Outcomes of COVID-19 With the Mayo Clinic Model of Care and Research

Published on
Journal: Mayo Clinic proceedings
[저자] John Charles O’Horo, James R. Cerhan, Elliot J. Cahn, Philippe R. Bauer, Zelalem Temesgen, Jon Ebbert, Andy Abril, Omar M. Abu Saleh, Mariam Assi, Elie F. Berbari, Dennis M. Bierle, Wendelyn Bosch, Charles D. Burger, Edison J. Cano Cevallos, Casey M. Clements, Eva M. Carmona Porquera, Natalia E. Castillo Almeida, Douglas W. Challener, Supavit Chesdachai, Isin Y. Comba, Cristina G. Corsini Campioli, Sarah J. Crane, Ala S. Dababneh, Mark J. Enzler, Hind J. Fadel, Ravindra Ganesh, Alice Gallo De Moraes, John R. Go, Joel E. Gordon, Pooja R. Gurram, Pramod K. Guru, Erika L. Halverson, Michael F. Harrison, Heather A. Heaton, Ryan Hurt, Mary J. Kasten, Augustine S. Lee, Emily R. Levy, Claudia R. Libertin, Jorge M. Mallea, William F. Marshall, Gautam Matcha, Anne M. Meehan, Pablo Moreno Franco, William G. Morice, Jennifer J. O’Brien, Richard Oeckler, Steve Ommen, Caitlin P. Oravec, Robert Orenstein, Natalie J. Ough, Raj Palraj, Bhavesh M. Patel, Vincent S. Pureza, Brian Pickering, David M. Phelan, Raymund R. Razonable, Stacey Rizza, Priya Sampathkumar, Devang K. Sanghavi, Ayan Sen, Jason L. Siegel, Kai Singbartl, Aditya S. Shah, FNU Shweta, Leigh L. Speicher, Gina Suh, Hussam Tabaja, Aaron Tande, Henry H. Ting, Russell C. Tontz, James J. Vaillant, Paschalis Vergidis, Mohamed Y. Warsame, Zachary A. Yetmar, Catherine (Cate) D. Zomok, Amy W. Williams, Andrew D. Badley
[Category] MERS, SARS,
PMC URL    Pubmed URL    [DOI] 10.1016/j.mayocp.2020.12.006    
[Article Type] Multicenter Study
[Source] PMC

Objective To report the Mayo Clinic experience with coronavirus disease 2019 (COVID-19) related to patient outcomes. Methods We conducted a retrospective chart review of patients with COVID-19 diagnosed between March 1, 2020, and July 31, 2020, at any of the Mayo Clinic sites. We abstracted pertinent comorbid conditions such as age, sex, body mass index, Charlson Comorbidity Index variables, and treatments received. Factors associated with hospitalization and mortality were assessed in univariate and multivariate models. Results A total of 7891 patients with confirmed COVID-19 infection with research authorization on file received care across the Mayo Clinic sites during the study period. Of these, 7217 patients were adults 18 years or older who were analyzed further. A total of 897 (11.4%) patients required hospitalization, and 354 (4.9%) received care in the intensive care unit (ICU). All hospitalized patients were reviewed by a COVID-19 Treatment Review Panel, and 77.5% (695 of 897) of inpatients received a COVID-19–directed therapy. Overall mortality was 1.2% (94 of 7891), with 7.1% (64 of 897) mortality in hospitalized patients and 11.3% (40 of 354) in patients requiring ICU care. Conclusion Mayo Clinic outcomes of patients with COVID-19 infection in the ICU, hospital, and community compare favorably with those reported nationally. This likely reflects the impact of interprofessional multidisciplinary team evaluation, effective leveraging of clinical trials and available treatments, deployment of remote monitoring tools, and maintenance of adequate operating capacity to not require surge adjustments. These best practices can help guide other health care systems with the continuing response to the COVID-19 pandemic.

All Keywords
【저자키워드】 COVID-19, Coronavirus disease 2019, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2, OR, odds ratio, ARDS, acute respiratory distress syndrome, BMI, Body mass index, ICU, Intensive care unit, LOS, length of stay, NIH, National Institutes of Health, EHR, electronic health record, ECMO, extracorporeal membrane oxygenation, SOFA, sequential organ failure assessment, APACHE IV, Acute Physiology and Chronic Health Evaluation IV, CCI, Charlson Comorbidity Index, EAP, Expanded Access Program, ICD-10, International Classification of Diseases, Tenth Revision,