Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection

Severe acute respiratory syndrome virus (SARS-CoV-2) has infected millions of people worldwide. Our goal was to identify risk factors associated with admission and disease severity in patients with SARS-CoV-2. This was an observational, retrospective study based on real-world data for 7,995 patients...

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Veröffentlicht in:PloS one 2021-03, Vol.16 (3), p.e0243291-e0243291
Hauptverfasser: McPadden, Jacob, Warner, Frederick, Young, H Patrick, Hurley, Nathan C, Pulk, Rebecca A, Singh, Avinainder, Durant, Thomas J S, Gong, Guannan, Desai, Nihar, Haimovich, Adrian, Taylor, Richard Andrew, Gunel, Murat, Dela Cruz, Charles S, Farhadian, Shelli F, Siner, Jonathan, Villanueva, Merceditas, Churchwell, Keith, Hsiao, Allen, Torre, Jr, Charles J, Velazquez, Eric J, Herbst, Roy S, Iwasaki, Akiko, Ko, Albert I, Mortazavi, Bobak J, Krumholz, Harlan M, Schulz, Wade L
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container_title PloS one
container_volume 16
creator McPadden, Jacob
Warner, Frederick
Young, H Patrick
Hurley, Nathan C
Pulk, Rebecca A
Singh, Avinainder
Durant, Thomas J S
Gong, Guannan
Desai, Nihar
Haimovich, Adrian
Taylor, Richard Andrew
Gunel, Murat
Dela Cruz, Charles S
Farhadian, Shelli F
Siner, Jonathan
Villanueva, Merceditas
Churchwell, Keith
Hsiao, Allen
Torre, Jr, Charles J
Velazquez, Eric J
Herbst, Roy S
Iwasaki, Akiko
Ko, Albert I
Mortazavi, Bobak J
Krumholz, Harlan M
Schulz, Wade L
description Severe acute respiratory syndrome virus (SARS-CoV-2) has infected millions of people worldwide. Our goal was to identify risk factors associated with admission and disease severity in patients with SARS-CoV-2. This was an observational, retrospective study based on real-world data for 7,995 patients with SARS-CoV-2 from a clinical data repository. Yale New Haven Health (YNHH) is a five-hospital academic health system serving a diverse patient population with community and teaching facilities in both urban and suburban areas. The study included adult patients who had SARS-CoV-2 testing at YNHH between March 1 and April 30, 2020. Primary outcomes were admission and in-hospital mortality for patients with SARS-CoV-2 infection as determined by RT-PCR testing. We also assessed features associated with the need for respiratory support. Of the 28605 patients tested for SARS-CoV-2, 7995 patients (27.9%) had an infection (median age 52.3 years) and 2154 (26.9%) of these had an associated admission (median age 66.2 years). Of admitted patients, 2152 (99.9%) had a discharge disposition at the end of the study period. Of these, 329 (15.3%) required invasive mechanical ventilation and 305 (14.2%) expired. Increased age and male sex were positively associated with admission and in-hospital mortality (median age 80.7 years), while comorbidities had a much weaker association with the risk of admission or mortality. Black race (OR 1.43, 95%CI 1.14-1.78) and Hispanic ethnicity (OR 1.81, 95%CI 1.50-2.18) were identified as risk factors for admission, but, among discharged patients, age-adjusted in-hospital mortality was not significantly different among racial and ethnic groups. This observational study identified, among people testing positive for SARS-CoV-2 infection, older age and male sex as the most strongly associated risks for admission and in-hospital mortality in patients with SARS-CoV-2 infection. While minority racial and ethnic groups had increased burden of disease and risk of admission, age-adjusted in-hospital mortality for discharged patients was not significantly different among racial and ethnic groups. Ongoing studies will be needed to continue to evaluate these risks, particularly in the setting of evolving treatment guidelines.
doi_str_mv 10.1371/journal.pone.0243291
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Of admitted patients, 2152 (99.9%) had a discharge disposition at the end of the study period. Of these, 329 (15.3%) required invasive mechanical ventilation and 305 (14.2%) expired. Increased age and male sex were positively associated with admission and in-hospital mortality (median age 80.7 years), while comorbidities had a much weaker association with the risk of admission or mortality. Black race (OR 1.43, 95%CI 1.14-1.78) and Hispanic ethnicity (OR 1.81, 95%CI 1.50-2.18) were identified as risk factors for admission, but, among discharged patients, age-adjusted in-hospital mortality was not significantly different among racial and ethnic groups. This observational study identified, among people testing positive for SARS-CoV-2 infection, older age and male sex as the most strongly associated risks for admission and in-hospital mortality in patients with SARS-CoV-2 infection. 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Of admitted patients, 2152 (99.9%) had a discharge disposition at the end of the study period. Of these, 329 (15.3%) required invasive mechanical ventilation and 305 (14.2%) expired. Increased age and male sex were positively associated with admission and in-hospital mortality (median age 80.7 years), while comorbidities had a much weaker association with the risk of admission or mortality. Black race (OR 1.43, 95%CI 1.14-1.78) and Hispanic ethnicity (OR 1.81, 95%CI 1.50-2.18) were identified as risk factors for admission, but, among discharged patients, age-adjusted in-hospital mortality was not significantly different among racial and ethnic groups. This observational study identified, among people testing positive for SARS-CoV-2 infection, older age and male sex as the most strongly associated risks for admission and in-hospital mortality in patients with SARS-CoV-2 infection. 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Ongoing studies will be needed to continue to evaluate these risks, particularly in the setting of evolving treatment guidelines.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bioinformatics</subject><subject>Biology and life sciences</subject><subject>Cohort Studies</subject><subject>Computational neuroscience</subject><subject>Computer programs</subject><subject>Computer science</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - mortality</subject><subject>COVID-19 - therapy</subject><subject>COVID-19 Testing</subject><subject>Critical care</subject><subject>Data analysis</subject><subject>Diagnosis</subject><subject>Editing</subject><subject>Emergency medical care</subject><subject>Emergency medical 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characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection</title><author>McPadden, Jacob ; Warner, Frederick ; Young, H Patrick ; Hurley, Nathan C ; Pulk, Rebecca A ; Singh, Avinainder ; Durant, Thomas J S ; Gong, Guannan ; Desai, Nihar ; Haimovich, Adrian ; Taylor, Richard Andrew ; Gunel, Murat ; Dela Cruz, Charles S ; Farhadian, Shelli F ; Siner, Jonathan ; Villanueva, Merceditas ; Churchwell, Keith ; Hsiao, Allen ; Torre, Jr, Charles J ; Velazquez, Eric J ; Herbst, Roy S ; Iwasaki, Akiko ; Ko, Albert I ; Mortazavi, Bobak J ; Krumholz, Harlan M ; Schulz, Wade L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-fbf057c651e6572e0cb8a482f895e216af0854b3a6c4d5ceddac2657223b17573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bioinformatics</topic><topic>Biology and life sciences</topic><topic>Cohort Studies</topic><topic>Computational neuroscience</topic><topic>Computer programs</topic><topic>Computer science</topic><topic>COVID-19 - diagnosis</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - mortality</topic><topic>COVID-19 - therapy</topic><topic>COVID-19 Testing</topic><topic>Critical care</topic><topic>Data analysis</topic><topic>Diagnosis</topic><topic>Editing</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Epidemics</topic><topic>Epidemiology</topic><topic>Evaluation</topic><topic>Female</topic><topic>Funding</topic><topic>Genetics</topic><topic>Genomes</topic><topic>Health policy</topic><topic>Health risks</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Information technology</topic><topic>Interdisciplinary research</topic><topic>Interdisciplinary studies</topic><topic>Internal medicine</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine and health sciences</topic><topic>Methodology</topic><topic>Microorganisms</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neurosurgery</topic><topic>Pathogenesis</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>People and Places</topic><topic>Prognosis</topic><topic>Public health</topic><topic>Respiratory diseases</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Severe acute respiratory syndrome</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Sleep</topic><topic>Suburban areas</topic><topic>Supervision</topic><topic>Treatment Outcome</topic><topic>United States</topic><topic>Urban areas</topic><topic>Viral diseases</topic><topic>Viruses</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McPadden, Jacob</creatorcontrib><creatorcontrib>Warner, Frederick</creatorcontrib><creatorcontrib>Young, H Patrick</creatorcontrib><creatorcontrib>Hurley, Nathan C</creatorcontrib><creatorcontrib>Pulk, Rebecca A</creatorcontrib><creatorcontrib>Singh, Avinainder</creatorcontrib><creatorcontrib>Durant, Thomas J S</creatorcontrib><creatorcontrib>Gong, Guannan</creatorcontrib><creatorcontrib>Desai, Nihar</creatorcontrib><creatorcontrib>Haimovich, Adrian</creatorcontrib><creatorcontrib>Taylor, Richard Andrew</creatorcontrib><creatorcontrib>Gunel, Murat</creatorcontrib><creatorcontrib>Dela Cruz, Charles S</creatorcontrib><creatorcontrib>Farhadian, Shelli F</creatorcontrib><creatorcontrib>Siner, Jonathan</creatorcontrib><creatorcontrib>Villanueva, Merceditas</creatorcontrib><creatorcontrib>Churchwell, Keith</creatorcontrib><creatorcontrib>Hsiao, Allen</creatorcontrib><creatorcontrib>Torre, Jr, Charles J</creatorcontrib><creatorcontrib>Velazquez, Eric J</creatorcontrib><creatorcontrib>Herbst, Roy S</creatorcontrib><creatorcontrib>Iwasaki, Akiko</creatorcontrib><creatorcontrib>Ko, Albert I</creatorcontrib><creatorcontrib>Mortazavi, Bobak J</creatorcontrib><creatorcontrib>Krumholz, Harlan M</creatorcontrib><creatorcontrib>Schulz, Wade L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing &amp; Allied Health 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titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McPadden, Jacob</au><au>Warner, Frederick</au><au>Young, H Patrick</au><au>Hurley, Nathan C</au><au>Pulk, Rebecca A</au><au>Singh, Avinainder</au><au>Durant, Thomas J S</au><au>Gong, Guannan</au><au>Desai, Nihar</au><au>Haimovich, Adrian</au><au>Taylor, Richard Andrew</au><au>Gunel, Murat</au><au>Dela Cruz, Charles S</au><au>Farhadian, Shelli F</au><au>Siner, Jonathan</au><au>Villanueva, Merceditas</au><au>Churchwell, Keith</au><au>Hsiao, Allen</au><au>Torre, Jr, Charles J</au><au>Velazquez, Eric J</au><au>Herbst, Roy S</au><au>Iwasaki, Akiko</au><au>Ko, Albert I</au><au>Mortazavi, Bobak J</au><au>Krumholz, Harlan M</au><au>Schulz, Wade L</au><au>Di Gennaro, Francesco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-03-31</date><risdate>2021</risdate><volume>16</volume><issue>3</issue><spage>e0243291</spage><epage>e0243291</epage><pages>e0243291-e0243291</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Severe acute respiratory syndrome virus (SARS-CoV-2) has infected millions of people worldwide. Our goal was to identify risk factors associated with admission and disease severity in patients with SARS-CoV-2. This was an observational, retrospective study based on real-world data for 7,995 patients with SARS-CoV-2 from a clinical data repository. Yale New Haven Health (YNHH) is a five-hospital academic health system serving a diverse patient population with community and teaching facilities in both urban and suburban areas. The study included adult patients who had SARS-CoV-2 testing at YNHH between March 1 and April 30, 2020. Primary outcomes were admission and in-hospital mortality for patients with SARS-CoV-2 infection as determined by RT-PCR testing. We also assessed features associated with the need for respiratory support. Of the 28605 patients tested for SARS-CoV-2, 7995 patients (27.9%) had an infection (median age 52.3 years) and 2154 (26.9%) of these had an associated admission (median age 66.2 years). Of admitted patients, 2152 (99.9%) had a discharge disposition at the end of the study period. Of these, 329 (15.3%) required invasive mechanical ventilation and 305 (14.2%) expired. Increased age and male sex were positively associated with admission and in-hospital mortality (median age 80.7 years), while comorbidities had a much weaker association with the risk of admission or mortality. Black race (OR 1.43, 95%CI 1.14-1.78) and Hispanic ethnicity (OR 1.81, 95%CI 1.50-2.18) were identified as risk factors for admission, but, among discharged patients, age-adjusted in-hospital mortality was not significantly different among racial and ethnic groups. This observational study identified, among people testing positive for SARS-CoV-2 infection, older age and male sex as the most strongly associated risks for admission and in-hospital mortality in patients with SARS-CoV-2 infection. While minority racial and ethnic groups had increased burden of disease and risk of admission, age-adjusted in-hospital mortality for discharged patients was not significantly different among racial and ethnic groups. Ongoing studies will be needed to continue to evaluate these risks, particularly in the setting of evolving treatment guidelines.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33788846</pmid><doi>10.1371/journal.pone.0243291</doi><tpages>e0243291</tpages><orcidid>https://orcid.org/0000-0003-1107-8148</orcidid><orcidid>https://orcid.org/0000-0003-1717-005X</orcidid><orcidid>https://orcid.org/0000-0001-7230-1409</orcidid><orcidid>https://orcid.org/0000-0003-2384-2545</orcidid><orcidid>https://orcid.org/0000-0003-2245-7477</orcidid><orcidid>https://orcid.org/0000-0002-4972-6705</orcidid><orcidid>https://orcid.org/0000-0003-2046-127X</orcidid><orcidid>https://orcid.org/0000-0001-8625-181X</orcidid><orcidid>https://orcid.org/0000-0002-0348-7593</orcidid><orcidid>https://orcid.org/0000-0003-2535-5847</orcidid><orcidid>https://orcid.org/0000-0001-5588-7372</orcidid><orcidid>https://orcid.org/0000-0002-2655-2095</orcidid><orcidid>https://orcid.org/0000-0002-2048-4028</orcidid><orcidid>https://orcid.org/0000-0003-0949-9699</orcidid><orcidid>https://orcid.org/0000-0002-8080-0002</orcidid><orcidid>https://orcid.org/0000-0002-7824-9856</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Aged
Aged, 80 and over
Bioinformatics
Biology and life sciences
Cohort Studies
Computational neuroscience
Computer programs
Computer science
COVID-19 - diagnosis
COVID-19 - epidemiology
COVID-19 - mortality
COVID-19 - therapy
COVID-19 Testing
Critical care
Data analysis
Diagnosis
Editing
Emergency medical care
Emergency medical services
Epidemics
Epidemiology
Evaluation
Female
Funding
Genetics
Genomes
Health policy
Health risks
Hospital Mortality
Hospitals
Humans
Infectious diseases
Information technology
Interdisciplinary research
Interdisciplinary studies
Internal medicine
Laboratories
Male
Medicine
Medicine and health sciences
Methodology
Microorganisms
Middle Aged
Mortality
Neurosurgery
Pathogenesis
Patient outcomes
Patients
Pediatrics
People and Places
Prognosis
Public health
Respiratory diseases
Retrospective Studies
Risk factors
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
Sleep
Suburban areas
Supervision
Treatment Outcome
United States
Urban areas
Viral diseases
Viruses
Young Adult
title Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection
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