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Risk factors and outcomes of COVID-19 in New York City; a retrospective cohort study.

ABSTRACT: Coronavirus disease 2019 (COVID-19) is a global pandemic and information on risk factors for worse prognosis is needed to accurately identify patients at risk and potentially provide insight into therapeutic options. In this retrospective cohort study, including 3703 patients with laboratory confirmed COVID-19, we identified risk factors associated with all-cause mortality, need for hospitalization and mechanical ventilation. Male gender was independently associated with increased risk of hospitalization (adjusted odds ratio [OR_adj ]: 1.62; 95% confidence interval [95% CI]: 1.38-1.91)), mechanical ventilation (OR_adj : 1.35; 95% CI: 1.08-1.69) and death (OR_adj : 1.46; 95% CI: 1.17-1.82). Patients > 60 years had higher risk of hospitalization (OR_adj : 5.47; 95% CI: 4.29-6.96), mechanical ventilation (OR_adj : 3.26; 95% CI: 2.08-5.11) and death (OR_adj : 13.04; 95% CI: 6.25-27.24). Congestive heart failure (ORadj: 1.47; 95% CI: 1.06-2.02) and dementia (OR_adj : 2.03; 95% CI: 1.46-2.83) were associated with increased odds of death, as well as the presence of more than two comorbidities (OR_adj : 1.90; 95% CI: 1.35-2.68). Patients with COVID-19 of older age, male gender, or having more than two comorbidities are at higher risk of hospitalization, mechanical ventilation and death, and should therefore be closely monitored.

SUBMITTER: van Gerwen M

PROVIDER: S-EPMC7404409 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Risk factors and outcomes of COVID-19 in New York City; a retrospective cohort study.

van Gerwen Maaike M Alsen Mathilda M Little Christine C Barlow Joshua J Genden Eric E Naymagon Leonard L Tremblay Douglas D

Journal of medical virology 20200813 2

Coronavirus disease 2019 (COVID-19) is a global pandemic and information on risk factors for worse prognosis is needed to accurately identify patients at risk and potentially provide insight into therapeutic options. In this retrospective cohort study, including 3703 patients with laboratory confirmed COVID-19, we identified risk factors associated with all-cause mortality, need for hospitalization and mechanical ventilation. Male gender was independently associated with increased risk of hospit ...[more]

PMID: 32706392

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Project description: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.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.Setting: All patients were admitted to the Mount Sinai Health System, a large quaternary care urban hospital system.Participants: Participants over the age of 18 years were included.Primary outcomes: We investigated in-hospital mortality during the study period.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??g/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??g/mL, C reactive protein was 79?mg/L and procalcitonin was 0.09?ng/mL.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.

Project description:BackgroundNew York City (NYC) is the epicenter of severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) in the United States. Clinical characteristics and outcomes of vulnerable populations, such as those with gynecologic cancer who develop COVID-19 infections, is limited.MethodsPatients from 6 NYC-area hospital systems with known gynecologic cancer and a COVID-19 diagnosis were identified. Demographic and clinical outcome data were abstracted through a review of electronic medical records.ResultsRecords for 121 patients with gynecologic cancer and COVID-19 were abstracted; the median age at the COVID-19 diagnosis was 64.0 years (interquartile range, 51.0-73.0 years). Sixty-six of the 121 patients (54.5%) required hospitalization; among the hospitalized patients, 45 (68.2%) required respiratory intervention, 20 (30.3%) were admitted to the intensive care unit, and 9 (13.6%) underwent invasive mechanical ventilation. Seventeen patients (14.0%) died of COVID-19 complications. No patient requiring mechanical ventilation survived. On multivariable analysis, hospitalization was associated with an age ≥64 years (risk ratio [RR], 1.73; 95% confidence interval [CI], 1.18-2.51), African American race (RR, 1.56; 95% CI, 1.13-2.15), and 3 or more comorbidities (RR, 1.43; 95% CI, 1.03-1.98). Only recent immunotherapy use (RR, 3.49; 95% CI, 1.08-11.27) was associated with death due to COVID-19 on multivariable analysis; chemotherapy treatment and recent major surgery were not predictive of COVID-19 severity or mortality.ConclusionsThe case fatality rate among gynecologic oncology patients with a COVID-19 infection is 14.0%. Recent immunotherapy use is associated with an increased risk of mortality related to COVID-19 infection.Lay summaryThe case fatality rate among gynecologic oncology patients with a coronavirus disease 2019 (COVID-19) infection is 14.0%; there is no association between cytotoxic chemotherapy and cancer-directed surgery and COVID-19 severity or death. As such, patients can be counseled regarding the safety of continued anticancer treatments during the pandemic. This is important because the ability to continue cancer therapies for cancer control and cure is critical.

Dataset Information

Risk factors and outcomes of COVID-19 in New York City; a retrospective cohort study.

Publications

Risk factors and outcomes of COVID-19 in New York City; a retrospective cohort study.

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