Objective To characterize patients with coronavirus disease 2019 (covid-19) in a large New York City medical center and describe their clinical course across the emergency department, hospital wards, and intensive care units. Design Retrospective manual medical record review. Setting NewYork-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical center in New York City. Participants The first 1000 consecutive patients with a positive result on the reverse transcriptase polymerase chain reaction assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who presented to the emergency department or were admitted to hospital between 1 March and 5 April 2020. Patient data were manually abstracted from electronic medical records. Main outcome measures Characterization of patients, including demographics, presenting symptoms, comorbidities on presentation, hospital course, time to intubation, complications, mortality, and disposition. Results Of the first 1000 patients, 150 presented to the emergency department, 614 were admitted to hospital (not intensive care units), and 236 were admitted or transferred to intensive care units. The most common presenting symptoms were cough (732/1000), fever (728/1000), and dyspnea (631/1000). Patients in hospital, particularly those treated in intensive care units, often had baseline comorbidities including hypertension, diabetes, and obesity. Patients admitted to intensive care units were older, predominantly male (158/236, 66.9%), and had long lengths of stay (median 23 days, interquartile range 12-32 days); 78.0% (184/236) developed acute kidney injury and 35.2% (83/236) needed dialysis. Only 4.4% (6/136) of patients who required mechanical ventilation were first intubated more than 14 days after symptom onset. Time to intubation from symptom onset had a bimodal distribution, with modes at three to four days, and at nine days. As of 30 April, 90 patients remained in hospital and 211 had died in hospital. Conclusions Patients admitted to hospital with covid-19 at this medical center faced major morbidity and mortality, with high rates of acute kidney injury and inpatient dialysis, prolonged intubations, and a bimodal distribution of time to intubation from symptom onset.

中文翻译：

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纽约 1000 例 2019 年冠状病毒病患者的特征和临床过程：回顾性病例系列。

目的 描述纽约市一家大型医疗中心的 2019 年冠状病毒病 (covid-19) 患者的特征，并描述他们在急诊科、医院病房和重症监护室的临床过程。设计回顾性手动病历审查。设置纽约长老会/哥伦比亚大学欧文医学中心，这是纽约市的四级护理学术医疗中心。2020 年 3 月 1 日至 4 月 5 日期间到急诊科就诊或入院的前 1000 名连续出现严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 逆转录酶聚合酶链反应检测阳性的患者. 患者数据是从电子病历中手动提取的。主要结果测量患者的特征，包括人口统计学，症状、就诊时的合并症、住院病程、插管时间、并发症、死亡率和处置情况。结果前1000例患者中，急诊150例，入院614例（非重症监护室），236例入院或转入重症监护室。最常见的症状是咳嗽 (732/1000)、发烧 (728/1000) 和呼吸困难 (631/1000)。住院患者，特别是在重症监护室接受治疗的患者，通常有基线合并症，包括高血压、糖尿病和肥胖症。入住重症监护病房的患者年龄较大，主要是男性（158/236, 66.9%），住院时间长（中位数 23 天，四分位间距 12-32 天）；78.0% (184/236) 发生急性肾损伤，35.2% (83/236) 需要透析。只有4个。4% (6/136) 需要机械通气的患者在症状出现 14 天后首次插管。从症状出现到插管的时间呈双峰分布，模式为 3 至 4 天和 9 天。截至 4 月 30 日，仍有 90 名患者住院，其中 211 人在医院死亡。结论 该医疗中心因 COVID-19 入院的患者面临严重的发病率和死亡率，急性肾损伤和住院透析的发生率高，插管时间延长，从症状出现到插管的时间呈双峰分布。90名患者仍在医院，211人在医院死亡。结论 该医疗中心因 COVID-19 入院的患者面临严重的发病率和死亡率，急性肾损伤和住院透析的发生率高，插管时间延长，从症状出现到插管的时间呈双峰分布。90名患者仍在医院，211人在医院死亡。结论 该医疗中心因 COVID-19 入院的患者面临严重的发病率和死亡率，急性肾损伤和住院透析的发生率高，插管时间延长，从症状出现到插管的时间呈双峰分布。