Predictors of Mortality in Adults Admitted with COVID-19: Retrospective Cohort Study from New York City
Predictors of Mortality in Adults Admitted with COVID-19: Retrospective Cohort Study from New York City
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DOI：
10.5811/westjem.2020.6.47919
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发表时间：
2020-07-01
影响因子：
3.1
通讯作者：
Nayudu, Suresh K.
中科院分区：
文献类型：
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作者：
Chilimuri, Sridhar;Sun, Haozhe;Nayudu, Suresh K.
简介：2019冠状病毒病（COVID-19）在美国迅速蔓延，尤其是在纽约市（NYC），导致住院人数和死亡率大幅增加。与COVID-19患者住院期间的结果相关的可用数据非常有限。方法：在这项回顾性队列研究中，我们回顾了2020年3月9日至4月9日期间入院的COVID-19患者的健康记录纽约市的一家社区医院。纳入经鼻咽拭子逆转录-聚合酶链反应（RT-PCR）证实为严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）的受试者。我们收集了与人口统计学、实验室检查结果和住院结局相关的数据。结果：在研究期间，共有888名连续因COVID-19入院的患者，其中513名因未确定结果或信息不完整而被排除。研究共纳入375例患者，其中215例（57%）存活，160例（43%）在住院期间死亡。大多数患者为男性（63%）和西班牙裔（66%），其次为黑人（25%）和其他（9%）。高血压（60%）是最常见的合并症，其次是糖尿病（47%）、心血管疾病（17%）、慢性肾病（17%）和人类免疫缺陷病毒/获得性免疫缺陷综合征（9%）。在多元回归分析中，住院期间死亡率增加的几率与年龄较大（比值比[OR] 1.04; 95%置信区间[CI]，每年增加1.01-1.06; p < 0.0001），入院时D-二聚体超过1000纳克/毫升（ng/mL）（OR 3.16; 95% CI，1.75-5.73; p <0.0001），
Introduction: Rapid spread of coronavirus disease 2019 (COVID-19) in the United States, especially in New York City (NYC), led to a tremendous increase in hospitalizations and mortality. There is very limited data available that associates outcomes during hospitalization in patients with COVID-19.Methods: In this retrospective cohort study, we reviewed the health records of patients with COVID-19 who were admitted from March 9-April 9, 2020, to a community hospital in NYC. Subjects with confirmed reverse transcriptase-polymerase chain reaction (RT-PCR) of the nasopharyngeal swab for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were included. We collected data related to demographics, laboratory results, and outcome of hospitalization. Outcome was measured based on whether the patient was discharged home or died during hospitalization.Results: There were 888 consecutive admissions with COVID-19 during the study period, of which 513 were excluded with pending outcome or incomplete information. We included a total of 375 patients in the study, of whom 215 (57%) survived and 160 (43%) died during hospitalization. The majority of patients were male (63%) and of Hispanic origin (66%) followed by Blacks (25%), and others (9%). Hypertension (60%) stands out to be the most common comorbidity followed by diabetes mellitus (47%), cardiovascular disease (17%), chronic kidney disease (17%), and human immunodeficiency virus/acquired immunodeficiency syndrome (9%). On multiple regression analysis, increasing odds of mortality during hospitalization was associated with older age (odds ratio [OR] 1.04; 95% confidence interval [CI], 1.01-1.06 per year increase; p < 0.0001), admission D-dimer more than 1000 nanograms per milliliter (ng/mL) (OR 3.16; 95% CI, 1.75-5.73; p