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Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area
JAMA ( IF 63.1 ) Pub Date : 2020-05-26 , DOI: 10.1001/jama.2020.6775 Safiya Richardson 1, 2 , Jamie S Hirsch 1, 2, 3 , Mangala Narasimhan 2 , James M Crawford 2 , Thomas McGinn 1, 2 , Karina W Davidson 1, 2 , , Douglas P Barnaby 1, 2 , Lance B Becker 2 , John D Chelico 1, 2 , Stuart L Cohen 1, 2 , Jennifer Cookingham 1 , Kevin Coppa 3 , Michael A Diefenbach 1 , Andrew J Dominello 1 , Joan Duer-Hefele 1 , Louise Falzon 1 , Jordan Gitlin 2 , Negin Hajizadeh 1, 2 , Tiffany G Harvin 1 , David A Hirschwerk 2 , Eun Ji Kim 1, 2 , Zachary M Kozel 2 , Lyndonna M Marrast 1, 2 , Jazmin N Mogavero 1 , Gabrielle A Osorio 1 , Michael Qiu 3 , Theodoros P Zanos 4
JAMA ( IF 63.1 ) Pub Date : 2020-05-26 , DOI: 10.1001/jama.2020.6775 Safiya Richardson 1, 2 , Jamie S Hirsch 1, 2, 3 , Mangala Narasimhan 2 , James M Crawford 2 , Thomas McGinn 1, 2 , Karina W Davidson 1, 2 , , Douglas P Barnaby 1, 2 , Lance B Becker 2 , John D Chelico 1, 2 , Stuart L Cohen 1, 2 , Jennifer Cookingham 1 , Kevin Coppa 3 , Michael A Diefenbach 1 , Andrew J Dominello 1 , Joan Duer-Hefele 1 , Louise Falzon 1 , Jordan Gitlin 2 , Negin Hajizadeh 1, 2 , Tiffany G Harvin 1 , David A Hirschwerk 2 , Eun Ji Kim 1, 2 , Zachary M Kozel 2 , Lyndonna M Marrast 1, 2 , Jazmin N Mogavero 1 , Gabrielle A Osorio 1 , Michael Qiu 3 , Theodoros P Zanos 4
Affiliation
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Importance
There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19). Objective
To describe the clinical characteristics and outcomes of patients with COVID-19 hospitalized in a US health care system. Design, Setting, and Participants
Case series of patients with COVID-19 admitted to 12 hospitals in New York City, Long Island, and Westchester County, New York, within the Northwell Health system. The study included all sequentially hospitalized patients between March 1, 2020, and April 4, 2020, inclusive of these dates. Exposures
Confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample among patients requiring admission. Main Outcomes and Measures
Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy, and death. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected. Results
A total of 5700 patients were included (median age, 63 years [interquartile range {IQR}, 52-75; range, 0-107 years]; 39.7% female). The most common comorbidities were hypertension (3026; 56.6%), obesity (1737; 41.7%), and diabetes (1808; 33.8%). At triage, 30.7% of patients were febrile, 17.3% had a respiratory rate greater than 24 breaths/minute, and 27.8% received supplemental oxygen. The rate of respiratory virus co-infection was 2.1%. Outcomes were assessed for 2634 patients who were discharged or had died at the study end point. During hospitalization, 373 patients (14.2%) (median age, 68 years [IQR, 56-78]; 33.5% female) were treated in the intensive care unit care, 320 (12.2%) received invasive mechanical ventilation, 81 (3.2%) were treated with kidney replacement therapy, and 553 (21%) died. Mortality for those requiring mechanical ventilation was 88.1%. The median postdischarge follow-up time was 4.4 days (IQR, 2.2-9.3). A total of 45 patients (2.2%) were readmitted during the study period. The median time to readmission was 3 days (IQR, 1.0-4.5) for readmitted patients. Among the 3066 patients who remained hospitalized at the final study follow-up date (median age, 65 years [IQR, 54-75]), the median follow-up at time of censoring was 4.5 days (IQR, 2.4-8.1). Conclusions and Relevance
This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID-19 in the New York City area.
中文翻译：
介绍纽约市地区 5700 名 COVID-19 住院患者的特征、合并症和结果
重要性 描述 2019 年冠状病毒病 (COVID-19) 需要住院治疗的美国患者的表现特征和结果的信息有限。目的描述在美国医疗保健系统住院的 COVID-19 患者的临床特征和结果。设计、设置和参与者病例系列 COVID-19 患者入住纽约市、长岛和纽约州威彻斯特县的 12 家医院，位于 Northwell Health 系统内。该研究包括 2020 年 3 月 1 日至 2020 年 4 月 4 日（包括这些日期）期间所有连续住院的患者。暴露 通过对需要入院的患者的鼻咽样本进行聚合酶链反应检测呈阳性结果，确认了严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 感染。主要结果和措施住院期间的临床结果，如有创机械通气、肾脏替代治疗和死亡。还收集了人口统计学、基线合并症、呈现的生命体征和测试结果。结果 共纳入 5700 名患者（中位年龄，63 岁 [四分位距 {IQR}，52-75；范围，0-107 岁]；39.7% 女性）。最常见的合并症是高血压（3026；56.6%）、肥胖（1737；41.7%）和糖尿病（1808；33.8%）。分诊时，30.7% 的患者发热，17.3% 的患者呼吸频率大于 24 次/分钟，27.8% 的患者接受了补充氧气。呼吸道病毒合并感染率为2.1%。对在研究终点出院或死亡的 2634 名患者的结果进行了评估。住院期间，373 名患者 (14.2%)（中位年龄，68 岁 [IQR，56-78]；33.5% 的女性在重症监护室接受治疗，320 人（12.2%）接受有创机械通气，81 人（3.2%）接受肾脏替代治疗，553 人（21%）死亡。需要机械通气的死亡率为 88.1%。中位出院后随访时间为 4.4 天（IQR，2.2-9.3）。在研究期间，共有 45 名患者 (2.2%) 再次入院。再入院患者的再入院时间中位数为 3 天（IQR，1.0-4.5）。在最终研究随访日期（中位年龄，65 岁 [IQR，54-75]）时仍住院的 3066 名患者中，审查时的中位随访时间为 4.5 天（IQR，2.4-8.1）。
更新日期：2020-05-26
中文翻译：
介绍纽约市地区 5700 名 COVID-19 住院患者的特征、合并症和结果
重要性 描述 2019 年冠状病毒病 (COVID-19) 需要住院治疗的美国患者的表现特征和结果的信息有限。目的描述在美国医疗保健系统住院的 COVID-19 患者的临床特征和结果。设计、设置和参与者病例系列 COVID-19 患者入住纽约市、长岛和纽约州威彻斯特县的 12 家医院，位于 Northwell Health 系统内。该研究包括 2020 年 3 月 1 日至 2020 年 4 月 4 日（包括这些日期）期间所有连续住院的患者。暴露 通过对需要入院的患者的鼻咽样本进行聚合酶链反应检测呈阳性结果，确认了严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 感染。主要结果和措施住院期间的临床结果，如有创机械通气、肾脏替代治疗和死亡。还收集了人口统计学、基线合并症、呈现的生命体征和测试结果。结果 共纳入 5700 名患者（中位年龄，63 岁 [四分位距 {IQR}，52-75；范围，0-107 岁]；39.7% 女性）。最常见的合并症是高血压（3026；56.6%）、肥胖（1737；41.7%）和糖尿病（1808；33.8%）。分诊时，30.7% 的患者发热，17.3% 的患者呼吸频率大于 24 次/分钟，27.8% 的患者接受了补充氧气。呼吸道病毒合并感染率为2.1%。对在研究终点出院或死亡的 2634 名患者的结果进行了评估。住院期间，373 名患者 (14.2%)（中位年龄，68 岁 [IQR，56-78]；33.5% 的女性在重症监护室接受治疗，320 人（12.2%）接受有创机械通气，81 人（3.2%）接受肾脏替代治疗，553 人（21%）死亡。需要机械通气的死亡率为 88.1%。中位出院后随访时间为 4.4 天（IQR，2.2-9.3）。在研究期间，共有 45 名患者 (2.2%) 再次入院。再入院患者的再入院时间中位数为 3 天（IQR，1.0-4.5）。在最终研究随访日期（中位年龄，65 岁 [IQR，54-75]）时仍住院的 3066 名患者中，审查时的中位随访时间为 4.5 天（IQR，2.4-8.1）。
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