Journal
CLINICAL INFECTIOUS DISEASES
Volume 72, Issue 10, Pages E558-E565Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciaa1268
Keywords
SARS-CoV-2; COVID-19; observational study; hydroxychloroquine; remdesivir
Categories
Funding
- TARGET PharmaSolutions Inc.
- Gilead
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This study analyzed a large cohort of COVID-19 patients hospitalized in the United States, identifying factors such as male sex, older age, obesity, geographic region, chronic kidney disease, and preexisting cardiovascular disease associated with increased odds of mechanical ventilation and death. These data can guide strategies for prioritizing prevention and treatment of the disease.
Background. As coronavirus disease 2019 (COVID-19) disseminates throughout the United States, a better understanding of the patient characteristics associated with hospitalization, morbidity, and mortality in diverse geographic regions is essential. Methods. Hospital chargemaster data on adult patients with COVID-19 admitted to 245 hospitals across 38 states between 15 February and 20 April 2020 were assessed. The clinical course from admission, through hospitalization, and to discharge or death was analyzed. Results. A total of 11 721 patients were included (majority were >60 years of age [59.9%] and male [53.496]). Comorbidities included hypertension (46.7%), diabetes (27.8%), cardiovascular disease (18.6%), obesity (16.1%), and chronic kidney disease (12.2%). Mechanical ventilation was required by 1967 patients (16.8%). Mortality among hospitalized patients was 21.4% and increased to 70.5% among those on mechanical ventilation. Male sex, older age, obesity, geographic region, and the presence of chronic kidney disease or a preexisting cardiovascular disease were associated with increased odds of mechanical ventilation. All aforementioned risk factors, with the exception of obesity, were associated with increased odds of death (all P values < .001). Many patients received investigational medications for treatment of COVID-19, including 48 patients on remdesivir and 4232 on hydroxychloroquine. Conclusions. This large observational cohort describes the clinical course and identifies factors associated with the outcomes of hospitalized patients with COVID-19 across the United States. These data can inform strategies to prioritize prevention and treatment for this disease.
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