• Amol A Verma, Tejasvi Hora, Hae Young Jung, Michael Fralick, Sarah L Malecki, Lauren Lapointe-Shaw, Adina Weinerman, Terence Tang, Janice L Kwan, Jessica J Liu, Shail Rawal, ChanTimothy C YTCYLi Ka Shing Knowledge Institute (Verma, Hora, Jung, Chan, Mamdani, Razak), St. Michael's Hospital, Unity Health Toronto; Department of Medicine (Verma, Fralick, Malecki, Lapointe-Shaw, Weinerman, Tang, Kwan, Liu, Rawal, Cheung, Herridge,, Angela M Cheung, Laura C Rosella, Marzyeh Ghassemi, Margaret Herridge, Muhammad Mamdani, and Fahad Razak.
• Li Ka Shing Knowledge Institute (Verma, Hora, Jung, Chan, Mamdani, Razak), St. Michael's Hospital, Unity Health Toronto; Department of Medicine (Verma, Fralick, Malecki, Lapointe-Shaw, Weinerman, Tang, Kwan, Liu, Rawal, Cheung, Herridge, Mamdani, Razak), and Institute of Health Policy, Management and Evaluation (Verma, Cheung, Mamdani, Razak), University of Toronto, Toronto, Ont.; Department of Geography and Environmental Management (Hora), University of Waterloo, Waterloo, Ont.; Department of Medicine (Fralick, Kwan), Sinai Health System; Department of Medicine (Lapointe-Shaw, Liu, Rawal, Cheung, Herridge) and Toronto General Hospital Research Institute (Lapointe-Shaw), University Health Network; Women's Institute for Health System Solutions and Virtual Care (Lapointe-Shaw), Women's College Hospital; ICES Central (Lapointe-Shaw, Rosella); Department of Medicine (Weinerman), Sunnybrook Health Sciences Centre; Institute for Better Health (Tang, Rosella), Trillium Health Partners, Mississauga, Ont.; Department of Mechanical and Industrial Engineering (Chan), University of Toronto; Joint Department of Medical Imaging (Cheung), University Health Network; Division of Epidemiology (Cheung, Rosella), Dalla Lana School of Public Health; Vector Institute (Rosella, Ghassemi); Department of Computer Science (Ghassemi) and Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Ont. amol.verma@mail.utoronto.ca.
• CMAJ. 2021 Mar 22; 193 (12): E410E418E410-E418.

BackgroundPatient characteristics, clinical care, resource use and outcomes associated with admission to hospital for coronavirus disease 2019 (COVID-19) in Canada are not well described.MethodsWe described all adults with COVID-19 or influenza discharged from inpatient medical services and medical-surgical intensive care units (ICUs) between Nov. 1, 2019, and June 30, 2020, at 7 hospitals in Toronto and Mississauga, Ontario. We compared patient outcomes using multivariable regression models, controlling for patient sociodemographic factors and comorbidity level. We validated the accuracy of 7 externally developed risk scores to predict mortality among patients with COVID-19.ResultsThere were 1027 hospital admissions with COVID-19 (median age 65 yr, 59.1% male) and 783 with influenza (median age 68 yr, 50.8% male). Patients younger than 50 years accounted for 21.2% of all admissions for COVID-19 and 24.0% of ICU admissions. Compared with influenza, patients with COVID-19 had significantly greater in-hospital mortality (unadjusted 19.9% v. 6.1%, adjusted relative risk [RR] 3.46, 95% confidence interval [CI] 2.56-4.68), ICU use (unadjusted 26.4% v. 18.0%, adjusted RR 1.50, 95% CI 1.25-1.80) and hospital length of stay (unadjusted median 8.7 d v. 4.8 d, adjusted rate ratio 1.45, 95% CI 1.25-1.69). Thirty-day readmission was not significantly different (unadjusted 9.3% v. 9.6%, adjusted RR 0.98, 95% CI 0.70-1.39). Three points-based risk scores for predicting in-hospital mortality showed good discrimination (area under the receiver operating characteristic curve [AUC] ranging from 0.72 to 0.81) and calibration.InterpretationDuring the first wave of the pandemic, admission to hospital for COVID-19 was associated with significantly greater mortality, ICU use and hospital length of stay than influenza. Simple risk scores can predict in-hospital mortality in patients with COVID-19 with good accuracy.© 2021 Joule Inc. or its licensors.

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