- Critical COVID-19 illness was more common among racial and ethnic minorities in this study of patients in New York City.
- These authors identified IL-6 and D-dimers as independent predictors of increased mortality risk.
Why this matters
- Related editorial notes "relatively high" proportion of patients age accompanying comorbidities that might be factors.
- 257 patients were critically ill.
- Median age, 62 years (interquartile range [IQR], 51-72).
- 67% were men.
- 62% were Hispanic/Latino.
- 82% had >1 comorbidity (hypertension, diabetes most common).
- 39% died.
- 79% (203/257) received invasive mechanical ventilation (median, 18 days; IQR, 9-28 days).
- 41% (84/203) of these patients died.
- 37% (94/257) remained hospitalized at publication (median duration, 33 days; IQR, 29-36 days).
- Medications: 66% vasopressors, 72% hydroxychloroquine, 9% remdesivir, 89% antibacterials, 26% corticosteroids, 17% IL-6 receptor antagonist.
- On multivariate analysis, risk factors (adjusted HRs; 95% CIs) independently associated with in-hospital mortality included:
- Older age: 1.31 (1.09-1.57) for each 10-year increase.
- Chronic cardiovascular disease: 1.76 (1.08-2.86).
- Chronic pulmonary disease: 2.94 (1.48-5.84).
- Elevated IL-6: 1.11 (1.02-1.20).
- Elevated D-dimer: 1.10 (1.01-1.19).
- Prospective, observational, cohort study, including critically ill adults hospitalized with laboratory-confirmed COVID-19, March 2-April 1, 2020 (follow-up ended April 28).
- Funding: National Institute of Allergy and Infectious Diseases; others.
- Limited generalizability.
- Unexplored confounders.
- Underestimated in-hospital mortality rate.