Article Text

Original research
Characterising the long-term clinical outcomes of 1190 hospitalised patients with COVID-19 in New York City: a retrospective case series
  1. Sherif M Shoucri1,
  2. Lawrence Purpura1,
  3. Clare DeLaurentis2,
  4. Matthew A Adan3,
  5. Deborah A Theodore1,
  6. Alexandria Lauren Irace3,
  7. Shelief Y Robbins-Juarez3,
  8. Apurva M Khedagi3,
  9. Daniel Letchford3,
  10. Amro A Harb3,
  11. Lillian M Zerihun3,
  12. Kate E Lee3,
  13. Karen Gambina3,
  14. Max C Lauring3,
  15. Noah Chen3,
  16. Colin P Sperring3,
  17. Sanket S Mehta3,
  18. Ellen L Myers3,
  19. Hueyjong Shih3,
  20. Michael G Argenziano3,
  21. Samuel L Bruce3,
  22. Cody L Slater3,
  23. Jonathan R Tiao3,
  24. Karthik Natarajan4,
  25. George Hripcsak4,
  26. Ruijun Chen4,5,
  27. Michael T Yin1,
  28. Magdalena E Sobieszczyk1,
  29. Delivette Castor1,
  30. Jason E Zucker1
  1. 1Medicine, Infectious Diseases, Columbia University Irving Medical Center, New York City, New York, USA
  2. 2Medicine, Columbia University Irving Medical Center, New York City, New York, USA
  3. 3Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, USA
  4. 4Biomedical Informatics, Columbia University Irving Medical Center, New York City, New York, USA
  5. 5Translational Data Science and Informatics, Geisinger, Danville, Pennsylvania, USA
  1. Correspondence to Dr Sherif M Shoucri; sms2319{at}cumc.columbia.edu

Abstract

Objective To characterise the long-term outcomes of patients with COVID-19 admitted to a large New York City medical centre at 3 and 6 months after hospitalisation and describe their healthcare usage, symptoms, morbidity and mortality.

Design Retrospective cohort through manual chart review of the electronic medical record.

Setting NewYork-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical centre in New York City.

Participants The first 1190 consecutive patients with symptoms of COVID-19 who presented to the hospital for care between 1 March and 8 April 2020 and tested positive for SARS-CoV-2 on reverse transcriptase PCR assay.

Main outcome measures Type and frequency of follow-up encounters, self-reported symptoms, morbidity and mortality at 3 and 6 months after presentation, respectively; patient disposition information prior to admission, at discharge, and at 3 and 6 months after hospital presentation.

Results Of the 1190 reviewed patients, 929 survived their initial hospitalisation and 261 died. Among survivors, 570 had follow-up encounters (488 at 3 months and 364 at 6 months). An additional 33 patients died in the follow-up period. In the first 3 months after admission, most encounters were telehealth visits (59%). Cardiopulmonary symptoms (35.7% and 28%), especially dyspnoea (22.1% and 15.9%), were the most common reported symptoms at 3-month and 6-month encounters, respectively. Additionally, a large number of patients reported generalised (26.4%) or neuropsychiatric (24.2%) symptoms 6 months after hospitalisation. Patients with severe COVID-19 were more likely to have reduced mobility, reduced independence or a new dialysis requirement in the 6 months after hospitalisation.

Conclusions Patients hospitalised with SARS-CoV-2 infection reported persistent symptoms up to 6 months after diagnosis. These results highlight the long-term morbidity of COVID-19 and its burden on patients and healthcare resources.

  • COVID-19
  • infectious diseases
  • virology

Data availability statement

Data are available upon reasonable request. Requests for the statistical code and data set can be made to the corresponding author.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Data availability statement

Data are available upon reasonable request. Requests for the statistical code and data set can be made to the corresponding author.

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Footnotes

  • Contributors SMS is the first author. JEZ and DC share senior authorship. Study conception and design: SMS, JEZ, DC, LP, MGA, SLB, CLS, JRT, RC. Manuscript composition: SMS, MAA, CD, DC. Acquisition, analysis or interpretation of data: SMS, JEZ, DC, LP, MAA, ALI, SYR-J, AMK, DL, AAH, LMZ, KEL, KG, MCL, NC, CPS, SSM, ELM, HS. Review and revision of the manuscript for important intellectual content: SMS, LP, MAA, DC, DAT, ALI, SYR-J, AMK, DL, AAH, LMZ, KEL, KG, MCL, NC, CPS, SSM, ELM, HS, GH, KN, RC, MTY, MES, JEZ, DC. Study supervision and guarantors of the study: SMS, JEZ, DC. The corresponding author attests that all listed authors meet the authorship criteria and that no others meeting the criteria have been omitted.

  • Funding Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under award number K23AI150378 (JEZ), L30AI133789 (JEZ), UM1AI069470 and supplement to the award (DAT, MES, JEZ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. SMS is supported by T32AI100852-08. KEL is supported by T32DK083256-12S1. GH is supported by R01LM006910. No funding organisation or sponsor was involved in the study design, data collection or analysis, manuscript composition, or the decision to submit for publication.

  • Competing interests GH reports grants from Janssen Research, outside the submitted work.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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