients having a particularly high risk. By comparison, in another German study of more than 10,000 COVID patients, 22 percent died. The Asklepios study identified old age as the greatest risk factor for a severe or fatal course of the disease - anologous to other studies, which primarily identify age 70 and older and previous illnesses as risk factors. However, there are striking differences in mortality in the Asklepios study: while it was very high at the peak of the pandemic, such as in the spring or at the end of the year, comparatively fewer patients died in the summer.
The teamwork of the "Corona Germany" study was led by Prof. Dr. Christoph U. Herborn (Chief Medical Officer of Asklepios Kliniken), the extensive research, also in collaboration with a large team, was conceived and coordinated by Dr. Nele Geßler (Asklepios proresearch), whereby the initiative for this came from the scientists themselves.
"Our clinics and our medical specialists have made a valuable contribution to the fight against the Corona pandemic and have even cared for a disproportionate number of inpatients in the Hamburg metropolitan region, some of whom were seriously ill. For this, our physicians and nursing staff in particular deserve a great deal of thanks," says Prof. Dr. Christoph U. Herborn, Chief Medical Officer (CMO) of the Asklepios Kliniken Group. "With the study now published, our renowned internists, intensive care specialists, lung specialists and cardiologists between Hamburg and Munich are once again documenting the high level of medical care from which our patients benefit on a daily basis. By evaluating and analyzing the - naturally anonymized - patient data, they are at the same time making a relevant contribution to science," says Professor Herborn. "It should also be emphasized that the extensive study was financed entirely from Asklepios Kliniken's own funds," adds Dr. Nele Geßler, who as head of the Asklepios proresearch research facility is responsible for the conception and publication of the study, supported by Dr. Melanie Gunawardene, a study team in Hamburg and Gauting, as well as a 21-member steering committee with chief physicians from Asklepios clinics nationwide. Six medical students at the Asklepios Campus Hamburg of Semmelweis University (ACH) were also involved in the study as part of their theses.
From the perspective of the study authors from Asklepios, one of the surprising findings was that both the mortality and the severity of illness of the patients treated in the 45 Asklepios clinics fluctuated considerably between February 2020 (start of the study) and the end of 2020 (end of the study). For example, mortality was 22.4 percent in April, only three percent in June, and then increased to as high as 23.1 percent by the end of the year. Rates for pneumonia, respiratory failure and need for mechanical ventilation showed similar trends. The analysis of more than 4,700 disease histories also found that more than one-third of all hospitalized COVID-19 patients had a fatal or severe illness that required mechanical ventilation and or admission to the intensive care unit. One-third of all critically ill COVID patients also received palliative care.
In addition to the data, which provide a very good retrospective view of the medical consequences of the pandemic, the study authors also gained many insights that are very valuable for the treatment of future COVID patients: For the study, important key figures such as age, respiratory rate, lactate dehydrogenase, C-reactive protein and creatinine were collected and analyzed in the clinics. "Based on these data, the risk of a serious or, in the worst case, fatal disease can be calculated in the future using a simple risk score," explains Dr. Geßler. "This risk score will help general practitioners or clinicians in emergency rooms to quickly and easily identify patients at risk," the authors of the study conclude.
Asklepios Pro Research
Clinical outcome, risk assessment, and seasonal variation in hospitalized COVID-19 patients-Results from the CORONA Germany study