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COVID-19 in China and the US: Differences in Hospital Admission Co-Variates and Outcomes
1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Insights
This study compared hospitalized coronavirus infectious disease-2019 (COVID-19) patients in Wuhan and New York City. Wuhan patients were younger with fewer comorbidities, but had longer hospital stays and lower mortality rates, except for those on invasive mechanical ventilation.
Area of Science:
- Infectious Diseases
- Epidemiology
- Critical Care Medicine
Background:
- Extensive data exists on coronavirus infectious disease-2019 (COVID-19) patient covariates and outcomes, but subject-level comparisons between international regions are limited.
- This study addresses the gap by comparing hospitalized COVID-19 patients in Wuhan City, China, and the New York City region, USA.
Purpose of the Study:
- To investigate and compare hospital admission covariates and clinical outcomes of COVID-19 patients between Wuhan and New York City.
- To identify demographic, epidemiological, and laboratory differences and their impact on patient outcomes.
Main Methods:
- Retrospective analysis of clinical data from 1859 hospitalized COVID-19 patients in Wuhan (Jan-Apr 2020) and 5700 from New York (Mar-Apr 2020).
- Comparison of hospital admission covariates (demographic, epidemiological, laboratory) and outcomes (ICU admission, mechanical ventilation, organ failure, death, length of stay).
Main Results:
- Wuhan patients were younger, more female, had fewer comorbidities, and presented with different laboratory findings (e.g., lymphocyte counts, liver/cardiac function) compared to New York patients.
- Wuhan patients experienced longer hospitalizations and were less likely to receive invasive mechanical ventilation (IMV) or intensive care unit (ICU) admission.
- While mortality was lower in Wuhan patients not on IMV, the risk of death was similar for patients receiving IMV in both locations.
Conclusions:
- Significant differences exist in admission characteristics and outcomes for hospitalized COVID-19 patients between Wuhan and New York City.
- These findings contribute to a more comprehensive global understanding of SARS-CoV-2 infection patterns and clinical management strategies.
Abstract:
(1) Background: Although there are extensive data on admission co-variates and outcomes of persons with coronavirus infectious disease-2019 (COVID-19) at diverse geographic sites, there are few, if any, subject-level comparisons between sites in regions and countries. We investigated differences in hospital admission co-variates and outcomes of hospitalized people with COVID-19 between Wuhan City, China and the New York City region, USA. (2) Methods: We retrospectively analyzed clinical data on 1859 hospitalized subjects with COVID-19 in Wuhan City, China, from 20 January to 4 April 2020. Data on 5700 hospitalized subjects with COVID-19 in the New York City region, USA, from 1 March to 4 April 2020 were extracted from an article by Richardson et al. Hospital admission co-variates (epidemiological, demographic, and laboratory co-variates) and outcomes (rate of intensive care unit [ICU] admission, invasive mechanical ventilation [IMV], major organ failure and death, and length of hospital stay) were compared between the cohorts. (3) Results: Wuhan subjects were younger, more likely female, less likely to have co-morbidities and fever, more likely to have a blood lymphocyte concentration > 1 × 109/L, and less likely to have abnormal liver and cardiac function tests compared with New York subjects. There were outcomes data on all Wuhan subjects and 2634 New York subjects. Wuhan subjects had higher blood nadir median lymphocyte concentrations and longer hospitalizations, and were less likely to receive IMV, ICU hospitalization, and interventions for kidney failure. Amongst subjects not receiving IMV, those in Wuhan were less likely to die compared with New York subjects. In contrast, risk of death was similar in subjects receiving IMV at both sites. (4) Conclusions: We found different hospital admission co-variates and outcomes between hospitalized persons with COVID-19 between Wuhan City and the New York region, which should be useful developing a comprehensive global understanding of the SARS-CoV-2 pandemic and COVID-19.
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