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Published on: December 19, 2020
Clinical Characteristics of Hospitalized Covid-19 Patients in New York City
Insights
The largest US study of hospitalized COVID-19 patients found high intensive care needs and mortality. Patients who died often had pre-existing conditions and abnormal inflammatory markers.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- The COVID-19 pandemic presents a significant global health challenge.
- There is a need for data on the clinical progression of hospitalized patients, especially in the US.
Conclusions:
- This study represents the largest and most diverse case series of hospitalized COVID-19 patients in the US to date.
- High rates of intensive care requirement and mortality were observed.
- Pre-existing conditions and significant alterations in inflammatory markers were characteristic of patients who died.
Background:
The coronavirus 2019 (Covid-19) pandemic is a global public health crisis, with over 1.6 million cases and 95,000 deaths worldwide. Data are needed regarding the clinical course of hospitalized patients, particularly in the United States.
Methods:
Demographic, clinical, and outcomes data for patients admitted to five Mount Sinai Health System hospitals with confirmed Covid-19 between February 27 and April 2, 2020 were identified through institutional electronic health records. We conducted a descriptive study of patients who had in-hospital mortality or were discharged alive.
Results:
A total of 2,199 patients with Covid-19 were hospitalized during the study period. As of April 2 nd , 1,121 (51%) patients remained hospitalized, and 1,078 (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 ug/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 ug/ml, C-reactive protein was 79 mg/L, and procalcitonin was 0.09 ng/mL.
Conclusions:
This is the largest and most diverse case series of hospitalized patients with Covid-19 in the United States to date. Requirement of intensive care and mortality were high. Patients who died typically had pre-existing conditions and severe perturbations in inflammatory markers.
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