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Comparison of patients admitted to an inner-city intensive care unit across 3 COVID-19 waves

Sindhaghatta Venkatram1, Arundhati Dileep2, Ked Fortuzi3

  • 1Associate Professor of Clinical Medicine, Division of Pulmonary and Critical Care Medicine, BronxCare Health System, Bronx, NY, USA.

Medicine
|February 24, 2023
PubMed

Insights

COVID-19 outcomes in inner-city ICU patients improved over three waves, with decreased mortality and better discharge rates. Mechanical ventilation and length of stay were lower in the initial wave.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Public Health

Background:

  • Inner-city populations face disproportionately high COVID-19 mortality.
  • Limited data exists on COVID-19 outcomes in inner-city intensive care units (ICUs) across multiple infection waves.

Purpose of the Study:

  • To analyze COVID-19 outcomes in an inner-city ICU over three distinct infection waves.
  • To identify changes in mortality, length of stay, mechanical ventilation use, and discharge disposition.

Main Methods:

  • Retrospective study of 716 patients admitted to an ICU in Bronx, NY, from March 2020 to February 2022.
  • Comparison of outcomes across three COVID-19 waves.
  • Analysis of in-hospital mortality, length of stay, mechanical ventilation, and discharge disposition.

Main Results:

  • In-hospital mortality decreased significantly from 57% in the first wave to 37% in the third wave (P < .001).
  • Length of stay and mechanical ventilation days were lower in the first wave.
  • Improved discharge disposition observed in later waves, with more patients discharged directly home.

Conclusions:

  • Inner-city COVID-19 patient outcomes, including mortality and discharge disposition, showed significant improvement across successive infection waves.
  • Factors predicting mortality included age, male gender, COPD, shock, acute kidney injury, dialysis, and mechanical ventilation.
  • These findings are encouraging given the historically high COVID-19 mortality risk in this demographic.

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