Characterising the long-term clinical outcomes of 1190 hospitalised patients with COVID-19 in New York City: a retrospective case series

• Published in: BMJ open 2021-06, Vol.11 (6), p.e049488-e049488
• Main Authors: Shoucri, Sherif M, Purpura, Lawrence, DeLaurentis, Clare, Adan, Matthew A, Theodore, Deborah A, Irace, Alexandria Lauren, Robbins-Juarez, Shelief Y, Khedagi, Apurva M, Letchford, Daniel, Harb, Amro A, Zerihun, Lillian M, Lee, Kate E, Gambina, Karen, Lauring, Max C, Chen, Noah, Sperring, Colin P, Mehta, Sanket S, Myers, Ellen L, Shih, Hueyjong, Argenziano, Michael G, Bruce, Samuel L, Slater, Cody L, Tiao, Jonathan R, Natarajan, Karthik, Hripcsak, George, Chen, Ruijun, Yin, Michael T, Sobieszczyk, Magdalena E, Castor, Delivette, Zucker, Jason E
• Format: Article
• Language: English
• Subjects: Anxiety; Cities; Clinical outcomes; Coronaviruses; COVID-19; Disease; Dyspnea; Fatigue; Health services; Homeless people; Hospitalization; Hospitals; Humans; Infections; Infectious Diseases; Medical records; Medicine; Mental depression; Morbidity; Mortality; New York City - epidemiology; Pain; Patients; Retrospective Studies; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Symptoms; Telemedicine; Treatment outcomes; virology
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2021-049488

ObjectiveTo characterise the long-term outcomes of patients with COVID-19 admitted to a large New York City medical centre at 3 and 6 months after hospitalisation and describe their healthcare usage, symptoms, morbidity and mortality.DesignRetrospective cohort through manual chart review of the electronic medical record.SettingNewYork-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical centre in New York City.ParticipantsThe first 1190 consecutive patients with symptoms of COVID-19 who presented to the hospital for care between 1 March and 8 April 2020 and tested positive for SARS-CoV-2 on reverse transcriptase PCR assay.Main outcome measuresType and frequency of follow-up encounters, self-reported symptoms, morbidity and mortality at 3 and 6 months after presentation, respectively; patient disposition information prior to admission, at discharge, and at 3 and 6 months after hospital presentation.ResultsOf the 1190 reviewed patients, 929 survived their initial hospitalisation and 261 died. Among survivors, 570 had follow-up encounters (488 at 3 months and 364 at 6 months). An additional 33 patients died in the follow-up period. In the first 3 months after admission, most encounters were telehealth visits (59%). Cardiopulmonary symptoms (35.7% and 28%), especially dyspnoea (22.1% and 15.9%), were the most common reported symptoms at 3-month and 6-month encounters, respectively. Additionally, a large number of patients reported generalised (26.4%) or neuropsychiatric (24.2%) symptoms 6 months after hospitalisation. Patients with severe COVID-19 were more likely to have reduced mobility, reduced independence or a new dialysis requirement in the 6 months after hospitalisation.ConclusionsPatients hospitalised with SARS-CoV-2 infection reported persistent symptoms up to 6 months after diagnosis. These results highlight the long-term morbidity of COVID-19 and its burden on patients and healthcare resources.