JMIR Publications

ABSTRACT

Background:

In the midst of COVID-19 pandemic, emerging clinical data across the globe has equipped frontline health care workers, policy makers and researchers to better understand and combat the illness more prepared. There has been heavy under representation of the American minority and hence further research is required among these underprivileged communities

Objective:

To delineate patient characteristics, natural disease history, clinical attributes among the SARS-CoV-2 infected patients belonging to our New York inner city hospital. Further characterization between those intubated and not intubated and subgroup analysis among the deceased and living.

Methods:

Review of patients with SARS-CoV-2 confirmed infection admitted and managed by our institution during the last month. Patients were grouped into intubated and non-intubated and sub grouped to alive and deceased. Comprehensive analysis using the following parameters were performed, Age, Sex, Ethnicity, BMI, Comorbidities, inflammatory markers, Laboratory values, cardiac and renal function, EKG, Chest xray findings, temperature, treatment groups, hospital acquired SARS-CoV-2 patients

Results:

A total of 184 patients were included in our study with age ranging from 28-97 years, mean of 64.72, 73 females (39.67%), 111 males (60.33%), with a mean BMI of 29.10. We had 114 African Americans (61.96%), 58 Hispanics (31.52%), 11 Asians (5.98%), 1 Caucasian (0.54%), with mean comorbidity of 1.70. Overall mortality rate was 17.39%, 16.30% of our patients required mechanical ventilation and 11.41% had hospital acquired SARS-CoV-2 infection. Pertinent and statistically significant results in the Intubated (I-T) versus Non Intubated (NI-T) SARS-CoV-2 confirmed patients for the following parameters with p values were: Age - 0.0131, BMI - 0.071, African American Ethnicity - 0.0002, Hispanic Ethnicity - 0.0173, DM - 0.0012, Cr - 0.029, BUN - 0.001, Procalcitonin - 0.029, CRP - 0.007, LDH - 0.001, Glucose - 0.012, Temperature - 0.0043, B/L pulmonary infiltrates in CXR - <0.0001, B/L patchy opacity - 0.0178. In the living and deceased of SARS-CoV-2 confirmed ( linking to or against mortality) were BMI - 0.042, LOS - 0.0001, HTN - 0.0192, Multiple comorbidity - 0.0453, BUN - 0.041, EKG findings with arrythmias/block - 0.0208

Conclusions:

We arrived at the following conclusion based on a comprehensive review of our study group, data collection and statistical analysis. Parameters that were strongly correlated with the need for mechanical ventilation were younger age group, overweight, hispanic ethnicity, higher core body temperature , EKG findings with sinus tachycardia and bilateral diffuse pulmonary infiltrates on the CXR. Those intubated exhibited increased disease severity with significantly elevated levels of serum Procalcitonin, CRP, LDH, Mean glucose, Creatinine, BUN. Mortality was strongly correlated with BMI, African american ethnicity, Hypertension, presence of multiple comorbidity with a mean of 2.32, worsening renal function with acute kidney injury or acute on chronic kidney injury and EKG findings of arrhythmias and heart blocks.