In a large case series of patients hospitalised with COVID-19 in New York, relatively few had HIV (0.8%). Aidsmap reports that as the background prevalence of HIV in New York City is around 1.3%, the data appear to confirm that HIV is not in itself a risk factor for greater vulnerability to the new coronavirus. The most common co-morbidities were high blood pressure (57%), obesity (42%), and diabetes (34%).
Reported by researchers at Feinstein Institutes for Medical Research, Northwell Health, the data come from 5,700 sequentially hospitalised patients at the hospitals of Northwell Health, the largest academic medical centre in New York, with hospitals in New York City, Long Island and Westchester County (the county to the north of the Bronx).
The authors say this is the largest case series to be published on coronavirus patients in the US. In contrast to several case series from China, data on HIV are included.
Just under a third of US coronavirus cases are in the state of New York.
A total of 43 people (0.8%) had HIV, eight people (0.1%) had hepatitis B and three people (0.1%) hepatitis C.
Abstract
Importance: There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).
Objective: To describe the clinical characteristics and outcomes of patients with COVID-19 hospitalized in a US health care system.
Design, Setting, and Participants: Case series of patients with COVID-19 admitted to 12 hospitals in New York City, Long Island, and Westchester County, New York, within the Northwell Health system. The study included all sequentially hospitalized patients between March 1, 2020, and April 4, 2020, inclusive of these dates.
Exposures: Confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample among patients requiring admission.
Main Outcomes and Measures: Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy, and death. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected.
Results: A total of 5700 patients were included (median age, 63 years [interquartile range {IQR}, 52-75; range, 0-107 years]; 39.7% female). The most common comorbidities were hypertension (3026; 56.6%), obesity (1737; 41.7%), and diabetes (1808; 33.8%). At triage, 30.7% of patients were febrile, 17.3% had a respiratory rate greater than 24 breaths/min, and 27.8% received supplemental oxygen. The rate of respiratory virus co-infection was 2.1%. Outcomes were assessed for 2634 patients who were discharged or had died at the study end point. During hospitalization, 373 patients (14.2%) (median age, 68 years [IQR, 56-78]; 33.5% female) were treated in the intensive care unit care, 320 (12.2%) received invasive mechanical ventilation, 81 (3.2%) were treated with kidney replacement therapy, and 553 (21%) died. As of April 4, 2020, for patients requiring mechanical ventilation (n = 1151, 20.2%), 38 (3.3%) were discharged alive, 282 (24.5%) died, and 831 (72.2%) remained in hospital. The median postdischarge follow-up time was 4.4 days (IQR, 2.2-9.3). A total of 45 patients (2.2%) were readmitted during the study period. The median time to readmission was 3 days (IQR, 1.0-4.5) for readmitted patients. Among the 3066 patients who remained hospitalized at the final study follow-up date (median age, 65 years [IQR, 54-75]), the median follow-up at time of censoring was 4.5 days (IQR, 2.4-8.1).
Conclusions and Relevance: This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID-19 in the New York City area.
Authors
Safiya Richardson; Jamie S Hirsch; Mangala Narasimhan; James M Crawford; Thomas McGinn; Karina W Davidson and the Northwell COVID-19 Research Consortium
[link url="http://www.aidsmap.com/news/apr-2020/hiv-low-list-co-morbidities-among-coronavirus-patients-new-york"]Full Aidsmap report[/link]
[link url="https://jamanetwork.com/journals/jama/article-abstract/2765184"]JAMA abstract[/link]