Objective The COVID-19 pandemic is a global public health crisis, with over 33 million cases and 999 000 deaths worldwide. Data are needed regarding the clinical course of hospitalised patients, particularly in the USA. We aimed to compare clinical characteristic of patients with COVID-19 who had in-hospital mortality with those who were discharged alive.
Design Demographic, clinical and outcomes data for patients admitted to five Mount Sinai Health System hospitals with confirmed COVID-19 between 27 February and 2 April 2020 were identified through institutional electronic health records. We performed a retrospective comparative analysis of patients who had in-hospital mortality or were discharged alive.
Setting All patients were admitted to the Mount Sinai Health System, a large quaternary care urban hospital system.
Participants Participants over the age of 18 years were included.
Primary outcomes We investigated in-hospital mortality during the study period.
Results A total of 2199 patients with COVID-19 were hospitalised during the study period. As of 2 April, 1121 (51%) patients remained hospitalised, and 1078 (49%) completed their hospital course. Of the latter, the overall mortality was 29%, and 36% required intensive care. The median age was 65 years overall and 75 years in those who died. Pre-existing conditions were present in 65% of those who died and 46% of those discharged. In those who died, the admission median lymphocyte percentage was 11.7%, D-dimer was 2.4 μg/mL, C reactive protein was 162 mg/L and procalcitonin was 0.44 ng/mL. In those discharged, the admission median lymphocyte percentage was 16.6%, D-dimer was 0.93 μg/mL, C reactive protein was 79 mg/L and procalcitonin was 0.09 ng/mL.
Conclusions In our cohort of hospitalised patients, requirement of intensive care and mortality were high. Patients who died typically had more pre-existing conditions and greater perturbations in inflammatory markers as compared with those who were discharged.
- infectious diseases
- public health
- internal medicine
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EPB, AWC, BSG and GNN are joint senior authors.
Twitter @ParanjpeIshan, @RFreeman_RN, @BenGlicksberg
IP, AJR, JKDF and AL contributed equally.
Contributors IP, AJR, JKDF, AL, MS, AV, KWJ, SS, AK, RO'H, SM, UN, SKJ, AK, PT, JJ and AF developed and performed the analysis. PG, MAL, JF, JAA, EB, CRH and BM critically appraised the manuscript and helped acquire data. IP, AL, AJR, JKDpF, RM, MD, EG, DM, LMH, RF, MS, PK, VF, EPB, JN, EJN, CC-C, DC and DLR supervised the project. IP, AL, AJR, JKDF, GNN, BSG, AWC and AJ drafted the manuscript.
Funding This work was Supported by U54 TR001433-05, National Center for Advancing Translational Sciences, National Institutes of Health.
Competing interests GNN reports grants, personal fees and non-financial support from Renalytix AI, non-financial support from Pensieve Health, personal fees from AstraZeneca, BioVie, GLG Consulting, from outside the submitted work. AL reports personal fees from Zoll, outside the submitted work. ZAF reports grants from Daiichi Sankyo, grants from Amgen, Bristol Myers Squibb and Siemens Healthineers, personal fees from Alexion, GlaxoSmithKline, Trained Therapeutix Discovery, outside the submitted work. In addition, ZAF has patents licensed to Trained Therapeutix Discovery. The other authors have nothing to disclose.
Patient consent for publication Not required.
Ethics approval The Mount Sinai Institutional Review Board approved this research under a broad regulatory protocol allowing for analysis of limited patient-level data.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available. Please contact authors for information on data availability.
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