Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area.
Adolescent
Adult
Aged
Aged, 80 and over
Betacoronavirus
COVID-19
Child
Child, Preschool
Comorbidity
Coronavirus Infections
/ complications
Diabetes Complications
Female
Hospitalization
Humans
Hypertension
/ complications
Infant
Infant, Newborn
Male
Middle Aged
New York City
/ epidemiology
Pandemics
Pneumonia, Viral
/ complications
Risk Factors
SARS-CoV-2
Treatment Outcome
Young Adult
Journal
JAMA
ISSN: 1538-3598
Titre abrégé: JAMA
Pays: United States
ID NLM: 7501160
Informations de publication
Date de publication:
26 05 2020
26 05 2020
Historique:
pubmed:
23
4
2020
medline:
26
9
2020
entrez:
23
4
2020
Statut:
ppublish
Résumé
There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19). To describe the clinical characteristics and outcomes of patients with COVID-19 hospitalized in a US health care system. Case series of patients with COVID-19 admitted to 12 hospitals in New York City, Long Island, and Westchester County, New York, within the Northwell Health system. The study included all sequentially hospitalized patients between March 1, 2020, and April 4, 2020, inclusive of these dates. Confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample among patients requiring admission. Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy, and death. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected. A total of 5700 patients were included (median age, 63 years [interquartile range {IQR}, 52-75; range, 0-107 years]; 39.7% female). The most common comorbidities were hypertension (3026; 56.6%), obesity (1737; 41.7%), and diabetes (1808; 33.8%). At triage, 30.7% of patients were febrile, 17.3% had a respiratory rate greater than 24 breaths/min, and 27.8% received supplemental oxygen. The rate of respiratory virus co-infection was 2.1%. Outcomes were assessed for 2634 patients who were discharged or had died at the study end point. During hospitalization, 373 patients (14.2%) (median age, 68 years [IQR, 56-78]; 33.5% female) were treated in the intensive care unit care, 320 (12.2%) received invasive mechanical ventilation, 81 (3.2%) were treated with kidney replacement therapy, and 553 (21%) died. As of April 4, 2020, for patients requiring mechanical ventilation (n = 1151, 20.2%), 38 (3.3%) were discharged alive, 282 (24.5%) died, and 831 (72.2%) remained in hospital. The median postdischarge follow-up time was 4.4 days (IQR, 2.2-9.3). A total of 45 patients (2.2%) were readmitted during the study period. The median time to readmission was 3 days (IQR, 1.0-4.5) for readmitted patients. Among the 3066 patients who remained hospitalized at the final study follow-up date (median age, 65 years [IQR, 54-75]), the median follow-up at time of censoring was 4.5 days (IQR, 2.4-8.1). This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID-19 in the New York City area.
Identifiants
pubmed: 32320003
pii: 2765184
doi: 10.1001/jama.2020.6775
pmc: PMC7177629
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
2052-2059Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL145114
Pays : United States
Organisme : NLM NIH HHS
ID : R01 LM012836
Pays : United States
Organisme : NIA NIH HHS
ID : R24 AG064191
Pays : United States
Commentaires et corrections
Type : ErratumIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
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