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COVID-19 related deaths in an urban academic medical center in Brooklyn - a descriptive case series
James Andrew McCracken1, Mohamed Nakeshbandi1, Jeffrey Arace1
1University Hospital of Brooklyn, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 36, Brooklyn, New York 11203 USA.
Insights
Black Americans with multiple comorbidities faced high COVID-19 mortality in Brooklyn. Elevated inflammatory markers and dyspnea at admission indicated increased risk for in-hospital death, highlighting healthcare disparities.
Area of Science:
- Medical research
- Public health
- Epidemiology
Background:
- Limited data exists on baseline demographics and hospital presentation of patients at risk of expiring from coronavirus disease 2019 (COVID-19), especially among Black American patients.
- This study addresses the gap by examining similarities in demographics and hospital presentation among COVID-19 patients who died at an academic medical center in Brooklyn, New York.
Purpose of the Study:
- To analyze the demographics and hospital presentation of patients who expired due to COVID-19.
- To identify factors associated with increased risk of in-hospital mortality in COVID-19 patients, with a focus on the Black American population.
Main Methods:
- Retrospective observational study of 200 patients with laboratory-confirmed SARS-CoV-2 infection who expired during hospital admission.
- Data collection focused on patients who expired between March 17 and April 16, 2020, at an academic medical center in Brooklyn, New York.
- Analysis included demographics, comorbidities, presenting symptoms, laboratory values (C-reactive protein, lactate dehydrogenase, ferritin), and time from symptom onset to expiration.
Main Results:
- The study population was predominantly Black American (89%), with most patients having no history of international travel and multiple comorbidities (81%).
- Common comorbidities included hypertension (84.5%), diabetes mellitus (57.5%), and obesity (41.5%). 55% had three or more comorbidities.
- Elevated C-reactive protein, lactate dehydrogenase, and ferritin levels were observed on admission. Dyspnea was the most frequent symptom (92.5%), with a median of 8.42 days from symptom onset to expiration.
Conclusions:
- Socioeconomic status and healthcare inequalities significantly impact the Black population, exacerbating COVID-19 infection outcomes in Brooklyn.
- Patients presenting with multiple comorbidities and elevated inflammatory markers are at high risk for in-hospital mortality from COVID-19.
- Findings underscore the need to address health disparities to mitigate severe outcomes in vulnerable populations.
Background:
Available studies are lacking in analysis of baseline demographics and hospital presentation of patients at risk of expiring due to coronavirus disease 2019 (COVID-19), particularly Black American patients. We conducted a retrospective chart review to determine similarities in demographics and hospital presentation among patients who expired due to COVID-19 at an academic medical center in Brooklyn, New York.
Study Design And Methods:
This is a retrospective observational study of 200 patients who expired due to complications of COVID-19. Patients were included in this study if they had laboratory-confirmed SARS-CoV-2 infection and expired during their admission. Data were collected on patients who expired between March 17 and April 16, 2020.
Results:
A vast majority of patients were Black Americans (89%) with no history of international travel who had more than one comorbidity (81%), with the most common comorbidities being hypertension (84·5%), diabetes mellitus (57·5%), and obesity (41·5%). Fifty-five percent of our patient population had three or more comorbidities. Among patients with available data, C-reactive protein, lactate dehydrogenase, and ferritin values were elevated above normal limits at admission. Dyspnea was the most common presenting symptom (92·5%). Most (90·5%) presented within the first week of symptoms, with a median time of symptoms prior to expiration being 8·42 days (IQR 5·57-12·72).
Interpretation:
Socioeconomic status and healthcare inequalities have greatly affected the Black population of Brooklyn, New York, and these disparities become even more apparent in COVID-19 infection. Patients presenting with numerous comorbidities and elevated inflammatory markers represent a population at high risk of in-hospital mortality.
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