NEW YORK, May 26, 2020 /PRNewswire/ -- A team of investigators at NYU Langone Health determined that just over half of 5,279 patients who tested positive for COVID-19 were hospitalized -- and nearly a quarter of those hospitalized died or were discharged to hospice, including 60 percent who required ventilators.
The study -- recently published online in The BMJ -- is the most complete report of outcomes for COVID-19 hospitalized patients in the United States to date, according to the authors. The investigators found that while age and comorbidities were strong predictors of hospitalization, critical illness and death, patients with low levels of blood oxygen (88 percent or lower) upon admission, and those with markers of inflammation such as elevations in c-reactive protein (a substance produced by the liver in response to inflammation), were most likely to have the worst outcomes during hospitalization.
"Our findings provide a rich understanding of the characteristics of people most at risk for poor outcomes once they are hospitalized with COVID-19," says Leora Horwitz, MD, associate professor in the Departments of Population Health and Medicine, director of the Center for Healthcare Innovation and Delivery Science at NYU Langone Health, and the study's senior author. "We demonstrated that age, being male, being severely obese and having certain chronic diseases like heart failure and kidney disease put patients at high risk for hospitalization for COVID-19. We also showed that the degree of oxygen impairment and markers of inflammation in patients were most strongly associated with poor outcomes during hospitalization."
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As a result, Horwitz says clinicians should routinely test COVID-19 patients for inflammatory markers throughout their hospitalization. Another challenge, according to Horwitz, is that many study patients did not notice their oxygen levels were low. "If more people could monitor oxygen levels at home and come to the hospital earlier, perhaps that could improve their outcomes," says Horwitz.
Responding to a Pandemic: How the Study Was Conducted
Investigators obtained all data from NYU Langone's electronic health record (EHR) of inpatient and outpatient visits at the system's 260 outpatient office sites and four acute care hospitals in Manhattan, Brooklyn, and Long Island. For data on tobacco use, body mass index (BMI) and comorbidities, the researchers included data in the EHR entered during prior inpatient or outpatient visits.