Understanding an evolving pandemic: An analysis of the clinical time delay distributions of COVID-19 in the United Kingdom.

Understanding and monitoring the epidemiological time delay dynamics of SARS-CoV-2 infection provides insights that are key to discerning changes in the phenotype of the virus, the demographics impacted, the efficacy of treatment, and the ability of the health service to manage large volumes of pati...

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Autores principales:	Thomas Ward, Alexander Johnsen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2329796b3dce49c7b6edff8f1d94b68b
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spelling	oai:doaj.org-article:2329796b3dce49c7b6edff8f1d94b68b2021-12-02T20:07:50ZUnderstanding an evolving pandemic: An analysis of the clinical time delay distributions of COVID-19 in the United Kingdom.1932-620310.1371/journal.pone.0257978https://doaj.org/article/2329796b3dce49c7b6edff8f1d94b68b2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257978https://doaj.org/toc/1932-6203Understanding and monitoring the epidemiological time delay dynamics of SARS-CoV-2 infection provides insights that are key to discerning changes in the phenotype of the virus, the demographics impacted, the efficacy of treatment, and the ability of the health service to manage large volumes of patients. This paper analyses how the pandemic has evolved in the United Kingdom through the temporal changes to the epidemiological time delay distributions for clinical outcomes. Using the most complete clinical data presently available, we have analysed, through a doubly interval censored Bayesian modelling approach, the time from infection to a clinical outcome. Across the pandemic, for the periods that were defined as epidemiologically distinct, the modelled mean ranges from 8.0 to 9.7 days for infection to hospitalisation, 10.3 to 15.0 days for hospitalisation to death, and 17.4 to 24.7 days for infection to death. The time delay from infection to hospitalisation has increased since the first wave of the pandemic. A marked decrease was observed in the time from hospitalisation to death and infection to death at times of high incidence when hospitals and ICUs were under the most pressure. There is a clear relationship between age groups that is indicative of the youngest and oldest demographics having the shortest time delay distributions before a clinical outcome. A statistically significant difference was found between genders for the time delay from infection to hospitalisation, which was not found for hospitalisation to death. The results by age group indicate that younger demographics that require clinical intervention for SARS-CoV-2 infection are more likely to require earlier hospitalisation that leads to a shorter time to death, which is suggestive of the largely more vulnerable nature of these individuals that succumb to infection. The distinction found between genders for exposure to hospitalisation is revealing of gender healthcare seeking behaviours.Thomas WardAlexander JohnsenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0257978 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thomas Ward Alexander Johnsen Understanding an evolving pandemic: An analysis of the clinical time delay distributions of COVID-19 in the United Kingdom.
description	Understanding and monitoring the epidemiological time delay dynamics of SARS-CoV-2 infection provides insights that are key to discerning changes in the phenotype of the virus, the demographics impacted, the efficacy of treatment, and the ability of the health service to manage large volumes of patients. This paper analyses how the pandemic has evolved in the United Kingdom through the temporal changes to the epidemiological time delay distributions for clinical outcomes. Using the most complete clinical data presently available, we have analysed, through a doubly interval censored Bayesian modelling approach, the time from infection to a clinical outcome. Across the pandemic, for the periods that were defined as epidemiologically distinct, the modelled mean ranges from 8.0 to 9.7 days for infection to hospitalisation, 10.3 to 15.0 days for hospitalisation to death, and 17.4 to 24.7 days for infection to death. The time delay from infection to hospitalisation has increased since the first wave of the pandemic. A marked decrease was observed in the time from hospitalisation to death and infection to death at times of high incidence when hospitals and ICUs were under the most pressure. There is a clear relationship between age groups that is indicative of the youngest and oldest demographics having the shortest time delay distributions before a clinical outcome. A statistically significant difference was found between genders for the time delay from infection to hospitalisation, which was not found for hospitalisation to death. The results by age group indicate that younger demographics that require clinical intervention for SARS-CoV-2 infection are more likely to require earlier hospitalisation that leads to a shorter time to death, which is suggestive of the largely more vulnerable nature of these individuals that succumb to infection. The distinction found between genders for exposure to hospitalisation is revealing of gender healthcare seeking behaviours.
format	article
author	Thomas Ward Alexander Johnsen
author_facet	Thomas Ward Alexander Johnsen
author_sort	Thomas Ward
title	Understanding an evolving pandemic: An analysis of the clinical time delay distributions of COVID-19 in the United Kingdom.
title_short	Understanding an evolving pandemic: An analysis of the clinical time delay distributions of COVID-19 in the United Kingdom.
title_full	Understanding an evolving pandemic: An analysis of the clinical time delay distributions of COVID-19 in the United Kingdom.
title_fullStr	Understanding an evolving pandemic: An analysis of the clinical time delay distributions of COVID-19 in the United Kingdom.
title_full_unstemmed	Understanding an evolving pandemic: An analysis of the clinical time delay distributions of COVID-19 in the United Kingdom.
title_sort	understanding an evolving pandemic: an analysis of the clinical time delay distributions of covid-19 in the united kingdom.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/2329796b3dce49c7b6edff8f1d94b68b
work_keys_str_mv	AT thomasward understandinganevolvingpandemicananalysisoftheclinicaltimedelaydistributionsofcovid19intheunitedkingdom AT alexanderjohnsen understandinganevolvingpandemicananalysisoftheclinicaltimedelaydistributionsofcovid19intheunitedkingdom
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Understanding an evolving pandemic: An analysis of the clinical time delay distributions of COVID-19 in the United Kingdom.

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