Patel Sachin R, Mukkera Satyanarayana R, Tucker Lara, Vatsis Catherine, Poma Antonia, Ammar Ali, Vo Mai, Khan Rumi, Carlan Stephen
Critical Care Medicine Fellowship Program, Orlando Regional Medical Center, Orlando, FL.
University of Central Florida College of Medicine, Faculty and Academic Affairs Department, Orlando, FL.
Crit Care Explor. 2021 May 12;3(5):e0416. doi: 10.1097/CCE.0000000000000416. eCollection 2021 May.
Coronavirus disease 2019 continues to increase throughout the United States. Despite the rapid progression of the disease, there is limited information of the factors associated with mortality in Florida. This study aims to review the demographics, characteristics, comorbidities, complications, and outcomes of hospitalized patients, and their association with mortality.
Cohort study.
A community-based tertiary-care hospital of Orlando Health, Orlando Regional Medical Center.
PATIENTS/SUBJECTS: Data of hospitalized patients who tested positive for severe acute respiratory syndrome coronavirus 2 between March 1, 2020, and August 31, 2020, at the Orlando Regional Medical Center.
None.
Main data assessed included patient demographics, clinical characteristics, comorbidities, complications, outcomes, and inhospital mortality. The median age for hospitalized patients was 61 years; among them, 56% were males. Most were of African American ( = 288, 35.9%), Hispanic ( = 237, 29.6%), and Caucasian ( = 217, 27.1%) descent. More patients presented with symptoms developing at home ( = 589, 75.9%) than from skilled nursing and long-term acute care facilities. The most common comorbidities were diabetes mellitus (42.8%), obesity (39.2%), lung disease (23.3%), coronary artery disease (20.2%), and congestive heart failure (18.3%). Complications with higher odds of mortality were mechanical ventilation (odds ratio, 148.00, < 0.001), coinfections (odds ratio, 56.42, < 0.001), acute kidney injury (odds ratio, 84.01, < 0.001), atrial fibrillation (odds ratio, 28.30, < 0.001), acute myocardial infarction (odds ratio, 23.29, < 0.001), and acute venous thromboembolism (odds ratio, 26.43, < 0.001).
We identified an increase of severity of coronavirus disease 2019 within older patients of African American and Hispanic descent with comorbidities such as diabetes, coronary artery disease, congestive heart failure, chronic kidney disease, cancer, liver disease, or cerebrovascular disease. Noninvasive positive-pressure ventilation and high-flow nasal cannula oxygen may have helped avert mechanical ventilation, and this may have improved patient outcomes over the course of the study period.
2019冠状病毒病在美国持续蔓延。尽管该疾病进展迅速，但关于佛罗里达州与死亡率相关因素的信息有限。本研究旨在回顾住院患者的人口统计学特征、特点、合并症、并发症及预后情况，以及它们与死亡率的关联。
队列研究。
奥兰多健康中心的一家社区三级护理医院，奥兰多地区医疗中心。
患者/受试者：2020年3月1日至2020年8月31日期间在奥兰多地区医疗中心检测出严重急性呼吸综合征冠状病毒2呈阳性的住院患者数据。
无。
评估的主要数据包括患者人口统计学特征、临床特点、合并症、并发症、预后及住院死亡率。住院患者的中位年龄为61岁；其中，56%为男性。大多数患者为非裔美国人（n = 288，35.9%）、西班牙裔（n = 237，29.6%）和白种人（n = 217，27.1%）。在家中出现症状的患者（n = 589，75.9%）多于来自专业护理和长期急性护理机构的患者。最常见的合并症为糖尿病（42.8%）、肥胖（39.2%）、肺部疾病（23.3%）、冠状动脉疾病（20.2%）和充血性心力衰竭（18.3%）。死亡率较高的并发症为机械通气（比值比，148.00，P < 0.001）、合并感染（比值比，56.42，P < 0.001）、急性肾损伤（比值比，84.01，P < 0.001）、心房颤动（比值比，28.30，P < 0.001）、急性心肌梗死（比值比，23.29，P < 0.001）和急性静脉血栓栓塞症（比值比，26.43，P < 0.001）。
我们发现，在患有糖尿病、冠状动脉疾病、充血性心力衰竭、慢性肾病、癌症、肝病或脑血管疾病等合并症的非裔美国人和西班牙裔老年患者中，2019冠状病毒病的严重程度有所增加。在研究期间，无创正压通气和高流量鼻导管给氧可能有助于避免机械通气，这可能改善了患者的预后情况。
