Clinical Mortality Review in a Large COVID-19 Cohort

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Pulmonology

Background:

• Examined COVID-19 mortalities at Northwell Health, a major New York health system.
• Identified demographic characteristics and factors contributing to adverse events in COVID-19 patients.
• Focused on frequent rapid response team (RRT)/cardiac arrest (CA) calls among non-intensive care unit (ICU) patients.

Approach:

• Reviewed medical records of 2634 inpatients who died from SARS-CoV-2 infection.
• Collected data on patients admitted between March 13 and April 30, 2020.
• Statistically analyzed findings from non-ICU patients experiencing RRT/CA calls.

Key Points:

• Over 56% of COVID-19 mortalities had initial oxygen saturation >=90% and required no respiratory support.
• RRT/CA calls occurred in 42.2% of non-ICU patients, often with preceding normal oxygen saturation.
• A significant number of non-ICU patients (43.1%) experienced a drop in oxygen saturation <80% at the time of RRT/CA calls.

Conclusions:

• Nearly 50% of COVID-19 deaths occurred in non-ICU settings, indicating unexpected clinical deterioration.
• Non-ICU patients with COVID-19 are susceptible to rapid decline, often marked by sudden drops in oxygen saturation.
• Continuous oxygenation monitoring may benefit non-ICU patients, warranting further investigation.