Clinical Outcomes of Patients Hospitalized with Coronavirus Disease 2019 (COVID-19) in Boston

• Published in: Journal of general internal medicine : JGIM 2021-05, Vol.36 (5), p.1285-1291
• Main Authors: El-Jawahri, Areej, Bohossian, Hacho B., Paasche-Orlow, Michael K., Lakin, Joshua R., Johnson, P. Connor, Cooper, Zara, Jagielo, Annemarie D., Brannen, Elise N., Reynolds, Matthew J., Coogan, Kathleen, Vaughn, Dagny, Volandes, Angelo
• Format: Article
• Language: English
• Subjects: Clinical outcomes; Coronaviruses; COVID-19; Diabetes mellitus; Hospitalization; Hospitals; Internal Medicine; Intubation; L-Lactate dehydrogenase; Lactate dehydrogenase; Lactic acid; Males; Mechanical ventilation; Medicine; Medicine & Public Health; Mortality; Original Research; Oxygen; Patients; Public health; Regression analysis; Regression models; Resuscitation; Ventilation; Ventilators; Viral diseases
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-021-06622-x

Background Outcomes of hospitalized patients with COVID-19 have been described in health systems overwhelmed with a surge of cases. However, studies examining outcomes of patients admitted to hospitals not in crisis are lacking. Objective To describe clinical characteristic and outcomes of all patients with COVID-19 who are admitted to hospitals not in crisis, and factors associated with mortality in this population. Design A retrospective analysis Participants In total, 470 consecutive patients with COVID-19 requiring hospitalization in one health system in Boston from January 1, 2020 to April 15, 2020. Main Measures We collected clinical outcomes during hospitalization including intensive care unit (ICU) admission, receipt of mechanical ventilation, and vasopressors. We utilized multivariable logistic regression models to examine factors associated with mortality. Key Results A total of 470 patients (median age 66 [range 23–98], 54.0% male) were included. The most common comorbidities were diabetes (38.5%, 181/470) and obesity (41.3%, 194/470). On admission, 41.9% (197/470) of patients were febrile and 60.6% (285/470) required supplemental oxygen. During hospitalization, 37.9% (178/470) were admitted to the ICU, 33.6% (158/470) received mechanical ventilation, 29.4% (138/470) received vasopressors, 16.4% (77/470) reported limitations on their desire for life-sustaining therapies such as intubation and cardiopulmonary resuscitation, and 25.1% (118/470) died. Among those admitted to the ICU ( N =178), the median number of days on the ventilator was 10 days (IQR 1–29), and 58.4% (104/178) were discharged alive. Older age (OR=1.04, P