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518. Factors Associated with Severe COVID-19 among Patients Hospitalized in Rhode Island

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Background: To better understand patient factors that impact clinical outcomes in COVID-19, we performed a retrospective cohort study of patients hospitalized with COVID-19 in Rhode Island to identify patient and… Click to show full abstract

Background: To better understand patient factors that impact clinical outcomes in COVID-19, we performed a retrospective cohort study of patients hospitalized with COVID-19 in Rhode Island to identify patient and clinical characteristics associated with severe disease Methods: We analyzed 259 patients admitted to our academic medical center during a three month period with confirmed COVID-19 Clinical data was extracted via chart review and lab results within the first 24 hours of admission were extracted directly from electronic medical records Patients were divided in two groups based upon the highest level of supplemental oxygen (O2) required during hospitalization: severe COVID-19 (high flow O2, non-invasive, or invasive mechanical ventilation) and non-severe COVID-19 (low flow O2 or no supplemental O2) SAS 9 4 (Cary, NC) was used for statistical analyses Chi-square or Fisher's exact tests for categorical variables and the Student's t-test for continuous variables were used to compare demographics, baseline comorbidities, and clinical data between the severe and non-severe groups Results: Of 259 patients, 166 (64%) had non-severe disease, and 93 (36%) severe disease;median age [IQR] was 62 [51,73] There were 138(53%) males and 75 (29%) Hispanics Among non-Hispanics,124(48%) were White, 48(19%) African Americans, and 12(5%) other races Sixty (23%) were admitted from a nursing facility and the in-hospital mortality rate was 15% (38/259) Severe COVID-19 was associated with older age (p=0 02), admission from nursing facility (p=0 009), increased BMI (p=0 03), diabetes mellitus (p=0 0002), and COPD (p=0 03) At the time of presentation, severe COVID-19 was associated with tachypnea, hypoxia, hypotension (all p< 0 0001), elevated BUN (p=0 002) and AST (p=0 001), and acute or chronic kidney injury (p=0 01) Median hospital stay [IQR] was 11 days [7,18] in the severe vs 6 days [3,11] in the non-severe group In the severe group, 72% required ICU admission and 39% died Conclusion: In this cohort of patients with COVID-19, specific comorbidities, and vital signs at presentation were associated with severe COVID-19 These findings help clinicians with early identification and triage of high risk patients (Table Presented)

Keywords: non severe; covid; patients hospitalized; rhode island; severe covid; associated severe

Journal Title: Open Forum Infectious Diseases
Year Published: 2020

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