TY - JOUR
T1 - Early clinical and sociodemographic experience with patients hospitalized with COVID-19 at a large American healthcare system
AU - McCarthy, Cian P.
AU - Murphy, Sean
AU - Jones-O'Connor, Maeve
AU - Olshan, David S.
AU - Khambhati, Jay R.
AU - Rehman, Saad
AU - Cadigan, John B.
AU - Cui, Jinghan
AU - Meyerowitz, Eric A.
AU - Philippides, George
AU - Friedman, Lawrence S.
AU - Kadar, Aran Y.
AU - Hibbert, Kathryn
AU - Natarajan, Pradeep
AU - Massaro, Anthony F.
AU - Bohula, Erin A.
AU - Morrow, David A.
AU - Woolley, Ann E.
AU - Januzzi, James L.
AU - Wasfy, Jason H.
N1 - Funding Information:
The principal investigator, Dr. Wasfy reports a grant from the American Heart Association (18 CDA 34110215).
Funding Information:
Dr. Bohula reports personal fees from Servier, personal fees from Merck, personal fees from NIH, personal fees from Lexicon, personal fees from Medscape, personal fees from Academic CME, personal fees from MD Conference Express, personal fees from Paradigm, personal fees from Novartis, grants and personal fees from Amgen, grants from Astra Zeneca, grants from Merck, personal fees from Novo Nordisk, grants from Eisai, personal fees from PriMed, outside the submitted work. Dr. Morrow reports grants from Abbott Laboratories, grants from Amgen, grants and personal fees from AstraZeneca, grants from Eisai, grants from GlaxoSmithKline, grants and personal fees from Merck, grants and personal fees from Novartis, grants and personal fees from Roche Diagnostics, personal fees from Bayer Pharma, personal fees from InCarda, grants from Medicines Company, grants from Takeda, outside the submitted work; he is a member of the TIMI Study Group which has received institutional research grant support through Brigham and Women's Hospital from: Abbott, Amgen, Anthos Therapeutics, Aralez, AstraZeneca, Bayer HealthCare Pharmaceuticals, Inc., Daiichi-Sankyo, Eisai, GlaxoSmithKline, Intarcia, Janssen, MedImmune, Merck, Novartis, Pfizer, Poxel, Quark Pharmaceuticals, Regeneron, Roche, Siemens, Takeda, The Medicines Company, Zora Biosciences. Dr. Natarajan reports grants from Amgen, grants and personal fees from Apple, personal fees from Blackstone Life Sciences, grants from Boston Scientific, personal fees from Novartis, outside the submitted work. Dr. Wasfy reports grant funding from Harvard Catalyst/National Institutes of Health, American Heart Association, and consulting fees from Pfizer, Biotronik. He is vice-chair of the New England CEPAC. He has received travel funded by the American College of Cardiology and grant support to spouse from the National Institutes of Health; none of these are relevant to this topic. The remaining authors have no conflicts of interest to disclose.
Publisher Copyright:
© 2020 The Authors
PY - 2020/9
Y1 - 2020/9
N2 - Background: Despite over 4 million cases of novel coronavirus disease 2019 (COVID-19) in the United States, limited data exist including socioeconomic background and post-discharge outcomes for patients hospitalized with this disease. Methods: In this case series, we identified patients with COVID-19 admitted to 3 Partners Healthcare hospitals in Boston, Massachusetts between March 7th, 2020, and March 30th, 2020. Patient characteristics, treatment strategies, and outcomes were determined. Findings: A total of 247 patients hospitalized with COVID-19 were identified; the median age was 61 (interquartile range [IQR]: 50–76 years), 58% were men, 30% of Hispanic ethnicity, 21% enrolled in Medicaid, and 12% dual-enrolled Medicare/Medicaid. The median estimated household income was $66,701 [IQR: $50,336-$86,601]. Most patients were treated with hydroxychloroquine (72%), and statins (76%; newly initiated in 34%). During their admission, 103 patients (42%) required intensive care. At the end of the data collection period (June 24, 2020), 213 patients (86.2%) were discharged alive, 2 patients (0.8%) remain admitted, and 32 patients (13%) have died. Among those discharged alive (n = 213), 70 (32.9%) were discharged to a post-acute facility, 31 (14.6%) newly required supplemental oxygen, 19 (8.9%) newly required tube feeding, and 34 (16%) required new prescriptions for antipsychotics, benzodiazepines, methadone, or opioids. Over a median post-discharge follow-up of 80 days (IQR, 68–84), 22 patients (10.3%) were readmitted. Interpretation: Patients hospitalized with COVID-19 are frequently of vulnerable socioeconomic status and often require intensive care. Patients who survive COVID-19 hospitalization have substantial need for post-acute services.
AB - Background: Despite over 4 million cases of novel coronavirus disease 2019 (COVID-19) in the United States, limited data exist including socioeconomic background and post-discharge outcomes for patients hospitalized with this disease. Methods: In this case series, we identified patients with COVID-19 admitted to 3 Partners Healthcare hospitals in Boston, Massachusetts between March 7th, 2020, and March 30th, 2020. Patient characteristics, treatment strategies, and outcomes were determined. Findings: A total of 247 patients hospitalized with COVID-19 were identified; the median age was 61 (interquartile range [IQR]: 50–76 years), 58% were men, 30% of Hispanic ethnicity, 21% enrolled in Medicaid, and 12% dual-enrolled Medicare/Medicaid. The median estimated household income was $66,701 [IQR: $50,336-$86,601]. Most patients were treated with hydroxychloroquine (72%), and statins (76%; newly initiated in 34%). During their admission, 103 patients (42%) required intensive care. At the end of the data collection period (June 24, 2020), 213 patients (86.2%) were discharged alive, 2 patients (0.8%) remain admitted, and 32 patients (13%) have died. Among those discharged alive (n = 213), 70 (32.9%) were discharged to a post-acute facility, 31 (14.6%) newly required supplemental oxygen, 19 (8.9%) newly required tube feeding, and 34 (16%) required new prescriptions for antipsychotics, benzodiazepines, methadone, or opioids. Over a median post-discharge follow-up of 80 days (IQR, 68–84), 22 patients (10.3%) were readmitted. Interpretation: Patients hospitalized with COVID-19 are frequently of vulnerable socioeconomic status and often require intensive care. Patients who survive COVID-19 hospitalization have substantial need for post-acute services.
KW - COVID-19
KW - Outcomes research
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U2 - 10.1016/j.eclinm.2020.100504
DO - 10.1016/j.eclinm.2020.100504
M3 - Article
AN - SCOPUS:85089499567
VL - 26
JO - EClinicalMedicine
JF - EClinicalMedicine
SN - 2589-5370
M1 - 100504
ER -