Open AccessClinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection
Author(s) -
Jacob McPadden,
Frederick Warner,
H. Patrick Young,
Nathan C. Hurley,
Rebecca Pulk,
Avinainder Singh,
Thomas J S Durant,
Guannan Gong,
Nihar R. Desai,
Adrian D. Haimovich,
Richard A. Taylor,
Murat Günel,
Charles S. Dela Cruz,
Shelli Farhadian,
Jonathan Siner,
Merceditas Villanueva,
Keith Churchwell,
Allen Hsiao,
Charles J Torre,
Eric J. Velázquez,
Roy S. Herbst,
Akiko Iwasaki,
Albert Icksang Ko,
Bobak J. Mortazavi,
Harlan M. Krumholz,
Wade Schulz
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0243291
Subject(s) - medicine , retrospective cohort study , population , mechanical ventilation , observational study , pediatrics , young adult , emergency medicine , environmental health
Objective 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. Design This was an observational, retrospective study based on real-world data for 7,995 patients with SARS-CoV-2 from a clinical data repository. Setting 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. Populations The study included adult patients who had SARS-CoV-2 testing at YNHH between March 1 and April 30, 2020. Main outcome and performance measures 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. Results 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. Conclusions 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.