This prospective observational cohort study presents information on the epidemiology, clinical course, and outcomes of critically ill patients with COVID-19 in New York City.
The study took place at two New York-Presbyterian hospitals affiliated with Columbia University Irving Medical Center in northern Manhattan. The authors prospectively identified 1150 adult patients (aged ≥18 years) who were admitted to both hospitals from March 2 to April 1, 2020 with diagnosed, laboratory-confirmed COVID-19. Outcomes included rate of in-hospital death, frequency and duration of invasive mechanical ventilation, frequency of vasopressor use and renal replacement therapy, and time to in-hospital clinical deterioration following admission.
Of the 1150 patients:
- 57 (22%) were critically ill
- The median age was 62 years (IQR 51–72)
- 171 (67%) were men
- 212 (82%) had at least one chronic illness, the most common of which were hypertension (162 [63%]) and diabetes (92 [36%])
- 119 (46%) had obesity
- As of April 28, 2020, 101 (39%) patients had died and 94 (37%) remained hospitalised
- 203 (79%) patients received invasive mechanical ventilation for a median of 18 days (IQR 9–28)
- 170 (66%) of 257 patients received vasopressors and 79 (31%) received renal replacement therapy
- The median time to in-hospital deterioration was 3 days (IQR 1–6)
Using cox proportional hazards regression, the following factors were independently associated with in-hospital mortality: older age (adjusted hazard ratio [aHR] 1.31 [1.09–1.57] per 10-year increase), chronic cardiac disease (aHR 1.76 [1.08–2.86]), chronic pulmonary disease (aHR 2.94 [1.48–5.84]), higher concentrations of interleukin-6 (aHR 1.11 [95%CI 1.02–1.20] per decile increase), and higher concentrations of D-dimer (aHR 1.10 [1.01–1.19] per decile increase).