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Clinical Characteristics and Outcomes for 7,995 Patients with SARS-CoV-2 Infection
OBJECTIVE: 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. DESIGN: This was an observational, retrospective study based on real-world data...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cold Spring Harbor Laboratory
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386526/ https://www.ncbi.nlm.nih.gov/pubmed/32743602 http://dx.doi.org/10.1101/2020.07.19.20157305 |
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author | McPadden, Jacob Warner, Frederick Young, H. Patrick Hurley, Nathan C. Pulk, Rebecca A. Singh, Avinainder Durant, Thomas JS Gong, Guannan Desai, Nihar Haimovich, Adrian Taylor, Richard Andrew Gunel, Murat Cruz, Charles S. Dela Farhadian, Shelli F. Siner, Jonathan Villanueva, Merceditas Churchwell, Keith Hsiao, Allen Torre, Charles J. Velazquez, Eric J. Herbst, Roy S. Iwasaki, Akiko Ko, Albert I. Mortazavi, Bobak J. Krumholz, Harlan M. Schulz, Wade L. |
author_facet | McPadden, Jacob Warner, Frederick Young, H. Patrick Hurley, Nathan C. Pulk, Rebecca A. Singh, Avinainder Durant, Thomas JS Gong, Guannan Desai, Nihar Haimovich, Adrian Taylor, Richard Andrew Gunel, Murat Cruz, Charles S. Dela Farhadian, Shelli F. Siner, Jonathan Villanueva, Merceditas Churchwell, Keith Hsiao, Allen Torre, Charles J. Velazquez, Eric J. Herbst, Roy S. Iwasaki, Akiko Ko, Albert I. Mortazavi, Bobak J. Krumholz, Harlan M. Schulz, Wade L. |
author_sort | McPadden, Jacob |
collection | PubMed |
description | OBJECTIVE: 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. DESIGN: This was an observational, retrospective study based on real-world data for 7,995 patients with SARS-CoV-2 from a clinical data repository. SETTING: 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. POPULATIONS: The study included adult patients who had SARS-CoV-2 testing at YNHH between March 1 and April 30, 2020. MAIN OUTCOME AND PERFORMANCE MEASURES: 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. RESULTS: 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. CONCLUSIONS: This observational study identified, among people testing positive for SARSCoV-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. |
format | Online Article Text |
id | pubmed-7386526 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Cold Spring Harbor Laboratory |
record_format | MEDLINE/PubMed |
spelling | pubmed-73865262020-07-31 Clinical Characteristics and Outcomes for 7,995 Patients with SARS-CoV-2 Infection McPadden, Jacob Warner, Frederick Young, H. Patrick Hurley, Nathan C. Pulk, Rebecca A. Singh, Avinainder Durant, Thomas JS Gong, Guannan Desai, Nihar Haimovich, Adrian Taylor, Richard Andrew Gunel, Murat Cruz, Charles S. Dela Farhadian, Shelli F. Siner, Jonathan Villanueva, Merceditas Churchwell, Keith Hsiao, Allen Torre, Charles J. Velazquez, Eric J. Herbst, Roy S. Iwasaki, Akiko Ko, Albert I. Mortazavi, Bobak J. Krumholz, Harlan M. Schulz, Wade L. medRxiv Article OBJECTIVE: 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. DESIGN: This was an observational, retrospective study based on real-world data for 7,995 patients with SARS-CoV-2 from a clinical data repository. SETTING: 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. POPULATIONS: The study included adult patients who had SARS-CoV-2 testing at YNHH between March 1 and April 30, 2020. MAIN OUTCOME AND PERFORMANCE MEASURES: 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. RESULTS: 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. CONCLUSIONS: This observational study identified, among people testing positive for SARSCoV-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. Cold Spring Harbor Laboratory 2020-11-08 /pmc/articles/PMC7386526/ /pubmed/32743602 http://dx.doi.org/10.1101/2020.07.19.20157305 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which allows reusers to copy and distribute the material in any medium or format in unadapted form only, for noncommercial purposes only, and only so long as attribution is given to the creator. |
spellingShingle | Article McPadden, Jacob Warner, Frederick Young, H. Patrick Hurley, Nathan C. Pulk, Rebecca A. Singh, Avinainder Durant, Thomas JS Gong, Guannan Desai, Nihar Haimovich, Adrian Taylor, Richard Andrew Gunel, Murat Cruz, Charles S. Dela Farhadian, Shelli F. Siner, Jonathan Villanueva, Merceditas Churchwell, Keith Hsiao, Allen Torre, Charles J. Velazquez, Eric J. Herbst, Roy S. Iwasaki, Akiko Ko, Albert I. Mortazavi, Bobak J. Krumholz, Harlan M. Schulz, Wade L. Clinical Characteristics and Outcomes for 7,995 Patients with SARS-CoV-2 Infection |
title | Clinical Characteristics and Outcomes for 7,995 Patients with SARS-CoV-2 Infection |
title_full | Clinical Characteristics and Outcomes for 7,995 Patients with SARS-CoV-2 Infection |
title_fullStr | Clinical Characteristics and Outcomes for 7,995 Patients with SARS-CoV-2 Infection |
title_full_unstemmed | Clinical Characteristics and Outcomes for 7,995 Patients with SARS-CoV-2 Infection |
title_short | Clinical Characteristics and Outcomes for 7,995 Patients with SARS-CoV-2 Infection |
title_sort | clinical characteristics and outcomes for 7,995 patients with sars-cov-2 infection |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386526/ https://www.ncbi.nlm.nih.gov/pubmed/32743602 http://dx.doi.org/10.1101/2020.07.19.20157305 |
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