tetano
Editor, Senior Moderator
J Med Internet Res
. 2020 Jun 14.
doi: 10.2196/20548. Online ahead of print.
At the Epicenter of the American Coronavirus Outbreak - New York Inner City Hospital COVID-19 Experience and Current Data: A Retrospective Analysis
Vishnu R Mani[SUP] 1 [/SUP], Aleksandr Kalabin[SUP] 2 [/SUP], Sebastian C Valdivieso[SUP] 2 [/SUP], Max Murray-Ramcharan[SUP] 2 [/SUP], Brian Donaldson[SUP] 2 [/SUP]
Affiliations
Abstract
Background: In the midst of COVID-19 pandemic, emerging clinical data across the globe has equipped front line health care workers, policy makers and researchers to better understand and combat the illness more prepared.
Objective: Correlation of clinical and laboratory parameters with patients requiring mechanical ventilation and mortality in patients infected with SARS-CoV-2.
Methods: Review of patients with SARS-CoV-2 confirmed infection admitted and managed by our institution during the last month. Patients were grouped into intubated and non-intubated and sub grouped to alive and deceased. Comprehensive analysis using the following parameters were performed, Age, Sex, Ethnicity, Body Mass Index (BMI), Comorbidities, Inflammatory markers, Laboratory values, cardiac and renal function, electrocardiogram (EKG), Chest x ray findings, temperature, treatment groups, hospital acquired SARS-CoV-2 patients.
Results: A total of 184 patients were included in our study with age ranging from 28-97 years, mean of 64.72, 73 females (39.67%), 111 males (60.33%), with a mean BMI of 29.10. We had 114 African Americans (61.96%), 58 Hispanics (31.52%), 11 Asians (5.98%), 1 Caucasian (0.54%), with mean number of comorbidities of 1.70. Overall mortality rate was 17.39%, 16.30% of our patients required mechanical ventilation and 11.41% had hospital acquired SARS-CoV-2 infection. Pertinent and statistically significant results in the Intubated (I-T) versus Non Intubated (NI-T) SARS-CoV-2 confirmed patients for the following parameters with P values were: Age P=.01, BMI P= .07, African American Ethnicity P< .001, Hispanic Ethnicity P=.02, DM P=.001, Cr P=0.29, BUN P=.001, Procalcitonin P=.03, CRP P=.007, LDH P= .001, Glucose P=.01, Temperature P=.004, bilateral (B/L) pulmonary infiltrates in CXR P<.001, B/L patchy opacity P=.02. In the living and deceased subgroups of SARS-CoV-2 confirmed patients (linking to or against mortality) were BMI P=.04, LOS P<.001, HTN P=.02, Multiple comorbidity P=.045, BUN P=.04, EKG findings with arrhythmias/block P= .02.
Conclusions: We arrived at the following conclusions based on a comprehensive review of our study group, data collection and statistical analysis. Parameters that were strongly correlated with the need for mechanical ventilation were younger age group, overweight, Hispanic ethnicity, higher core body temperature , EKG findings with sinus tachycardia and bilateral diffuse pulmonary infiltrates on the CXR. Those intubated exhibited increased disease severity with significantly elevated levels of serum Procalcitonin, C reactive protein (CRP), Lactate Dehydrogenase (LDH), Mean glucose, Creatinine, Blood urea nitrogen (BUN). Mortality was strongly correlated with BMI, African American ethnicity, Hypertension, presence of multiple comorbidities with a mean of 2.32, worsening renal function with acute kidney injury or acute on chronic kidney injury and EKG findings of arrhythmias and heart blocks.
. 2020 Jun 14.
doi: 10.2196/20548. Online ahead of print.
At the Epicenter of the American Coronavirus Outbreak - New York Inner City Hospital COVID-19 Experience and Current Data: A Retrospective Analysis
Vishnu R Mani[SUP] 1 [/SUP], Aleksandr Kalabin[SUP] 2 [/SUP], Sebastian C Valdivieso[SUP] 2 [/SUP], Max Murray-Ramcharan[SUP] 2 [/SUP], Brian Donaldson[SUP] 2 [/SUP]
Affiliations
- PMID: 32540837
- DOI: 10.2196/20548
Abstract
Background: In the midst of COVID-19 pandemic, emerging clinical data across the globe has equipped front line health care workers, policy makers and researchers to better understand and combat the illness more prepared.
Objective: Correlation of clinical and laboratory parameters with patients requiring mechanical ventilation and mortality in patients infected with SARS-CoV-2.
Methods: Review of patients with SARS-CoV-2 confirmed infection admitted and managed by our institution during the last month. Patients were grouped into intubated and non-intubated and sub grouped to alive and deceased. Comprehensive analysis using the following parameters were performed, Age, Sex, Ethnicity, Body Mass Index (BMI), Comorbidities, Inflammatory markers, Laboratory values, cardiac and renal function, electrocardiogram (EKG), Chest x ray findings, temperature, treatment groups, hospital acquired SARS-CoV-2 patients.
Results: A total of 184 patients were included in our study with age ranging from 28-97 years, mean of 64.72, 73 females (39.67%), 111 males (60.33%), with a mean BMI of 29.10. We had 114 African Americans (61.96%), 58 Hispanics (31.52%), 11 Asians (5.98%), 1 Caucasian (0.54%), with mean number of comorbidities of 1.70. Overall mortality rate was 17.39%, 16.30% of our patients required mechanical ventilation and 11.41% had hospital acquired SARS-CoV-2 infection. Pertinent and statistically significant results in the Intubated (I-T) versus Non Intubated (NI-T) SARS-CoV-2 confirmed patients for the following parameters with P values were: Age P=.01, BMI P= .07, African American Ethnicity P< .001, Hispanic Ethnicity P=.02, DM P=.001, Cr P=0.29, BUN P=.001, Procalcitonin P=.03, CRP P=.007, LDH P= .001, Glucose P=.01, Temperature P=.004, bilateral (B/L) pulmonary infiltrates in CXR P<.001, B/L patchy opacity P=.02. In the living and deceased subgroups of SARS-CoV-2 confirmed patients (linking to or against mortality) were BMI P=.04, LOS P<.001, HTN P=.02, Multiple comorbidity P=.045, BUN P=.04, EKG findings with arrhythmias/block P= .02.
Conclusions: We arrived at the following conclusions based on a comprehensive review of our study group, data collection and statistical analysis. Parameters that were strongly correlated with the need for mechanical ventilation were younger age group, overweight, Hispanic ethnicity, higher core body temperature , EKG findings with sinus tachycardia and bilateral diffuse pulmonary infiltrates on the CXR. Those intubated exhibited increased disease severity with significantly elevated levels of serum Procalcitonin, C reactive protein (CRP), Lactate Dehydrogenase (LDH), Mean glucose, Creatinine, Blood urea nitrogen (BUN). Mortality was strongly correlated with BMI, African American ethnicity, Hypertension, presence of multiple comorbidities with a mean of 2.32, worsening renal function with acute kidney injury or acute on chronic kidney injury and EKG findings of arrhythmias and heart blocks.