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- Title
Clinical Outcomes of Patients Hospitalized with Coronavirus Disease 2019 (COVID-19) in Boston.
- Authors
El-Jawahri, Areej; Bohossian, Hacho B.; Paasche-Orlow, Michael K.; Lakin, Joshua R.; Johnson, P. Connor; Cooper, Zara; Jagielo, Annemarie D.; Brannen, Elise N.; Reynolds, Matthew J.; Coogan, Kathleen; Vaughn, Dagny; Volandes, Angelo
- Abstract
<bold>Background: </bold>Outcomes of hospitalized patients with COVID-19 have been described in health systems overwhelmed with a surge of cases. However, studies examining outcomes of patients admitted to hospitals not in crisis are lacking.<bold>Objective: </bold>To describe clinical characteristic and outcomes of all patients with COVID-19 who are admitted to hospitals not in crisis, and factors associated with mortality in this population.<bold>Design: </bold>A retrospective analysis PARTICIPANTS: In total, 470 consecutive patients with COVID-19 requiring hospitalization in one health system in Boston from January 1, 2020 to April 15, 2020.<bold>Main Measures: </bold>We collected clinical outcomes during hospitalization including intensive care unit (ICU) admission, receipt of mechanical ventilation, and vasopressors. We utilized multivariable logistic regression models to examine factors associated with mortality.<bold>Key Results: </bold>A total of 470 patients (median age 66 [range 23-98], 54.0% male) were included. The most common comorbidities were diabetes (38.5%, 181/470) and obesity (41.3%, 194/470). On admission, 41.9% (197/470) of patients were febrile and 60.6% (285/470) required supplemental oxygen. During hospitalization, 37.9% (178/470) were admitted to the ICU, 33.6% (158/470) received mechanical ventilation, 29.4% (138/470) received vasopressors, 16.4% (77/470) reported limitations on their desire for life-sustaining therapies such as intubation and cardiopulmonary resuscitation, and 25.1% (118/470) died. Among those admitted to the ICU (N=178), the median number of days on the ventilator was 10 days (IQR 1-29), and 58.4% (104/178) were discharged alive. Older age (OR=1.04, P<0.001), male sex (OR=2.14, P=0.007), higher comorbidities (OR=1.20, P=0.001), higher lactate dehydrogenase on admission (2nd tertile: OR=4.07, P<0.001; 3rd tertile: OR=8.04, P<0.001), and the need for supplemental oxygen on admission (OR=2.17, P=0.014) were all associated with higher mortality.<bold>Conclusions: </bold>The majority of hospitalized patients with COVID-19 and those who received mechanical ventilation survived. These data highlight the need to examine public health and system factors that contribute to improved outcomes for this population.
- Subjects
BOSTON (Mass.); COVID-19; TREATMENT effectiveness; INTENSIVE care units; ARTIFICIAL respiration; LACTATE dehydrogenase
- Publication
JGIM: Journal of General Internal Medicine, 2021, Vol 36, Issue 5, p1285
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-021-06622-x