COVID-19 first anniversary review of cases, hospitalization, and mortality in the UK

ABSTRACT

Introduction: The first confirmed COVID-19 case in UK dates to 11 January 2020, exhibiting its first peak during April 2020. The country has since been hit by another wave in the winter 2020, almost at the first anniversary of the pandemic.

Areas covered: An in-depth analysis of the COVID-19 positive cases in the UK throughout the year, hospitalizations, patients in critical care, and COVID-19 associated deaths.

Expert opinion: The COVID-19 associated hospital admission accounts to 15% of total COVID-19 positive cases in November 2020. The percentage of total COVID-19 positive patients in the country died from the disease was under 4% in November 2020. Total deaths in England (all-cause) from June to October 2020 were similar to the historic averages. Age was the single most determinator of COVID-19 associated mortality, 50 years or older accounted for 98% of total COVID deaths. Age distribution of COVID-19 associated deaths in 2020 was similar to all-cause mortality age distribution in 2019. There was no significant improvement in the survival rate of COVID-19 patients receiving critical care. This prompts an urgent need to invest in novel antiviral therapeutics to save the most vulnerable in the society.

KEYWORDS:

• Case fatality ratio
• herd immunity
• lockdown
• cure
• mortality
• SARS-CoV-2
• seroprevalence
• COVID vaccine

Article highlights

• Sixty-five percent of COVID-19 patients were hospitalized during the first wave, this has dropped to only 15% in November 2020

• 17% of people with confirmed COVID-19 died in April 2020, this has dropped to only 4% in November 2020

• 33% of total hospitalized patients with COVID-19 died in April 2020 (one in three patients died); this is now 27% in November 2020 indicating that one in four patients are still dying with COVID-19 while receiving hospital care

• 45% of COVID-19 patients on critical care in hospitals died during the first wave, whereas 33% of those admitted to critical care from September to November 2020 died from the disease; nevertheless, most of the surviving patients (60%) at that time were still in the hospital receiving critical or acute care.

• Total deaths in England (all-cause) from June to October 2020 were similar to historic averages.

• Age distribution of the COVID-19 associated deaths in 2020 was similar to the age distribution of the all-cause mortality in 2019 suggesting the coronavirus has hit the vulnerable the hardest.

• Age was the single most determinator of COVID-19 associated mortality, people with 50 years or older age accounted for 98% of total COVID deaths recorded in the country whereas 84% of COVID associated deaths were noted in 70 y or older.

• There was no significant improvement in survival rate of COVID-19 patients receiving critical care in hospitals during 2020. It is worth investing resources and strategies for a potential cure that may reduce the risk of death in severely ill hospitalized COVID-19 patients, for instance, novel broad-spectrum antivirals with efficacy against SARS-CoV-2 or monoclonal antibodies capable of clinically neutralizing the virus in an attempt to improve the disease survival rates in a vulnerable population.

Availability of data and material

The intensive care data were derived from the ICNARC Case Mix Programme Database. The Case Mix Programme is the national clinical audit of patient outcomes from adult critical care coordinated by the Intensive Care National Audit Research Centre (ICNARC). For more information on the representativeness and quality of these data, please contact ICNARC. The data related to the ICU bed occupancy, positive cases, 28-day mortality was retrieved from https://coronavirus.data.gov.uk/. The mortality data are extracted from the Office for National Statistics (ONS) and is available at https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contribution

HAM and SSH conceived the content, retrieved the data, and wrote the manuscript. HAM, SSH, and CSK reviewed the data, revised the manuscript, and approved the final version.

Additional information

Funding

This paper was not funded.