BACKGROUND AND PURPOSE:

• Richardson et al. (JAMA, 2020) describe the clinical characteristics and outcomes for hospitalized COVID-19 patients in the New York City area

METHODS:

• Case series (March 1, 2020 through April 4, 2020)
• Setting
  • 12 hospitals in New York City and surrounding area
• Participants
  • All hospitalized patients with COVID-19
  • Lab confirmed SARS-CoV-2 infection (RT-PCR testing using nasopharyngeal swabs)
• Primary outcomes
  • Clinical outcomes: Mechanical ventilation | Kidney replacement therapy | Death
  • Additional data collection: Demographics | Baseline comorbidities | Presenting vital signs | Test results

RESULTS:

• 5,700 patients
  • Median age: 63 years (IQR 52 to 75 years; range 0 to 107 years) | 39.7% female
• Most common comorbidities
  • Hypertension: 56.6% (3026 patients)
  • Obesity: 41.7% (1737 patients)
  • Diabetes: 33.8% (1808 patients)
• Symptoms and status at triage
  • Fever: 30.7%
  • Respiratory rate > 24 breaths/min: 17.3%
  • Supplemental oxygen: 27.8%
• 2.1% of patients had a co-infection with another respiratory virus
• Outcomes based on 2634 patients who were discharged or dead at time of study endpoint
  • ICU: 14.2%
    • Median age: 68 years (IQR 56 to 78 years) | 33.5% female
  • Invasive mechanical ventilation: 12.2%
  • Treated with kidney replacement therapy: 3.2%
  • Died: 21%
• Outcomes for those that required mechanical ventilation (1,151 patients, 20.2%, at time of study endpoint)
  • Discharged: 3.3% (38 patients)
  • Died: 24.5% (282 patients)
  • Still in hospital: 72.2% (831 patients)
• 2.2% of patients were readmitted during the study period
  • Median time to readmission: 3 days (IQR 1.0 to 4.5 days)
• A total of 3066 patients were still hospitalized at the study end point
  • Median age: 65 years (IQR 54 to 75 days)
• Mortality
  • <20 years of age: 0% (0/20)
  • Rates were higher in males vs females at every 10-year age interval >20 years
• Median postdischarge follow-up:  4.4 days (IQR, 2.2 to 9.3 days)

CONCLUSION:

• In this case series of patients hospitalized for COVID-19 in the New York City area, baseline characteristics included predominantly older individuals, mostly men, with a high index for comorbidities
• Mortality rates of hospitalized patients were lower in this study than reports from China
  • Outcomes may change with longer follow-up
  • Different countries and regions may have different thresholds for admitting patients to hospital

Learn More – Primary Sources:

Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

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