Largest COVID-19 Study of Hospitalized Patients in US Links Comorbidities to Acuity
Patients with diabetes were more likely to have received invasive mechanical ventilation, received treatment in the intensive care unit (ICU) or developed acute kidney disease.
Analyzing the electronic health records (EHR) of coronavirus disease 2019 (COVID-19) patients hospitalized at New York State’s largest health system, a team of researchers uncovered several comorbidities as a key factor in the acuity of the disease, according to a report in The Journal of the American Medical Association (JAMA).
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Largest US hospitalized COVID-19 patient group data is published (Credit: Lee Weissman @ Northwell Health)
The Northwell Health COVID-19 Research Consortium, with support from the Feinstein Institutes for Medical Research, described the clinical course and outcomes of 5,700 Northwell patients hospitalized with COVID-19 – the largest hospitalized patient cohort to date from the United States – between March 1 and April 4.
The Northwell Health Covid-19 Research Consortium’s findings, published today in JAMA, demonstrate that hypertension (57 percent), obesity (41 percent) and diabetes (34 percent) were the most common comorbidities in the COVID-19 patients studied. Patients with diabetes were more likely to have received invasive mechanical ventilation, received treatment in the intensive care unit (ICU) or developed acute kidney disease.
Of the 2,634 hospitalized patients for whom outcomes were known, 14 percent were treated in the ICU, 12 percent received invasive mechanical ventilation and 3 percent were treated with kidney replacement therapy. Twenty one percent passed away while 88 percent of individuals receiving mechanical ventilation died. To read the JAMA paper – for which Safiya Richardson, MD, MPH, assistant professor at the Feinstein Institutes, is the first author – click here.
“New York has become the epicenter of this epidemic. Clinicians, scientists, statisticians and laboratory professionals are working tirelessly to provide best care and comfort to the thousands of COVID-19 patients in our Northwell hospitals,” said Karina W. Davidson, PhD, MASc, professor and senior vice president at the Feinstein Institutes. “Through our consortium, we will share our clinical and scientific insights as we evolve the ways to care for and treat COVID-19 patients.”
The majority of patients in the study were male, and the median age of all patients being treated was 63 years old. At triage, about of third of all patients (1,734) presented with a fever, 986 had a high respiratory rate and 1,584 patients received supplemental oxygen. On average, patients were discharged after four days. The mortality rates were higher for male patients than female at every adult 10-year age interval.
The data were collected from the enterprise electronic health record reporting database and also consisted of patient demographic information, home medications, triage visits, initial laboratory tests, initial electrocardiogram results, diagnoses during the hospital course, inpatient medications, treatments (including invasive mechanical ventilation and kidney replacement therapy), and outcomes (including length of stay, discharge, readmission, and mortality).
“Dr. Davidson and the Northwell Consortium research team provide a crucial early insight into the front line response to the COVID-19 outbreak in New York,” said Kevin J. Tracey, MD, president and CEO of the Feinstein Institutes. “These observational studies and other randomized clinical trial results from the Feinstein Institutes will improve the care for others confronting Covid outbreaks.”
Research conducted at the Feinstein Institutes would not be possible without philanthropic support. In this most challenging moment in health care, we rely on supporters to provide resources for physicians and scientists to better understand COVID-19 and conduct research that benefit our patients. To support our research efforts, please click here.
About the Feinstein Institutes
The Feinstein Institutes for Medical Research is the research arm of Northwell Health, the largest health care provider and private employer in New York State. Home to 50 research labs, 2,500 clinical research studies and 5,000 researchers and staff, the Feinstein Institutes raises the standard of medical innovation through its five institutes of behavioral science, bioelectronic medicine, cancer, health innovations and outcomes, and molecular medicine. We make breakthroughs in genetics, oncology, brain research, mental health, autoimmunity, and are the global scientific leader in bioelectronic medicine – a new field of science that has the potential to revolutionize medicine. For more information about how we produce knowledge to cure disease, visit feinstein.northwell.edu.
About Northwell Health
Northwell Health is New York State’s largest health care provider and private employer, with 23 hospitals, about 750 outpatient facilities and more than 13,600 affiliated physicians. We care for over two million people annually in the New York metro area and beyond, thanks to philanthropic support from our communities. Our 70,000 employees – 16,000-plus nurses and 4,000 employed doctors, including members of Northwell Health Physician Partners – are working to change health care for the better. We’re making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Graduate Nursing and Physician Assistant Studies. For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, Twitter, Instagram and LinkedIn.
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