Abstract
Objectives: To describe the demographics, clinical characteristics, and outcomes of hospitalized adults with coronavirus disease 2019 (COVID-19) in an academic medical center in the southern United States.
Methods: Retrospective, observational cohort study of all adult patients (18 years and older) consecutively admitted with laboratory-confirmed severe acute respiratory syndrome-coronavirus-2 infection between March 13 and April 25, 2020 at the University of Mississippi Medical Center. All of the patients either survived to hospital discharge or died during hospitalization. Demographics, body mass index, comorbidities, clinical manifestations, and laboratory findings were collected. Patient outcomes (need for invasive mechanical ventilation and in-hospital death) were analyzed.
Results: One hundred patients were included, 53% of whom were women. Median age was 59 years (interquartile range 44-70) and 66% were younger than 65. Seventy-five percent identified themselves as Black, despite representing 58% of hospitalized patients at our institution in 2019. Common comorbid conditions included hypertension (68%), obesity (65%), and diabetes mellitus (31%). Frequent clinical manifestations included shortness of breath (76%), cough (75%), and fever (64%). Symptoms were present for a median of 7 days (interquartile range 4-7) on presentation. Twenty-four percent of patients required mechanical ventilation and, overall, 19% died (67% of those requiring mechanical ventilation). Eighty-four percent of those who died were Black. On multivariate analysis, ever smoking (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.2-28.6) and history of diabetes mellitus (OR 5.9, 95% CI 1.5-24.3) were associated with mortality, and those admitted from home were less likely to die (vs outside facility, OR 0.2, 95% CI 0.0-0.7). Neither age, sex, race, body mass index, insurance status, nor rural residence was independently associated with mortality.
Conclusions: Our study adds evidence that Black patients appear to be overrepresented in those hospitalized with and those who die from COVID-19, likely a manifestation of adverse social determinants of health. These findings should help guide preventive interventions targeting groups at higher risk of acquiring and developing severe COVID-19 disease.
【초록키워드】 COVID-19, coronavirus disease, Hospitalized, Mortality, mechanical ventilation, Hospitalization, Clinical characteristics, obesity, Infection, Comorbidities, Diabetes Mellitus, Sex, outcome, smoking, cough, hypertension, Laboratory, clinical manifestations, body mass index, Health, Fever, Patient, age, women, United States, group, university, severe COVID-19 disease, Evidence, Invasive mechanical ventilation, Analysis, Odds ratio, demographics, clinical manifestation, In-hospital death, Shortness of breath, preventive intervention, black, Observational cohort study, interquartile range, Older, higher risk, 95% CI, 95% confidence interval, hospital discharge, help, center, laboratory-confirmed, common, analyzed, collected, died, the patient, required, median, less, hospitalized patient, representing, survived, Black patient, comorbid condition, social determinant, 【제목키워드】 clinical, experience, center,