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  • Large-scale study details early outcomes for New York COVID-19 patients

    Comprehensive Ophthalmology

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    Review of: Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

    Richardson S, Hirsch J, Narasimhan M, et al. JAMA, April 2020

    This study presents the characteristics and early outcomes of patients hospitalized with COVID-19 in the New York City area.

    Study design

    The authors analyzed demographics, baseline comorbidities, presenting clinical characteristics, treatment and outcomes of sequentially hospitalized patients with COVID-19 from an academic health care system in New York. The case series included all 5,700 patients with confirmed COVID-19 admitted to the health system’s 12 hospitals in New York City, Long Island and Westchester County from March 1, 2020, through April 4, 2020. Cases were confirmed by a positive result from polymerase chain reaction testing of a nasopharyngeal sample.

    Outcomes

    The average age was 63 years. The most common comorbidities were hypertension (56.6%), obesity (41.7%) and diabetes (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. Among 2,634 patients who were discharged or died, 14.2% were treated in the intensive care unit (median age 68 years; 33.5% female), 12.2% received invasive mechanical ventilation, 3.2% were treated with kidney replacement therapy and 21% died. Overall mortality for those requiring mechanical ventilation was 88.1%.

    Limitations

    There were several limitations of the study including; a narrow geographic distribution, the data were obtained from the electronic health record database, the median post-discharge follow-up time was relatively brief at 4.4 days, the subgroup descriptive statistics were unadjusted for potential confounders and clinical outcome data were available for only 46.2% of admitted patients. The absence of data on patients who remained hospitalized at the final study date may have biased the findings including the high mortality rate of patients who received mechanical ventilation older than age 65 years.

    Clinical significance

    This study represents the first large case series of sequentially hospitalized patients with confirmed COVID-19 in the United States. This case series provides characteristics and early outcomes of patients with confirmed COVID-19.