Tags

Type your tag names separated by a space and hit enter

Clinical Course and Factors Associated With Hospitalization and Critical Illness Among COVID-19 Patients in Chicago, Illinois.
Acad Emerg Med. 2020 Aug 06 [Online ahead of print]AE

Abstract

BACKGROUND

SARS-CoV-2 is a global pandemic associated with significant morbidity and mortality. However, information from United States cohorts is limited. Understanding predictors of admission and critical illness in these patients is essential to guide prevention and risk stratification strategies.

METHODS

This was a retrospective, registry-based cohort study including all patients presenting to Rush University Medical Center in Chicago, Illinois, with COVID-19 from March 4, 2020 to June 21, 2020. Demographic, clinical, laboratory, and treatment data were obtained from the registry and compared between hospitalized and nonhospitalized patients as well as those with critical illness. We used logistic regression modeling to explore risk factors associated with hospitalization and critical illness.

RESULTS

A total of 8,673 COVID-19 patients were included in the study, of whom 1,483 (17.1%) were admitted to the hospital and 528 (6.1%) were admitted to the intensive care unit. Risk factors for hospital admission included advanced age, male sex (odds ratio [OR] = 1.69, 95% confidence interval [CI] = 1.44 to 1.98), Hispanic/Latino ethnicity (OR = 1.52, 95% CI = 1.18 to 1.92), hypertension (OR = 1.77, 95% CI = 1.46 to 2.16), diabetes mellitus (OR = 1.84, 95% CI = 1.53 to 2.22), prior CVA (OR = 3.20, 95% CI = 1.99 to 5.14), coronary artery disease (OR = 1.45, 95% CI = 1.03 to 2.06), heart failure (OR = 1.79, 95% CI = 1.23 to 2.61), chronic kidney disease (OR = 2.60, 95% CI = 1.77 to 3.83), end-stage renal disease (OR = 2.22, 95% CI = 1.12 to 4.41), cirrhosis (OR = 2.03, 95% CI = 1.42 to 2.91), fever (OR = 1.43, 95% CI = 1.19 to 1.71), and dyspnea (OR = 4.53, 95% CI = 3.75 to 5.47). Factors associated with critical illness included male sex (OR = 1.45, 95% CI = 1.12 to 1.88), congestive heart failure (OR = 1.45, 95% CI = 1.00 to 2.12), obstructive sleep apnea (OR = 1.58, 95% CI = 1.07 to 2.33), blood-borne cancer (OR = 3.53, 95% CI = 1.26 to 9.86), leukocytosis (OR = 1.53, 95% CI = 1.15 to 2.17), elevated neutrophil-to-lymphocyte ratio (OR = 1.61, 95% CI = 1.20 to 2.17), hypoalbuminemia (OR = 1.80, 95% CI = 1.39 to 2.32), elevated AST (OR = 1.66, 95% CI = 1.20 to 2.29), elevated lactate (OR = 1.95, 95% CI = 1.40 to 2.73), elevated D-Dimer (OR = 1.44, 95% CI = 1.05 to 1.97), and elevated troponin (OR = 3.65, 95% CI = 2.03 to 6.57).

CONCLUSION

There are a number of factors associated with hospitalization and critical illness. Clinicians should consider these factors when evaluating patients with COVID-19.

Authors+Show Affiliations

From the, Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA.the, Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, IL, USA.and the, Department of Cell and Molecular Medicine, Rush University Medical Center, Chicago, IL, USA.From the, Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA.the, Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, IL, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32762106

Citation

Gottlieb, Michael, et al. "Clinical Course and Factors Associated With Hospitalization and Critical Illness Among COVID-19 Patients in Chicago, Illinois." Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 2020.
Gottlieb M, Sansom S, Frankenberger C, et al. Clinical Course and Factors Associated With Hospitalization and Critical Illness Among COVID-19 Patients in Chicago, Illinois. Acad Emerg Med. 2020.
Gottlieb, M., Sansom, S., Frankenberger, C., Ward, E., & Hota, B. (2020). Clinical Course and Factors Associated With Hospitalization and Critical Illness Among COVID-19 Patients in Chicago, Illinois. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. https://doi.org/10.1111/acem.14104
Gottlieb M, et al. Clinical Course and Factors Associated With Hospitalization and Critical Illness Among COVID-19 Patients in Chicago, Illinois. Acad Emerg Med. 2020 Aug 6; PubMed PMID: 32762106.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical Course and Factors Associated With Hospitalization and Critical Illness Among COVID-19 Patients in Chicago, Illinois. AU - Gottlieb,Michael, AU - Sansom,Sarah, AU - Frankenberger,Casey, AU - Ward,Edward, AU - Hota,Bala, Y1 - 2020/08/06/ PY - 2020/05/21/received PY - 2020/07/11/revised PY - 2020/08/01/accepted PY - 2020/8/8/pubmed PY - 2020/8/8/medline PY - 2020/8/8/entrez JF - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine JO - Acad Emerg Med N2 - BACKGROUND: SARS-CoV-2 is a global pandemic associated with significant morbidity and mortality. However, information from United States cohorts is limited. Understanding predictors of admission and critical illness in these patients is essential to guide prevention and risk stratification strategies. METHODS: This was a retrospective, registry-based cohort study including all patients presenting to Rush University Medical Center in Chicago, Illinois, with COVID-19 from March 4, 2020 to June 21, 2020. Demographic, clinical, laboratory, and treatment data were obtained from the registry and compared between hospitalized and nonhospitalized patients as well as those with critical illness. We used logistic regression modeling to explore risk factors associated with hospitalization and critical illness. RESULTS: A total of 8,673 COVID-19 patients were included in the study, of whom 1,483 (17.1%) were admitted to the hospital and 528 (6.1%) were admitted to the intensive care unit. Risk factors for hospital admission included advanced age, male sex (odds ratio [OR] = 1.69, 95% confidence interval [CI] = 1.44 to 1.98), Hispanic/Latino ethnicity (OR = 1.52, 95% CI = 1.18 to 1.92), hypertension (OR = 1.77, 95% CI = 1.46 to 2.16), diabetes mellitus (OR = 1.84, 95% CI = 1.53 to 2.22), prior CVA (OR = 3.20, 95% CI = 1.99 to 5.14), coronary artery disease (OR = 1.45, 95% CI = 1.03 to 2.06), heart failure (OR = 1.79, 95% CI = 1.23 to 2.61), chronic kidney disease (OR = 2.60, 95% CI = 1.77 to 3.83), end-stage renal disease (OR = 2.22, 95% CI = 1.12 to 4.41), cirrhosis (OR = 2.03, 95% CI = 1.42 to 2.91), fever (OR = 1.43, 95% CI = 1.19 to 1.71), and dyspnea (OR = 4.53, 95% CI = 3.75 to 5.47). Factors associated with critical illness included male sex (OR = 1.45, 95% CI = 1.12 to 1.88), congestive heart failure (OR = 1.45, 95% CI = 1.00 to 2.12), obstructive sleep apnea (OR = 1.58, 95% CI = 1.07 to 2.33), blood-borne cancer (OR = 3.53, 95% CI = 1.26 to 9.86), leukocytosis (OR = 1.53, 95% CI = 1.15 to 2.17), elevated neutrophil-to-lymphocyte ratio (OR = 1.61, 95% CI = 1.20 to 2.17), hypoalbuminemia (OR = 1.80, 95% CI = 1.39 to 2.32), elevated AST (OR = 1.66, 95% CI = 1.20 to 2.29), elevated lactate (OR = 1.95, 95% CI = 1.40 to 2.73), elevated D-Dimer (OR = 1.44, 95% CI = 1.05 to 1.97), and elevated troponin (OR = 3.65, 95% CI = 2.03 to 6.57). CONCLUSION: There are a number of factors associated with hospitalization and critical illness. Clinicians should consider these factors when evaluating patients with COVID-19. SN - 1553-2712 UR - https://www.unboundmedicine.com/medline/citation/32762106/Clinical_Course_and_Factors_Associated_with_Hospitalization_and_Critical_Illness_Among_COVID-19_Patients_in_Chicago,_Illinois L2 - https://doi.org/10.1111/acem.14104 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.