In:
PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 11 ( 2020-11-23), p. e0242760-
Abstract:
Despite evidence of socio-demographic disparities in outcomes of COVID-19, little is known about characteristics and clinical outcomes of patients admitted to public hospitals during the COVID-19 outbreak. Objective To assess demographics, comorbid conditions, and clinical factors associated with critical illness and mortality among patients diagnosed with COVID-19 at a public hospital in New York City (NYC) during the first month of the COVID-19 outbreak. Design Retrospective chart review of patients diagnosed with COVID-19 admitted to NYC Health + Hospitals / Bellevue Hospital from March 9 th to April 8 th , 2020. Results A total of 337 patients were diagnosed with COVID-19 during the study period. Primary analyses were conducted among those requiring supplemental oxygen (n = 270); half of these patients (135) were admitted to the intensive care unit (ICU). A majority were male (67.4%) and the median age was 58 years. Approximately one-third (32.6%) of hypoxic patients managed outside the ICU required non-rebreather or non-invasive ventilation. Requirement of renal replacement therapy occurred in 42.3% of ICU patients without baseline end-stage renal disease. Overall, 30-day mortality among hypoxic patients was 28.9% (53.3% in the ICU, 4.4% outside the ICU). In adjusted analyses, risk factors associated with mortality included dementia (adjusted risk ratio (aRR) 2.11 95%CI 1.50–2.96), age 65 or older (aRR 1.97, 95%CI 1.31–2.95), obesity (aRR 1.37, 95%CI 1.07–1.74), and male sex (aRR 1.32, 95%CI 1.04–1.70). Conclusion COVID-19 demonstrated severe morbidity and mortality in critically ill patients. Modifications in care delivery outside the ICU allowed the hospital to effectively care for a surge of critically ill and severely hypoxic patients.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0242760
DOI:
10.1371/journal.pone.0242760.t001
DOI:
10.1371/journal.pone.0242760.t002
DOI:
10.1371/journal.pone.0242760.t003
DOI:
10.1371/journal.pone.0242760.t004
DOI:
10.1371/journal.pone.0242760.t005
DOI:
10.1371/journal.pone.0242760.s001
DOI:
10.1371/journal.pone.0242760.s002
DOI:
10.1371/journal.pone.0242760.s003
DOI:
10.1371/journal.pone.0242760.s004
DOI:
10.1371/journal.pone.0242760.s005
DOI:
10.1371/journal.pone.0242760.r001
DOI:
10.1371/journal.pone.0242760.r002
DOI:
10.1371/journal.pone.0242760.r003
DOI:
10.1371/journal.pone.0242760.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2020
detail.hit.zdb_id:
2267670-3
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