Apri 22 2020
Richardson and co-authors published results of investigation titled ”Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area”. The study subjects were consecutively admitted.
The findings confirm a number of facts, which became common knowledge in the last 3 months:
Age is the important predictor of mortality:
100% of the patients younger than 20 years were discharged alive;
63.6% of males and 46.4% of females >90 y.o. died;
60.6% of males and 48.1% of females between 80 - 89 y.o. died;
35.8% of males and 27.4% of females between 70 - 79 y.o. died;
35.8% of males and 27.4% of females between 70 - 79 y.o. died;
18.7% of males and 12% of females between 60- 69 y.o. died;
Majority of patients had co-morbidities:
only 6.1% had NO co-morbidities;
88% had >1 comorbidity:
56.6% had hypertension;
41.7% were obese with BMI>30;
33.8% had diabetes;
19% were morbidly obese with BMI>35;
11.1% had coronary artery disease;
9% had asthma;
6.9% had heart failure;
6% had cancer;
5.4% had COPD;
5% had chronic kidney disease;
3.5% had end-stage kidney disease;
2.9% had sleep apnea;
1% had a history of the transplant;
0.8% had HIV;
The mortality was highest amongst patients:
Admitted to ICU - 85.8%;
Requiring ventilation - 87.8%;
Only 11.7% of those who did not receive ventilation died;
There were several important take-aways:
The majority of patients did not meet criteria for admission but were admitted anyway thus explaining hospital overrun:
69.3% of patients had temperature <38 C;
79.6% of patients had oxygen saturation >90% with a mean saturation of 95%;
2.1% out of 1,996 tested had co-morbid viral infections, including 16.7% of patient who had no-COVID-19 coronavirus;
It is safe to use of Angiotensin-Converting Enzyme Inhibitor (ACEi) and Angiotensin II Receptor Blocker (ARB):
48.1% continued taking ACEi in the hospital;
50.1% continued taking ARB in the hospital;
There was no difference in mortality rates for patients with hypertension not taking an ACEi or ARB, taking an ACEi, and taking an ARB: 26.7%, 32.7%, and 30.6%, respectively.