Association Between COVID-19 Outcomes and Patient Characteristics: A Study in an Inner-City Community Hospital.

Area of Science:

• Hematology
• Infectious Diseases
• Critical Care Medicine

Background:

• Hematological abnormalities like lymphopenia and thrombocytopenia correlate with severe outcomes in SARS-CoV-2 infection.
• Previous research often originated from large academic centers, necessitating data from community hospitals.

Purpose of the Study:

• To investigate associations between patient characteristics, hematological parameters, and COVID-19 outcomes in an inner-city community hospital setting.
• To analyze demographic factors, comorbidities, and hematological markers in relation to mortality and ICU admission.

Main Methods:

• Retrospective chart review of 50 hospitalized COVID-19 patients at Saint Francis Medical Center (January-September 2020).
• Data collected included demographics, comorbidities (Charlson Comorbidity Index), complete blood counts, D-dimer, C-reactive protein, and treatments.
• Primary outcome: all-cause in-hospital mortality. Secondary outcomes: mechanical ventilation and ICU admission.

Main Results:

• Overall in-hospital mortality was 32%. Higher Charlson Comorbidity Index (≥3) and elevated D-dimer (≥3 mg/L FEU) were significantly associated with mortality.
• Patients who died had lower admission white blood cell counts (5.93 vs 9.3 Thou/ul) and platelet counts (157.7 vs 250.06 Thou/ul) compared to survivors.
• C-reactive protein levels were associated with ICU admission (p=0.03) but not mortality. Treatments like steroids and Remdesivir showed no significant impact on outcomes.

Conclusions:

• Older age, higher CCI, and elevated D-dimer are risk factors for mortality in hospitalized COVID-19 patients.
• Significantly lower white blood cell and platelet counts in non-survivors suggest their prognostic value.
• Thrombocytopenia and elevated CRP (≥15 mg/dL) may predict ICU admission, while lymphocyte counts did not differ significantly between mortality groups.