Clinical characteristics of hospitalised patients with COVID-19 and the impact on mortality: a single-network, retrospective cohort study from Pennsylvania state

Kinjal P Gadhiya; Panupong Hansrivijit; Mounika Gangireddy; John D Goldman

doi:10.1136/bmjopen-2020-042549

Clinical characteristics of hospitalised patients with COVID-19 and the impact on mortality: a single-network, retrospective cohort study from Pennsylvania state

BMJ Open. 2021 Apr 8;11(4):e042549. doi: 10.1136/bmjopen-2020-042549. eCollection 2021.

Authors

Kinjal P Gadhiya^#¹, Panupong Hansrivijit^#¹, Mounika Gangireddy^#¹, John D Goldman²

Affiliations

¹ Department of Internal Medicine, UPMC Pinnacle, Harrisburg, Pennsylvania, USA.
² Department of Infectious Diseases, UPMC Pinnacle, Harrisburg, Pennsylvania, USA.

^# Contributed equally.

Abstract

Objective: COVID-19 is a respiratory disease caused by SARS-CoV-2 with the highest burden in the USA. Data on clinical characteristics of patients with COVID-19 in US population are limited. Thus, we aim to determine the clinical characteristics and risk factors for in-hospital mortality from COVID-19.

Design: Retrospective observational study.

Setting: Single-network hospitals in Pennsylvania state.

Participants: Patients with confirmed SARS-CoV-2 infection who were hospitalised from 1 March to 31 May 2020.

Primary and secondary outcome measures: Primary outcome was in-hospital mortality. Secondary outcomes were complications, such as acute kidney injury (AKI) and acute respiratory distress syndrome (ARDS).

Results: Of 283 patients, 19.4% were non-survivors. The mean age of all patients was 64.1±15.9 years. 56.2% were male and 50.2% were white. Several factors were identified from our adjusted multivariate analyses to be associated with in-hospital mortality: increasing age (per 1-year increment; OR 1.07 (1.045 to 1.105)), hypoxia (oxygen saturation <95%; OR 4.630 (1.934 to 1.111)), opacity/infiltrate on imaging (OR 3.077 (1.276 to 7.407)), leucocytosis (white blood cell >10 ^109/µL; OR 2.732 (1.412 to 5.263)), ferritin >336 ng/mL (OR 4.016 (1.195 to 13.514)), lactate dehydrogenase >200 U/L (OR 7.752 (1.639 to 37.037)), procalcitonin >0.25 ng/mL (OR 2.404 (1.011 to 5.714)), troponin I >0.03 ng/mL (OR 2.242 (1.080 to 4.673)), need for advanced oxygen support other than simple nasal cannula (OR 4.608-13.889 (2.053 to 31.250)), intensive care unit admission/transfer (OR 13.699 (6.135 to 30.303)), renal replacement therapy (OR 21.277 (5.025 to 90.909)), need for vasopressor (OR 22.222 (9.434 to 52.632)), ARDS (OR 23.810 (10.204 to 55.556)), respiratory acidosis (OR 7.042 (2.915 to 16.949)), and AKI (OR 3.571 (1.715 to 7.407)). When critically ill patients were analysed independently, increasing Sequential Organ Failure Assessment score (OR 1.544 (1.168 to 2.039)), AKI (OR 2.128 (1.111 to 6.667)) and ARDS (OR 6.410 (2.237 to 18.182)) were predictive of in-hospital mortality.

Conclusion: We reported the characteristics of ethnically diverse, hospitalised patients with COVID-19 from Pennsylvania state.

Keywords: adult intensive & critical care; internal medicine; microbiology.