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COVID-19 Clinical Outcomes

Characteristics and Outcomes for 5700 COVID-19 Patients Hospitalized in the New York City Area

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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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Related ObG Topics:

CDC Weekly Update: Which Comorbidities are Associated with COVID-19 in the US?
What are the Strongest Predictors of COVID-19 Hospitalization and Critical Illness?
COVID-19 Patients and ICU Outcomes in Italy: Respiratory Findings and Mortality

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