COVID-19: US study finds 1 in 10 mortality rate among hospitalized patients in short term

  • Richardson S & al.
  • JAMA
  • 22 Apr 2020

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A US study of 5700 patients with COVID-19 hospitalized in New York City finds that of 2634 patients who had been discharged or died at administration censoring, 553 (21%) had died and 2081 (79%) had been discharged.
  • The remaining 3066 patients were still alive at the study's short median 4.5-day follow-up (interquartile range, 2.4-8.1 days), for an overall short-term mortality of 9.7%.

Why this matters

  • This study is the first large US prospective case series.

Study design

  • Prospective case-series (N=5700) of patients with COVID-19 (PCR-confirmed SARS-CoV-2 positive) admitted to 12 hospitals in the New York City area, March 1-April 4, 2020.
  • Authors focused on a subset of 2634 patients who had either been discharged or died by April 4, 2020 (study cutoff date).
  • Funding: NIH.

Key results

  • Overall cohort (5700 patients):
    • Median age, 63 years; 39.7% female.
    • At triage (case presentation), 30.7% were febrile, 17.3% had a respiratory rate >24 breaths/minute, and 27.8% received supplemental oxygen.
    • Most common comorbidities:
      • Hypertension, 56.6%.
      • Obesity, 41.7%.
      • Diabetes, 33.8%.
    • Rate of respiratory virus coinfection, 2.1%.
    • 1151 (20.2%) required invasive mechanical ventilation.
      • Of these 1151 patients, at study cutoff, 38 (3.3%) had been discharged alive, 282 (24.5%) had died, and 831 (72.2%) were still hospitalized.
    • 5147 (90.3%) were still alive at study cutoff.
  • In the subset of 2634 patients discharged alive or who had died at study administrative cutoff (April 4, 2020):
    • 373 (14.2%; median age, 68 years) were treated in the ICU.
    • 320 (12.2%) received invasive mechanical ventilation.
    • 81 (3.2%) were treated with kidney replacement therapy. 
    • 553 (21%) had died; 2081 (79%) had been discharged.
    • No deaths were reported among patients aged

Limitations

  • Case-series.
  • Observational design.
  • Very short follow-up.