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Comorbidity and clinical factors associated with COVID-19 critical illness and mortality at a large public hospital in New York City in the early phase of the pandemic (March-April 2020).

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  • معلومة اضافية
    • المصدر:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: San Francisco, CA : Public Library of Science
    • الموضوع:
      Hospitals, Public* ; Pandemics*; COVID-19/*epidemiology ; COVID-19/*mortality ; Critical Care/*methods ; SARS-CoV-2/*genetics; Aged ; COVID-19/virology ; Comorbidity ; Critical Illness ; Female ; Hospital Mortality ; Humans ; Intensive Care Units ; Male ; Middle Aged ; New York City/epidemiology ; Patient Discharge ; Respiration, Artificial ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Risk Factors
    • نبذة مختصرة :
      Background: Despite evidence of socio-demographic disparities in outcomes of COVID-19, little is known about characteristics and clinical outcomes of patients admitted to public hospitals during the COVID-19 outbreak.
      Objective: To assess demographics, comorbid conditions, and clinical factors associated with critical illness and mortality among patients diagnosed with COVID-19 at a public hospital in New York City (NYC) during the first month of the COVID-19 outbreak.
      Design: Retrospective chart review of patients diagnosed with COVID-19 admitted to NYC Health + Hospitals / Bellevue Hospital from March 9th to April 8th, 2020.
      Results: A total of 337 patients were diagnosed with COVID-19 during the study period. Primary analyses were conducted among those requiring supplemental oxygen (n = 270); half of these patients (135) were admitted to the intensive care unit (ICU). A majority were male (67.4%) and the median age was 58 years. Approximately one-third (32.6%) of hypoxic patients managed outside the ICU required non-rebreather or non-invasive ventilation. Requirement of renal replacement therapy occurred in 42.3% of ICU patients without baseline end-stage renal disease. Overall, 30-day mortality among hypoxic patients was 28.9% (53.3% in the ICU, 4.4% outside the ICU). In adjusted analyses, risk factors associated with mortality included dementia (adjusted risk ratio (aRR) 2.11 95%CI 1.50-2.96), age 65 or older (aRR 1.97, 95%CI 1.31-2.95), obesity (aRR 1.37, 95%CI 1.07-1.74), and male sex (aRR 1.32, 95%CI 1.04-1.70).
      Conclusion: COVID-19 demonstrated severe morbidity and mortality in critically ill patients. Modifications in care delivery outside the ICU allowed the hospital to effectively care for a surge of critically ill and severely hypoxic patients.
      Competing Interests: The authors have declared that no competing interests exist.
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    • الموضوع:
      Date Created: 20201123 Date Completed: 20201211 Latest Revision: 20231112
    • الموضوع:
      20240628
    • الرقم المعرف:
      PMC7682848
    • الرقم المعرف:
      10.1371/journal.pone.0242760
    • الرقم المعرف:
      33227019