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Retrospective cohort study of clinical characteristics of 2199 hospitalised patients with COVID-19 in New York City.

Authors :
Paranjpe I
Russak AJ
De Freitas JK
Lala A
Miotto R
Vaid A
Johnson KW
Danieletto M
Golden E
Meyer D
Singh M
Somani S
Kapoor A
O'Hagan R
Manna S
Nangia U
Jaladanki SK
O'Reilly P
Huckins LM
Glowe P
Kia A
Timsina P
Freeman RM
Levin MA
Jhang J
Firpo A
Kovatch P
Finkelstein J
Aberg JA
Bagiella E
Horowitz CR
Murphy B
Fayad ZA
Narula J
Nestler EJ
Fuster V
Cordon-Cardo C
Charney D
Reich DL
Just A
Bottinger EP
Charney AW
Glicksberg BS
Nadkarni GN
Source :
BMJ open [BMJ Open] 2020 Nov 27; Vol. 10 (11), pp. e040736. Date of Electronic Publication: 2020 Nov 27.
Publication Year :
2020

Abstract

Objective: The COVID-19 pandemic is a global public health crisis, with over 33 million cases and 999 000 deaths worldwide. Data are needed regarding the clinical course of hospitalised patients, particularly in the USA. We aimed to compare clinical characteristic of patients with COVID-19 who had in-hospital mortality with those who were discharged alive.<br />Design: Demographic, clinical and outcomes data for patients admitted to five Mount Sinai Health System hospitals with confirmed COVID-19 between 27 February and 2 April 2020 were identified through institutional electronic health records. We performed a retrospective comparative analysis of patients who had in-hospital mortality or were discharged alive.<br />Setting: All patients were admitted to the Mount Sinai Health System, a large quaternary care urban hospital system.<br />Participants: Participants over the age of 18 years were included.<br />Primary Outcomes: We investigated in-hospital mortality during the study period.<br />Results: A total of 2199 patients with COVID-19 were hospitalised during the study period. As of 2 April, 1121 (51%) patients remained hospitalised, and 1078 (49%) completed their hospital course. Of the latter, the overall mortality was 29%, and 36% required intensive care. The median age was 65 years overall and 75 years in those who died. Pre-existing conditions were present in 65% of those who died and 46% of those discharged. In those who died, the admission median lymphocyte percentage was 11.7%, D-dimer was 2.4 μg/mL, C reactive protein was 162 mg/L and procalcitonin was 0.44 ng/mL. In those discharged, the admission median lymphocyte percentage was 16.6%, D-dimer was 0.93 μg/mL, C reactive protein was 79 mg/L and procalcitonin was 0.09 ng/mL.<br />Conclusions: In our cohort of hospitalised patients, requirement of intensive care and mortality were high. Patients who died typically had more pre-existing conditions and greater perturbations in inflammatory markers as compared with those who were discharged.<br />Competing Interests: Competing interests: GNN reports grants, personal fees and non-financial support from Renalytix AI, non-financial support from Pensieve Health, personal fees from AstraZeneca, BioVie, GLG Consulting, from outside the submitted work. AL reports personal fees from Zoll, outside the submitted work. ZAF reports grants from Daiichi Sankyo, grants from Amgen, Bristol Myers Squibb and Siemens Healthineers, personal fees from Alexion, GlaxoSmithKline, Trained Therapeutix Discovery, outside the submitted work. In addition, ZAF has patents licensed to Trained Therapeutix Discovery. The other authors have nothing to disclose.<br /> (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Details

Language :
English
ISSN :
2044-6055
Volume :
10
Issue :
11
Database :
MEDLINE
Journal :
BMJ open
Publication Type :
Academic Journal
Accession number :
33247020
Full Text :
https://doi.org/10.1136/bmjopen-2020-040736