Characteristics and Outcomes of US Patients Hospitalized With COVID-19.

Peltan ID, Caldwell E, Admon AJ, Attia EF, Gundel SJ, Mathews KS, Nagrebetsky A, Sahetya SK, Ulysse C, Brown SM, Chang SY, Goodwin AJ, Hope AA, Iwashyna TJ, Johnson NJ, Lanspa MJ, Richardson LD, Vranas KC, Angus DC, Baron RM, Haaland BA, Hayden DL, Thompson BT, Rice TW, Hough CL. Characteristics and Outcomes of US Patients Hospitalized With COVID-19. American Journal of Critical Care : An Official Publication, American Association of Critical-Care Nurses. 2022 Mar 1; 31(2):146-157.

Related HSR&D Project(s)

• CDA 18-191 – Optimizing Critical Care for Patients with Acute Respiratory Failure: A Mixed-Methods Study

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Abstract:

BACKGROUND: Understanding COVID-19 epidemiology is crucial to clinical care and to clinical trial design and interpretation. OBJECTIVE: To describe characteristics, treatment, and outcomes among patients hospitalized with COVID-19 early in the pandemic. METHODS: A retrospective cohort study of consecutive adult patients with laboratory-confirmed, symptomatic SARS-CoV-2 infection admitted to 57 US hospitals from March 1 to April 1, 2020. RESULTS: Of 1480 inpatients with COVID-19, median (IQR) age was 62.0 (49.4-72.9) years, 649 (43.9%) were female, and 822 of 1338 (61.4%) were non-White or Hispanic/Latino. Intensive care unit admission occurred in 575 patients (38.9%), mostly within 4 days of hospital presentation. Respiratory failure affected 583 patients (39.4%), including 284 (19.2%) within 24 hours of hospital presentation and 413 (27.9%) who received invasive mechanical ventilation. Median (IQR) hospital stay was 8 (5-15) days overall and 15 (9-24) days among intensive care unit patients. Hospital mortality was 17.7% (n = 262). Risk factors for hospital death identified by penalized multivariable regression included older age; male sex; comorbidity burden; symptoms-to-admission interval; hypotension; hypoxemia; and higher white blood cell count, creatinine level, respiratory rate, and heart rate. Of 1218 survivors, 221 (18.1%) required new respiratory support at discharge and 259 of 1153 (22.5%) admitted from home required new health care services. CONCLUSIONS: In a geographically diverse early-pandemic COVID-19 cohort with complete hospital folllow-up, hospital mortality was associated with older age, comorbidity burden, and male sex. Intensive care unit admissions occurred early and were associated with protracted hospital stays. Survivors often required new health care services or respiratory support at discharge.