Journal Article

Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection

Velazquez, Eric J., Churchwell, Keith, Gong, Guannan, Desai, Nihar, Haimovich, Adrian, Torre, Charles J., Hurley, Nathan C., Pulk, Rebecca A., Villanueva, Merceditas, Taylor, Richard Andrew, Iwasaki, Akiko, Ko, Albert I., McPadden, Jacob, Siner, Jonathan, Farhadian, Shelli F., Mortazavi, Bobak J., Singh, Avinainder, Durant, Thomas J. S., Dela Cruz, Charles S., Schulz, Wade L., Warner, Frederick, Young, H. Patrick, Herbst, Roy S., Gunel, Murat, Hsiao, Allen, Krumholz, Harlan M.

2021

Overview

Severe acute respiratory syndrome virus (SARS-CoV-2) has infected millions of people worldwide. Our goal was to identify risk factors associated with admission and disease severity in patients with SARS-CoV-2. This was an observational, retrospective study based on real-world data for 7,995 patients with SARS-CoV-2 from a clinical data repository. Yale New Haven Health (YNHH) is a five-hospital academic health system serving a diverse patient population with community and teaching facilities in both urban and suburban areas. The study included adult patients who had SARS-CoV-2 testing at YNHH between March 1 and April 30, 2020. Primary outcomes were admission and in-hospital mortality for patients with SARS-CoV-2 infection as determined by RT-PCR testing. We also assessed features associated with the need for respiratory support. Of the 28605 patients tested for SARS-CoV-2, 7995 patients (27.9%) had an infection (median age 52.3 years) and 2154 (26.9%) of these had an associated admission (median age 66.2 years). Of admitted patients, 2152 (99.9%) had a discharge disposition at the end of the study period. Of these, 329 (15.3%) required invasive mechanical ventilation and 305 (14.2%) expired. Increased age and male sex were positively associated with admission and in-hospital mortality (median age 80.7 years), while comorbidities had a much weaker association with the risk of admission or mortality. Black race (OR 1.43, 95%CI 1.14-1.78) and Hispanic ethnicity (OR 1.81, 95%CI 1.50-2.18) were identified as risk factors for admission, but, among discharged patients, age-adjusted in-hospital mortality was not significantly different among racial and ethnic groups. This observational study identified, among people testing positive for SARS-CoV-2 infection, older age and male sex as the most strongly associated risks for admission and in-hospital mortality in patients with SARS-CoV-2 infection. While minority racial and ethnic groups had increased burden of disease and risk of admission, age-adjusted in-hospital mortality for discharged patients was not significantly different among racial and ethnic groups. Ongoing studies will be needed to continue to evaluate these risks, particularly in the setting of evolving treatment guidelines.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Adult / Aged / Aged, 80 and over / Bioinformatics / Biology and life sciences / Cohort Studies / Computational neuroscience / Computer programs / Computer science / COVID-19 - diagnosis / COVID-19 - epidemiology / COVID-19 - mortality / COVID-19 - therapy / COVID-19 Testing / Critical care / Data analysis / Diagnosis / Editing / Emergency medical care / Emergency medical services / Epidemics / Epidemiology / Evaluation / Female / Funding / Genetics / Genomes / Health policy / Health risks / Hospital Mortality / Hospitals / Humans / Infectious diseases / Information technology / Interdisciplinary research / Interdisciplinary studies / Internal medicine / Laboratories / Male / Medicine / Medicine and health sciences / Methodology / Microorganisms / Middle Aged / Mortality / Neurosurgery / Pathogenesis / Patient outcomes / Patients / Pediatrics / People and Places / Prognosis / Public health / Respiratory diseases / Retrospective Studies / Risk factors / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Sleep / Suburban areas / Supervision / Treatment Outcome / United States / Urban areas / Viral diseases / Viruses / Young Adult