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ISARIC (International Severe Acute Respiratory and emerging Infections Consortium) partnerships and outbreak preparedness initiatives enabled the rapid launch of standardised clinical data collection on COVID-19 in Jan 2020. Extensive global uptake of this resource has resulted in a large, standardised collection of comprehensive clinical data from hundreds of sites across dozens of countries. Data are analysed regularly and reported publicly to inform patient care and public health response. This report, our 16th report, is a part of a series. Data have been entered for 706,747 individuals from 1669 partner institutions and networks across 64 countries. The comprehensive analyses detailed in this report includes hospitalised individuals of all ages for whom data collection occurred between 30 January 2020 and up to and including 21 September 2021, AND who have laboratory-confirmed SARS-COV-2 infection or clinically diagnosed COVID-19. For the 614,497 cases who meet eligibility criteria for this report, selected findings include: o median age of 58 years, with an approximately equal (50/50) male:female sex distribution o one third of the cohort are at least 70 years of age, whereas 4% are 0-19 years of age o the most common symptom combination in this hospitalised cohort is shortness of breath, cough, and history of fever, which has remained constant over time o the five most common symptoms at admission were shortness of breath, cough, history of fever, fatigue/malaise, and altered consciousness/confusion, which is unchanged from the previous reports o age-associated differences in symptoms are evident, including the frequency of altered consciousness increasing with age, and fever, respiratory and constitutional symptoms being present mostly in those 40 years and above o 15% of patients with relevant data available were admitted at some point during their illness into an intensive care unit (ICU), which is slightly lower than previously reported (19%) o antibiotic use remains very high (56%), although it is lower than previously reported (80%), in those for whom relevant data are available (379,319); in ICU/HDU patients with data available (42,841), 91% received antibiotics o use of corticosteroids was reported for 24% of patients of all types for whom data were available (593,701); in ICU/HDU patients with data available (42,791), 67% received corticosteroids o outcomes are known for 556,928 patients and the overall estimated case fatality ratio (CFR) is 25.3% (95%CI 25.2-25.4), rising to 38.7% (95%CI 38.3-39) for patients who were admitted to ICU/HDU, demonstrating worse outcomes in those with the most severe disease We thank all the data contributors for their ongoing support. This report is the next in a series retrievable at To access previous versions of ISARIC COVID-19 Clinical Data Report please use the link below: ERRATUM for Due to a fault in processing of the data for the ISARIC Clinical Data Report issued 14 July 2021, the following results in that version of the report had errors: - Time periods: Length of hospital stay and symptom onset to admission - Patients who received oxygen therapy ever, including: the number of patients who were administered corticosteroids while on oxygen therapy but not IMV; the number of patients who were administered corticosteroids and did not receive oxygen therapy, proportion of patients who received oxygen therapy, and proportion of patients who received oxygen while in ICU These figures have been corrected in this version of the report. NB: the methods for assessing the proportion of patients that meet the 4 most common COVID-19 case definitions have been updated in this version of the report. Only patients with no missing data for the symptoms included in the corresponding definition are included in this analysis.

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Working paper

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ISARIC Clinical Characterisation Group