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527. Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York

BACKGROUND: The area of New York was hit hard by the COVID 19 pandemic with Suffolk county in Long Island numbering >40 thousand cases and 1900 deaths by the end of May 2020. The Veterans Affairs Medical Center (VAMC) at Northport NY serves over 30000 Veterans. We report our institution’s experie...

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Autores principales: Psevdos, George, Papamanoli, Aikaterini, Lobo, Zeena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778163/
http://dx.doi.org/10.1093/ofid/ofaa439.721
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author Psevdos, George
Papamanoli, Aikaterini
Lobo, Zeena
author_facet Psevdos, George
Papamanoli, Aikaterini
Lobo, Zeena
author_sort Psevdos, George
collection PubMed
description BACKGROUND: The area of New York was hit hard by the COVID 19 pandemic with Suffolk county in Long Island numbering >40 thousand cases and 1900 deaths by the end of May 2020. The Veterans Affairs Medical Center (VAMC) at Northport NY serves over 30000 Veterans. We report our institution’s experience during the COVID 19 outbreak METHODS: Retrospective chart review of hospitalized Veterans (VETS) with COVID-19 from March 1(st) to May 31(st) 2020 at Northport VAMC RESULTS: A total of 141 VETS had laboratory confirmed SARS-CoV-2 infection, 67 got hospitalized, and 20/67 died. The median age of the hospitalized cohort was 73 years (33 to 94). Figure 1 shows the dates of tests, Tables 1 &2 summarize the demographic characteristics, medical history and laboratory findings. No co-infection with influenza or other respiratory viruses were identified. The deceased group was older 77.5 vs 71 years P 0.007, had lower oxygen saturation and higher respiratory rate on presentation, had longer length of stay P 0.091, more likely to be in ICU and intubated, had lower bicarbonate levels, higher SAPS P < 0.001, higher lactate dehydrogenase, blood urea nitrogen, potassium levels, and higher peak procalcitonin, CRP, ferritin, ESR levels. There was no difference between recovered and deceased in terms of comorbidities except atrial fibrillation. Also, no difference in use of ACE inhibitors, statins, famotidine, hydroxychloroquine (HCQ), azithromycin, doxycycline, steroids. Beta lactam antibiotics and tocilizumab were given more in the deceased group. HCQ was stopped in 1 patient due to QTc prolongation. No bacteremia identified in the recovered group contrary to two occasions in the deceased, E. faecalis and S. mitis. Six pneumonias in intubated deceased patients were identified (3 had received steroids and one tocilizumab) and 4 in recovered (2 intubated/steroids and 1 tocilizumab). 12 recovered patients had persistent positive nasopharyngeal PCR for SARS-CoV-2 for average 29 days (14 to 79 days), and 4 of them were checked and had detectable IgG antibody Dates of Tests for Hospitalized Veterans with COVID-19 [Image: see text] Comparison of Demographic Data and Comorbidities in Recovered vs Diseased Hospitalized Veterans with COVID - 19 [Image: see text] Comparison of Laboratory Data in Recovered vs Diseased Hospitalized Veterans with COVID - 19 [Image: see text] CONCLUSION: The inpatient mortality of hospitalized VETS with COVID-19 in our institution was 30%. Mortality was associated with older age. Ongoing monitoring of outcomes in hospitalized patients will be important to understand the evolving epidemiology of COVID-19 among US VETS. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77781632021-01-07 527. Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York Psevdos, George Papamanoli, Aikaterini Lobo, Zeena Open Forum Infect Dis Poster Abstracts BACKGROUND: The area of New York was hit hard by the COVID 19 pandemic with Suffolk county in Long Island numbering >40 thousand cases and 1900 deaths by the end of May 2020. The Veterans Affairs Medical Center (VAMC) at Northport NY serves over 30000 Veterans. We report our institution’s experience during the COVID 19 outbreak METHODS: Retrospective chart review of hospitalized Veterans (VETS) with COVID-19 from March 1(st) to May 31(st) 2020 at Northport VAMC RESULTS: A total of 141 VETS had laboratory confirmed SARS-CoV-2 infection, 67 got hospitalized, and 20/67 died. The median age of the hospitalized cohort was 73 years (33 to 94). Figure 1 shows the dates of tests, Tables 1 &2 summarize the demographic characteristics, medical history and laboratory findings. No co-infection with influenza or other respiratory viruses were identified. The deceased group was older 77.5 vs 71 years P 0.007, had lower oxygen saturation and higher respiratory rate on presentation, had longer length of stay P 0.091, more likely to be in ICU and intubated, had lower bicarbonate levels, higher SAPS P < 0.001, higher lactate dehydrogenase, blood urea nitrogen, potassium levels, and higher peak procalcitonin, CRP, ferritin, ESR levels. There was no difference between recovered and deceased in terms of comorbidities except atrial fibrillation. Also, no difference in use of ACE inhibitors, statins, famotidine, hydroxychloroquine (HCQ), azithromycin, doxycycline, steroids. Beta lactam antibiotics and tocilizumab were given more in the deceased group. HCQ was stopped in 1 patient due to QTc prolongation. No bacteremia identified in the recovered group contrary to two occasions in the deceased, E. faecalis and S. mitis. Six pneumonias in intubated deceased patients were identified (3 had received steroids and one tocilizumab) and 4 in recovered (2 intubated/steroids and 1 tocilizumab). 12 recovered patients had persistent positive nasopharyngeal PCR for SARS-CoV-2 for average 29 days (14 to 79 days), and 4 of them were checked and had detectable IgG antibody Dates of Tests for Hospitalized Veterans with COVID-19 [Image: see text] Comparison of Demographic Data and Comorbidities in Recovered vs Diseased Hospitalized Veterans with COVID - 19 [Image: see text] Comparison of Laboratory Data in Recovered vs Diseased Hospitalized Veterans with COVID - 19 [Image: see text] CONCLUSION: The inpatient mortality of hospitalized VETS with COVID-19 in our institution was 30%. Mortality was associated with older age. Ongoing monitoring of outcomes in hospitalized patients will be important to understand the evolving epidemiology of COVID-19 among US VETS. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7778163/ http://dx.doi.org/10.1093/ofid/ofaa439.721 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Psevdos, George
Papamanoli, Aikaterini
Lobo, Zeena
527. Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York
title 527. Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York
title_full 527. Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York
title_fullStr 527. Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York
title_full_unstemmed 527. Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York
title_short 527. Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York
title_sort 527. corona virus disease-19 (covid-19) in a veterans affairs hospital at suffolk county, long island, new york
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778163/
http://dx.doi.org/10.1093/ofid/ofaa439.721
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