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Characterization of Critically Ill COVID-19 Patients at a Brooklyn Safety-Net Hospital
Background The novel coronavirus disease 2019 (COVID-19) pandemic continues to spread across the country with over 3 million cases and 150,000 deaths in the United States as of July 2020. Outcomes have been poor, with reported admission rates to the intensive care team of 5% in China and mortality a...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444967/ https://www.ncbi.nlm.nih.gov/pubmed/32850261 http://dx.doi.org/10.7759/cureus.9809 |
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author | Capone, Stephen Abramyan, Shogik Ross, Brent Rosenberg, Joshua Zeibeq, John Vasudevan, Viswanath Samad, Reza Gerolemou, Louis Pinelis, Evgeny Gasperino, James Orsini, Jose |
author_facet | Capone, Stephen Abramyan, Shogik Ross, Brent Rosenberg, Joshua Zeibeq, John Vasudevan, Viswanath Samad, Reza Gerolemou, Louis Pinelis, Evgeny Gasperino, James Orsini, Jose |
author_sort | Capone, Stephen |
collection | PubMed |
description | Background The novel coronavirus disease 2019 (COVID-19) pandemic continues to spread across the country with over 3 million cases and 150,000 deaths in the United States as of July 2020. Outcomes have been poor, with reported admission rates to the intensive care team of 5% in China and mortality among critically ill patients of 50% in Seattle. Here we explore the disease characteristics in a Brooklyn safety-net hospital affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods A retrospective chart review of COVID-19 positive patients at The Brooklyn Hospital Center who were treated by the intensive care team prior to April 20, 2020. Data was extracted from the electronic health record, analyzed and correlated for outcome. Results Impact of various clinical treatments was assessed, showing no change in median overall survival (OS) of both hydroxychloroquine with azithromycin or vitamin C with zinc. Supplemental therapies were used in selected patients, and some were shown to increase median OS and patients requiring vasopressor support or invasive mechanical ventilation showed decreased OS. There was no statistically significant difference in overall survival based on ethnicity, healthcare status, or individual medical comorbidities, although a negative trend exists for diabetes. Despite this, there is a trend towards increasingly poor prognosis based on the number of comorbidities and Class 3 obesity. Conclusions Despite the fact that we show no significant differences in mortality based on ethnicity, insurance status, or individual medical comorbidities, we show a high overall mortality. There is also a trend towards increased overall mortality in Class 3 obesity, which should be further investigated. We suggest that these findings may be attributed to both socioeconomic factors and an increased incidence of total medical comorbidities in our patient population. |
format | Online Article Text |
id | pubmed-7444967 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-74449672020-08-25 Characterization of Critically Ill COVID-19 Patients at a Brooklyn Safety-Net Hospital Capone, Stephen Abramyan, Shogik Ross, Brent Rosenberg, Joshua Zeibeq, John Vasudevan, Viswanath Samad, Reza Gerolemou, Louis Pinelis, Evgeny Gasperino, James Orsini, Jose Cureus Internal Medicine Background The novel coronavirus disease 2019 (COVID-19) pandemic continues to spread across the country with over 3 million cases and 150,000 deaths in the United States as of July 2020. Outcomes have been poor, with reported admission rates to the intensive care team of 5% in China and mortality among critically ill patients of 50% in Seattle. Here we explore the disease characteristics in a Brooklyn safety-net hospital affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods A retrospective chart review of COVID-19 positive patients at The Brooklyn Hospital Center who were treated by the intensive care team prior to April 20, 2020. Data was extracted from the electronic health record, analyzed and correlated for outcome. Results Impact of various clinical treatments was assessed, showing no change in median overall survival (OS) of both hydroxychloroquine with azithromycin or vitamin C with zinc. Supplemental therapies were used in selected patients, and some were shown to increase median OS and patients requiring vasopressor support or invasive mechanical ventilation showed decreased OS. There was no statistically significant difference in overall survival based on ethnicity, healthcare status, or individual medical comorbidities, although a negative trend exists for diabetes. Despite this, there is a trend towards increasingly poor prognosis based on the number of comorbidities and Class 3 obesity. Conclusions Despite the fact that we show no significant differences in mortality based on ethnicity, insurance status, or individual medical comorbidities, we show a high overall mortality. There is also a trend towards increased overall mortality in Class 3 obesity, which should be further investigated. We suggest that these findings may be attributed to both socioeconomic factors and an increased incidence of total medical comorbidities in our patient population. Cureus 2020-08-17 /pmc/articles/PMC7444967/ /pubmed/32850261 http://dx.doi.org/10.7759/cureus.9809 Text en Copyright © 2020, Capone et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Capone, Stephen Abramyan, Shogik Ross, Brent Rosenberg, Joshua Zeibeq, John Vasudevan, Viswanath Samad, Reza Gerolemou, Louis Pinelis, Evgeny Gasperino, James Orsini, Jose Characterization of Critically Ill COVID-19 Patients at a Brooklyn Safety-Net Hospital |
title | Characterization of Critically Ill COVID-19 Patients at a Brooklyn Safety-Net Hospital |
title_full | Characterization of Critically Ill COVID-19 Patients at a Brooklyn Safety-Net Hospital |
title_fullStr | Characterization of Critically Ill COVID-19 Patients at a Brooklyn Safety-Net Hospital |
title_full_unstemmed | Characterization of Critically Ill COVID-19 Patients at a Brooklyn Safety-Net Hospital |
title_short | Characterization of Critically Ill COVID-19 Patients at a Brooklyn Safety-Net Hospital |
title_sort | characterization of critically ill covid-19 patients at a brooklyn safety-net hospital |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444967/ https://www.ncbi.nlm.nih.gov/pubmed/32850261 http://dx.doi.org/10.7759/cureus.9809 |
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