Characterization and clinical course of 1000 patients with COVID-19 in New York: retrospective case series
Author:
Argenziano Michael GORCID, Bruce Samuel L, Slater Cody L, Tiao Jonathan R, Baldwin Matthew R, Barr R Graham, Chang Bernard P, Chau Katherine H, Choi Justin J, Gavin Nicholas, Goyal Parag, Mills Angela M, Patel Ashmi A, Romney Marie-Laure S, Safford Monika M., Schluger Neil W, Sengupta Soumitra, Sobieszczyk Magdalena E, Zucker Jason E, Asadourian Paul A, Bell Fletcher M, Boyd Rebekah, Cohen Matthew F, Colquhoun MacAlistair I, Colville Lucy A, de Jonge Joseph H, Dershowitz Lyle B, Dey Shirin A, Eiseman Katherine A, Girvin Zachary P, Goni Daniella T, Harb Amro A, Herzik Nicholas, Householder Sarah, Karaaslan Lara E, Lee Heather, Lieberman Evan, Ling Andrew, Lu Ree, Shou Arthur Y, Sisti Alexander C, Snow Zachary E, Sperring Colin P, Xiong Yuqing, Zhou Henry W, Natarajan Karthik, Hripcsak George, Chen Ruijun
Abstract
AbstractObjectiveTo characterize patients with coronavirus disease 2019 (COVID-19) in a large New York City (NYC) medical center and describe their clinical course across the emergency department (ED), inpatient wards, and intensive care units (ICUs).DesignRetrospective manual medical record review.SettingNewYork-Presbyterian/Columbia University Irving Medical Center (NYP/CUIMC), a quaternary care academic medical center in NYC.ParticipantsThe first 1000 consecutive patients with laboratory-confirmed COVID-19.MethodsWe identified the first 1000 consecutive patients with a positive RT-SARS-CoV-2 PCR test who first presented to the ED or were hospitalized at NYP/CUIMC between March 1 and April 5, 2020. Patient data was manually abstracted from the electronic medical record.Main outcome measuresWe describe patient characteristics including demographics, presenting symptoms, comorbidities on presentation, hospital course, time to intubation, complications, mortality, and disposition.ResultsAmong the first 1000 patients, 150 were ED patients, 614 were admitted without requiring ICU-level care, and 236 were admitted or transferred to the ICU. The most common presenting symptoms were cough (73.2%), fever (72.8%), and dyspnea (63.1%). Hospitalized patients, and ICU patients in particular, most commonly had baseline comorbidities including of hypertension, diabetes, and obesity. ICU patients were older, predominantly male (66.9%), and long lengths of stay (median 23 days; IQR 12 to 32 days); 78.0% developed AKI and 35.2% required dialysis. Notably, for patients who required mechanical ventilation, only 4.4% were first intubated more than 14 days after symptom onset. Time to intubation from symptom onset had a bimodal distribution, with modes at 3-4 and 9 days. As of April 30, 90 patients remained hospitalized and 211 had died in the hospital.ConclusionsHospitalized patients with COVID-19 illness at this medical center faced significant morbidity and mortality, with high rates of AKI, dialysis, and a bimodal distribution in time to intubation from symptom onset.
Publisher
Cold Spring Harbor Laboratory
Cited by
150 articles.
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