3219 hospitalised patients with COVID-19 in Southeast Michigan : a retrospective case cohort study

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OBJECTIVE: To report the clinical characteristics of patients hospitalised with COVID-19 in Southeast Michigan.

DESIGN: Retrospective cohort study.

SETTING: Eight hospitals in Southeast Michigan.

PARTICIPANTS: 3219 hospitalised patients with a positive SARS-CoV-2 infection by nasopharyngeal PCR test from 13 March 2020 until 29 April 2020.

MAIN OUTCOMES MEASURES: Outcomes were discharge from the hospital or in-hospital death. Examined predictors included patient demographics, chronic diseases, home medications, mechanical ventilation, in-hospital medications and timeframe of hospital admission. Multivariable logistic regression was conducted to identify risk factors for in-hospital mortality.

RESULTS: During the study period, 3219 (90.4%) patients were discharged or died in the hospital. The median age was 65.2 (IQR 52.6-77.2) years, the median length of stay in the hospital was 6.0 (IQR 3.2-10.1) days, and 51% were female. Hypertension was the most common chronic disease, occurring in 2386 (74.1%) patients. Overall mortality rate was 16.0%. Blacks represented 52.3% of patients and had a mortality rate of 13.5%. Mortality was highest at 18.5% in the prepeak hospital COVID-19 volume, decreasing to 15.3% during the peak period and to 10.8% in the postpeak period. Multivariable regression showed increasing odds of in-hospital death associated with older age (OR 1.04, 95% CI 1.03 to 1.05, p<0.001) for every increase in 1 year of age and being male (OR 1.47, 95% CI 1.21 to 1.81, p<0.001). Certain chronic diseases increased the odds of in-hospital mortality, especially chronic kidney disease. Administration of vitamin C, corticosteroids and therapeutic heparin in the hospital was associated with higher odds of death.

CONCLUSION: In-hospital mortality was highest in early admissions and improved as our experience in treating patients with COVID-19 increased. Blacks were more likely to get admitted to the hospital and to receive mechanical ventilation, but less likely to die in the hospital than whites.

Medienart:	E-Artikel

Erscheinungsjahr:	2021
Erschienen:	2021

Enthalten in:	Zur Gesamtaufnahme - volume:11
Enthalten in:	BMJ open - 11(2021), 4 vom: 07. Apr., Seite e042042

Sprache:	Englisch

Beteiligte Personen:	Mulhem, Elie [VerfasserIn] Oleszkowicz, Andrew [VerfasserIn] Lick, David [VerfasserIn]

Links:	Volltext

Themen:	Epidemiology Infectious diseases Journal Article Respiratory infections

Anmerkungen:	Date Completed 13.04.2021 Date Revised 07.04.2024 published: Electronic Citation Status MEDLINE

doi:	10.1136/bmjopen-2020-042042

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM323831095