abm-covid-lux / abmlux

Agent-based epidemic modelling
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VIRUS: Hospitalization #28

Closed StephenWattam closed 4 years ago

James-Thompson-724 commented 4 years ago

Standard care or intensive care? What is the best way to model an agent's expected disease progression?

mikkasprzak commented 4 years ago

This file from Laurent: LUX_Residents_Infections.xlsx has data on the percentage of infected people who were hospitalised. Here are some data from the US:

Among patients who developed severe disease, the medium time to dyspnea from the onset of illness or symptoms ranged from 5 to 8 days, the median time to acute respiratory distress syndrome (ARDS) from the onset of illness or symptoms ranged from 8 to 12 days, and the median time to ICU admission from the onset of illness or symptoms ranged from 10 to 12 days.Clinicians should be aware of the potential for some patients to rapidly deteriorate one week after illness onset. Among all hospitalized patients, a range of 26% to 32% of patients were admitted to the ICU. Among all patients, a range of 3% to 17% developed ARDS compared to a range of 20% to 42% for hospitalized patients and 67% to 85% for patients admitted to the ICU. Mortality among patients admitted to the ICU ranges from 39% to 72% depending on the study and characteristics of patient population.5,8,10,11 The median length of hospitalization among survivors was 10 to 13 days.

Also, the European agency says the following:

_According to data from the ISARIC COVID-19 database, 18%of hospitalised patients (4 752) were admitted to an ICU or high dependency unit (HDU), with a mean duration of stay of 9.7 days and a median of 7 (SD: 9.3 days) (n=3 458) [189]. Of these, 1 567 died, 1 106 are still in hospital,1 591 have recovered and been discharged and outcome records were missing for 488, as of 19 May 2020 [189]. In China, hospitalisation has occurred in 10.6% of reported cases [194]. A systematic review and meta-analysis reported pooled rates of ICU admission, acute respiratory distress syndrome (ARDS) and mortality of 10.9%, 18.4% and 4.3%, respectively, for 4 203 patients [190].

Median length of stay in ICU has been reported to be around 7 days for survivors and eight days for non-survivors though evidence is still limited [35,195-197].On 5 June 2020, the UK’s Intensive Care National Audit and Research Centre reported 8 533 (of 9 623) patients in critical care, of whom 3 615 patients have died and 4 918 have been discharged alive from critical care with a length of stay in ICU of 11 days for survivors and nine days for non-survivors (interquartile range (IQR) 4–24 days for survivors and 5–15 days for non-survivors) [198]. In a systematic review and meta-analysis of 11 studies [199], a significantly lower incidence of severe or critical disease was found in healthcare workers (HCW), compared to the incidence of severe or critical disease among all positive patients. Similarly, mortality was found to be significantly lower among HCWs than among all COVID-19 patients [199]._