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Clinical Characteristics and Risk Factors for Death of Hospitalized Patients With COVID-19 in a Community Hospital: A
Guillermo Rodriguez-Nava1, Maria Adriana Yanez-Bello1, Daniela Patricia Trelles-Garcia1
1Department of Internal Medicine, AMITA Health Saint Francis Hospital, Evanston, IL.
Insights
Older patients, residents of long-term care facilities (LTCF), and those with high quick Sequential Organ Failure Assessment scores faced increased mortality risk from coronavirus disease 2019 (COVID-19) in a community hospital setting.
Area of Science:
- Infectious Diseases
- Epidemiology
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) presented a significant public health challenge, necessitating understanding of patient outcomes in diverse healthcare settings.
- Community hospitals played a crucial role in managing the surge of COVID-19 patients, highlighting the need for localized data.
Purpose of the Study:
- To characterize the clinical presentation and outcomes of hospitalized COVID-19 patients.
- To identify risk factors associated with mortality in this patient cohort.
- To inform clinical management strategies in community hospital settings.
Main Methods:
- A single-center retrospective cohort study was conducted.
- Included 313 adult patients with laboratory-confirmed COVID-19 admitted between March 1 and May 25, 2020.
- Data collected included demographics, comorbidities, symptoms, laboratory findings, and outcomes (discharge or death).
Main Results:
- The median age of patients was 68 years, with 58.1% being male.
- 62% of patients were admitted from a long-term care facility (LTCF).
- Mortality was 32.3% (101 out of 313 patients).
Conclusions:
- Older age, residence in an LTCF, and elevated quick Sequential Organ Failure Assessment (qSOFA) scores were significantly associated with increased risk of inpatient death.
- These findings underscore the vulnerability of specific patient groups within community hospital settings during the COVID-19 pandemic.
Objective:
To describe the clinical characteristics, outcomes, and risk factors for death of patients with coronavirus disease 2019 (COVID-19) in a community hospital setting.
Patients And Methods:
This single-center retrospective cohort study included 313 adult patients with laboratory-confirmed COVID-19 admitted to a community hospital in Cook County, Illinois, from March 1, 2020, to May 25, 2020. Demographics, medical history, underlying comorbidities, symptoms, signs, laboratory findings, imaging studies, management, and progression to discharge or death data were collected and analyzed.
Results:
Of 313 patients, the median age was 68 years (interquartile range, 59.0-78.5 years; range, 19-98 years), 182 (58.1%) were male, 119 (38%) were white, and 194 (62%) were admitted from a long-term care facility (LTCF). As of May 25, 2020, there were 212 (67.7%) survivors identified, whereas 101 (32.3%) nonsurvivors were identified. Multivariable Cox regression analysis showed increasing hazards of inpatient death associated with older age (hazard ratio [HR] 1.02; 95% CI, 1.01-1.04), LTCF residence (HR, 3.23; 95% CI, 1.68-6.20), and quick Sequential Organ Failure Assessment scores (HR, 2.59; 95% CI, 1.78-3.76).
Conclusion:
In this single-center retrospective cohort study of 313 adult patients hospitalized with COVID-19 illness in a community hospital in Cook County, Illinois, older patients, LTCF residents, and patients with high quick Sequential Organ Failure Assessment scores were found to have worse clinical outcomes and increased risk of death.
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