Clinical Features and Outcomes of 105 Hospitalized Patients With COVID-19 in Seattle, Washington.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
19 11 2020
Historique:
received: 16 04 2020
accepted: 21 05 2020
pubmed: 24 5 2020
medline: 15 12 2020
entrez: 24 5 2020
Statut: ppublish

Résumé

Washington State served as the initial epicenter of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in the United States. An understanding of the risk factors and clinical outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19) may provide guidance for management. All laboratory-confirmed COVID-19 cases in adults admitted to an academic medical center in Seattle, Washington, between 2 March and 26 March 2020 were included. We evaluated individuals with and without severe disease, defined as admission to the intensive care unit or death. One hundred five COVID-19 patients were hospitalized. Thirty-five percent were admitted from a senior home or skilled nursing facility. The median age was 69 years, and half were women. Three or more comorbidities were present in 55% of patients, with hypertension (59%), obesity (47%), cardiovascular disease (38%), and diabetes (33%) being the most prevalent. Most (63%) had symptoms for ≥5 days prior to admission. Only 39% had fever in the first 24 hours, whereas 41% had hypoxia at admission. Seventy-three percent of patients had lymphopenia. Of 50 samples available for additional testing, no viral coinfections were identified. Severe disease occurred in 49%. Eighteen percent of patients were placed on mechanical ventilation, and the overall mortality rate was 33%. During the early days of the COVID-19 epidemic in Washington State, the disease had its greatest impact on elderly patients with medical comorbidities. We observed high rates of severe disease and mortality in our hospitalized patients.

Sections du résumé

BACKGROUND
Washington State served as the initial epicenter of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in the United States. An understanding of the risk factors and clinical outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19) may provide guidance for management.
METHODS
All laboratory-confirmed COVID-19 cases in adults admitted to an academic medical center in Seattle, Washington, between 2 March and 26 March 2020 were included. We evaluated individuals with and without severe disease, defined as admission to the intensive care unit or death.
RESULTS
One hundred five COVID-19 patients were hospitalized. Thirty-five percent were admitted from a senior home or skilled nursing facility. The median age was 69 years, and half were women. Three or more comorbidities were present in 55% of patients, with hypertension (59%), obesity (47%), cardiovascular disease (38%), and diabetes (33%) being the most prevalent. Most (63%) had symptoms for ≥5 days prior to admission. Only 39% had fever in the first 24 hours, whereas 41% had hypoxia at admission. Seventy-three percent of patients had lymphopenia. Of 50 samples available for additional testing, no viral coinfections were identified. Severe disease occurred in 49%. Eighteen percent of patients were placed on mechanical ventilation, and the overall mortality rate was 33%.
CONCLUSIONS
During the early days of the COVID-19 epidemic in Washington State, the disease had its greatest impact on elderly patients with medical comorbidities. We observed high rates of severe disease and mortality in our hospitalized patients.

Identifiants

pubmed: 32444880
pii: 5842263
doi: 10.1093/cid/ciaa632
pmc: PMC7314181
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

2167-2173

Subventions

Organisme : NIAID NIH HHS
ID : T32 AI007044
Pays : United States

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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Auteurs

Frederick S Buckner (FS)

Department of Medicine, University of Washington, Seattle, Washington, USA.

Denise J McCulloch (DJ)

Department of Medicine, University of Washington, Seattle, Washington, USA.

Vidya Atluri (V)

Department of Medicine, University of Washington, Seattle, Washington, USA.

Michela Blain (M)

Department of Medicine, University of Washington, Seattle, Washington, USA.

Sarah A McGuffin (SA)

Department of Medicine, University of Washington, Seattle, Washington, USA.

Arun K Nalla (AK)

Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.

Meei-Li Huang (ML)

Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.

Alex L Greninger (AL)

Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.

Keith R Jerome (KR)

Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.

Seth A Cohen (SA)

Department of Medicine, University of Washington, Seattle, Washington, USA.

Santiago Neme (S)

Department of Medicine, University of Washington, Seattle, Washington, USA.

Margaret L Green (ML)

Department of Medicine, University of Washington, Seattle, Washington, USA.

Helen Y Chu (HY)

Department of Medicine, University of Washington, Seattle, Washington, USA.

H Nina Kim (HN)

Department of Medicine, University of Washington, Seattle, Washington, USA.

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