CovidSeniorV1, Main, Exploration, bibRecord, 000263

Risk factors for severe illness in hospitalized Covid-19 patients at a regional hospital.

Identifieur interne : 000263 ( Main/Exploration ); précédent : 000262; suivant : 000264

Risk factors for severe illness in hospitalized Covid-19 patients at a regional hospital.

Auteurs : Justin J. Turcotte [États-Unis] ; Barry R. Meisenberg [États-Unis] ; James H. Macdonald [États-Unis] ; Nandakumar Menon [États-Unis] ; Marcia B. Fowler [États-Unis] ; Michaline West [États-Unis] ; Jane Rhule [États-Unis] ; Sadaf S. Qureshi [États-Unis] ; Eileen B. Macdonald [États-Unis]

Source :

PloS one [ 1932-6203 ] ; 2020.

RBID : pubmed:32785285

Descripteurs français

English descriptors

KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Betacoronavirus (genetics), Coronavirus Infections (epidemiology), Coronavirus Infections (mortality), Coronavirus Infections (pathology), Coronavirus Infections (virology), Critical Illness (MeSH), Female (MeSH), Health Care Rationing (MeSH), Hospital Mortality (MeSH), Hospitalization (MeSH), Hospitals, Community (MeSH), Humans (MeSH), Intensive Care Units (MeSH), Length of Stay (MeSH), Male (MeSH), Maryland (epidemiology), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (epidemiology), Pneumonia, Viral (mortality), Pneumonia, Viral (pathology), Pneumonia, Viral (virology), Respiration, Artificial (MeSH), Retrospective Studies (MeSH), Reverse Transcriptase Polymerase Chain Reaction (MeSH), Risk Factors (MeSH).
MESH :
- geographic , epidemiology : Maryland.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- genetics : Betacoronavirus.
- mortality : Coronavirus Infections, Pneumonia, Viral.
- pathology : Coronavirus Infections, Pneumonia, Viral.
- virology : Coronavirus Infections, Pneumonia, Viral.
- Aged, Aged, 80 and over, Critical Illness, Female, Health Care Rationing, Hospital Mortality, Hospitalization, Hospitals, Community, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Pandemics, Respiration, Artificial, Retrospective Studies, Reverse Transcriptase Polymerase Chain Reaction, Risk Factors.

Abstract

BACKGROUND

The Covid-19 pandemic threatens to overwhelm scarce clinical resources. Risk factors for severe illness must be identified to make efficient resource allocations.

OBJECTIVE

To evaluate risk factors for severe illness.

DESIGN

Retrospective, observational case series.

SETTING

Single-institution.

PARTICIPANTS

First 117 consecutive patients hospitalized for Covid-19 from March 1 to April 12, 2020.

EXPOSURE

None.

MAIN OUTCOMES AND MEASURES

Intensive care unit admission or death.

RESULTS

In-hospital mortality was 24.8% and average total length of stay was 11.82 days (95% CI: 10.01 to 13.63 days). 30.8% of patients required intensive care unit admission and 29.1% required mechanical ventilation. Multivariate regression identified the amount of supplemental oxygen required at admission (OR: 1.208, 95% CI: 1.011-1.443, p = .037), sputum production (OR: 6.734, 95% CI: 1.630-27.812, p = .008), insulin dependent diabetes mellitus (OR: 11.873, 95% CI: 2.218-63.555, p = .004) and chronic kidney disease (OR: 4.793, 95% CI: 1.528-15.037, p = .007) as significant risk factors for intensive care unit admission or death. Of the 48 patients who were admitted to the intensive care unit or died, this occurred within 3 days of arrival in 42%, within 6 days in 71%, and within 9 days in 88% of patients.

CONCLUSIONS

At our regional medical center, patients with Covid-19 had an average length of stay just under 12 days, required ICU care in 31% of cases, and had a 25% mortality rate. Patients with increased sputum production and higher supplemental oxygen requirements at admission, and insulin dependent diabetes or chronic kidney disease may be at increased risk for severe illness. A model for predicting intensive care unit admission or death with excellent discrimination was created that may aid in treatment decisions and resource allocation. Early identification of patients at increased risk for severe illness may lead to improved outcomes in patients hospitalized with Covid-19.

DOI: 10.1371/journal.pone.0237558
PubMed: 32785285
PubMed Central: PMC7423129

Affiliations:

Links toward previous steps (curation, corpus...)

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Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Betacoronavirus (genetics)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Coronavirus Infections (mortality)</term>
<term>Coronavirus Infections (pathology)</term>
<term>Coronavirus Infections (virology)</term>
<term>Critical Illness (MeSH)</term>
<term>Female (MeSH)</term>
<term>Health Care Rationing (MeSH)</term>
<term>Hospital Mortality (MeSH)</term>
<term>Hospitalization (MeSH)</term>
<term>Hospitals, Community (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Intensive Care Units (MeSH)</term>
<term>Length of Stay (MeSH)</term>
<term>Male (MeSH)</term>
<term>Maryland (epidemiology)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Pneumonia, Viral (mortality)</term>
<term>Pneumonia, Viral (pathology)</term>
<term>Pneumonia, Viral (virology)</term>
<term>Respiration, Artificial (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Reverse Transcriptase Polymerase Chain Reaction (MeSH)</term>
<term>Risk Factors (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term>
<term>Betacoronavirus (génétique)</term>
<term>Durée du séjour (MeSH)</term>
<term>Facteurs de risque (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Hospitalisation (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Hôpitaux communautaires (MeSH)</term>
<term>Infections à coronavirus (anatomopathologie)</term>
<term>Infections à coronavirus (mortalité)</term>
<term>Infections à coronavirus (virologie)</term>
<term>Infections à coronavirus (épidémiologie)</term>
<term>Maladie grave (MeSH)</term>
<term>Maryland (épidémiologie)</term>
<term>Mortalité hospitalière (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (anatomopathologie)</term>
<term>Pneumopathie virale (mortalité)</term>
<term>Pneumopathie virale (virologie)</term>
<term>Pneumopathie virale (épidémiologie)</term>
<term>RT-PCR (MeSH)</term>
<term>Rationnement des services de santé (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Unités de soins intensifs (MeSH)</term>
<term>Ventilation artificielle (MeSH)</term>
<term>Études rétrospectives (MeSH)</term>
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<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Maryland</term>
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<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
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<keywords scheme="MESH" qualifier="génétique" xml:lang="fr"><term>Betacoronavirus</term>
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<term>Pneumonia, Viral</term>
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<term>Pneumopathie virale</term>
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<term>Pneumonia, Viral</term>
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<term>Pneumopathie virale</term>
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<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infections à coronavirus</term>
<term>Maryland</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Critical Illness</term>
<term>Female</term>
<term>Health Care Rationing</term>
<term>Hospital Mortality</term>
<term>Hospitalization</term>
<term>Hospitals, Community</term>
<term>Humans</term>
<term>Intensive Care Units</term>
<term>Length of Stay</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pandemics</term>
<term>Respiration, Artificial</term>
<term>Retrospective Studies</term>
<term>Reverse Transcriptase Polymerase Chain Reaction</term>
<term>Risk Factors</term>
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<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Durée du séjour</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Hospitalisation</term>
<term>Humains</term>
<term>Hôpitaux communautaires</term>
<term>Maladie grave</term>
<term>Mortalité hospitalière</term>
<term>Mâle</term>
<term>Pandémies</term>
<term>RT-PCR</term>
<term>Rationnement des services de santé</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Unités de soins intensifs</term>
<term>Ventilation artificielle</term>
<term>Études rétrospectives</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>The Covid-19 pandemic threatens to overwhelm scarce clinical resources. Risk factors for severe illness must be identified to make efficient resource allocations.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>To evaluate risk factors for severe illness.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DESIGN</b>
</p>
<p>Retrospective, observational case series.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>SETTING</b>
</p>
<p>Single-institution.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>PARTICIPANTS</b>
</p>
<p>First 117 consecutive patients hospitalized for Covid-19 from March 1 to April 12, 2020.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>EXPOSURE</b>
</p>
<p>None.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>MAIN OUTCOMES AND MEASURES</b>
</p>
<p>Intensive care unit admission or death.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>In-hospital mortality was 24.8% and average total length of stay was 11.82 days (95% CI: 10.01 to 13.63 days). 30.8% of patients required intensive care unit admission and 29.1% required mechanical ventilation. Multivariate regression identified the amount of supplemental oxygen required at admission (OR: 1.208, 95% CI: 1.011-1.443, p = .037), sputum production (OR: 6.734, 95% CI: 1.630-27.812, p = .008), insulin dependent diabetes mellitus (OR: 11.873, 95% CI: 2.218-63.555, p = .004) and chronic kidney disease (OR: 4.793, 95% CI: 1.528-15.037, p = .007) as significant risk factors for intensive care unit admission or death. Of the 48 patients who were admitted to the intensive care unit or died, this occurred within 3 days of arrival in 42%, within 6 days in 71%, and within 9 days in 88% of patients.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>At our regional medical center, patients with Covid-19 had an average length of stay just under 12 days, required ICU care in 31% of cases, and had a 25% mortality rate. Patients with increased sputum production and higher supplemental oxygen requirements at admission, and insulin dependent diabetes or chronic kidney disease may be at increased risk for severe illness. A model for predicting intensive care unit admission or death with excellent discrimination was created that may aid in treatment decisions and resource allocation. Early identification of patients at increased risk for severe illness may lead to improved outcomes in patients hospitalized with Covid-19.</p>
</div>
</front>
</TEI>
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<Month>08</Month>
<Day>28</Day>
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<Month>08</Month>
<Day>28</Day>
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<Issue>8</Issue>
<PubDate><Year>2020</Year>
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</JournalIssue>
<Title>PloS one</Title>
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<ArticleTitle>Risk factors for severe illness in hospitalized Covid-19 patients at a regional hospital.</ArticleTitle>
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<AbstractText Label="OBJECTIVE">To evaluate risk factors for severe illness.</AbstractText>
<AbstractText Label="DESIGN">Retrospective, observational case series.</AbstractText>
<AbstractText Label="SETTING">Single-institution.</AbstractText>
<AbstractText Label="PARTICIPANTS">First 117 consecutive patients hospitalized for Covid-19 from March 1 to April 12, 2020.</AbstractText>
<AbstractText Label="EXPOSURE">None.</AbstractText>
<AbstractText Label="MAIN OUTCOMES AND MEASURES">Intensive care unit admission or death.</AbstractText>
<AbstractText Label="RESULTS">In-hospital mortality was 24.8% and average total length of stay was 11.82 days (95% CI: 10.01 to 13.63 days). 30.8% of patients required intensive care unit admission and 29.1% required mechanical ventilation. Multivariate regression identified the amount of supplemental oxygen required at admission (OR: 1.208, 95% CI: 1.011-1.443, p = .037), sputum production (OR: 6.734, 95% CI: 1.630-27.812, p = .008), insulin dependent diabetes mellitus (OR: 11.873, 95% CI: 2.218-63.555, p = .004) and chronic kidney disease (OR: 4.793, 95% CI: 1.528-15.037, p = .007) as significant risk factors for intensive care unit admission or death. Of the 48 patients who were admitted to the intensive care unit or died, this occurred within 3 days of arrival in 42%, within 6 days in 71%, and within 9 days in 88% of patients.</AbstractText>
<AbstractText Label="CONCLUSIONS">At our regional medical center, patients with Covid-19 had an average length of stay just under 12 days, required ICU care in 31% of cases, and had a 25% mortality rate. Patients with increased sputum production and higher supplemental oxygen requirements at admission, and insulin dependent diabetes or chronic kidney disease may be at increased risk for severe illness. A model for predicting intensive care unit admission or death with excellent discrimination was created that may aid in treatment decisions and resource allocation. Early identification of patients at increased risk for severe illness may lead to improved outcomes in patients hospitalized with Covid-19.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Turcotte</LastName>
<ForeName>Justin J</ForeName>
<Initials>JJ</Initials>
<Identifier Source="ORCID">0000-0002-5591-8033</Identifier>
<AffiliationInfo><Affiliation>Department of Orthopedics, Anne Arundel Medical Center, Annapolis, MD, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Meisenberg</LastName>
<ForeName>Barry R</ForeName>
<Initials>BR</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, Anne Arundel Medical Center, Annapolis, MD, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>MacDonald</LastName>
<ForeName>James H</ForeName>
<Initials>JH</Initials>
<AffiliationInfo><Affiliation>Department of Orthopedics, Anne Arundel Medical Center, Annapolis, MD, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Menon</LastName>
<ForeName>Nandakumar</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Department of Orthopedics, Anne Arundel Medical Center, Annapolis, MD, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fowler</LastName>
<ForeName>Marcia B</ForeName>
<Initials>MB</Initials>
<AffiliationInfo><Affiliation>Department of Orthopedics, Anne Arundel Medical Center, Annapolis, MD, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>West</LastName>
<ForeName>Michaline</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Orthopedics, Anne Arundel Medical Center, Annapolis, MD, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rhule</LastName>
<ForeName>Jane</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Anne Arundel Research Institute, Anne Arundel Medical Center, Annapolis, MD, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Qureshi</LastName>
<ForeName>Sadaf S</ForeName>
<Initials>SS</Initials>
<AffiliationInfo><Affiliation>Anne Arundel Research Institute, Anne Arundel Medical Center, Annapolis, MD, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>MacDonald</LastName>
<ForeName>Eileen B</ForeName>
<Initials>EB</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, Anne Arundel Medical Center, Annapolis, MD, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D064888">Observational Study</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>08</Month>
<Day>12</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>PLoS One</MedlineTA>
<NlmUniqueID>101285081</NlmUniqueID>
<ISSNLinking>1932-6203</ISSNLinking>
</MedlineJournalInfo>
<SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName>
<SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName>
</SupplMeshList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName>
<QualifierName UI="Q000235" MajorTopicYN="Y">genetics</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015276" MajorTopicYN="N">Health Care Rationing</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017052" MajorTopicYN="N">Hospital Mortality</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006760" MajorTopicYN="Y">Hospitalization</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006764" MajorTopicYN="N">Hospitals, Community</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName>
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<MeshHeading><DescriptorName UI="D007902" MajorTopicYN="N">Length of Stay</DescriptorName>
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<MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
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<CoiStatement>The authors have declared that no competing interests exist.</CoiStatement>
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	Serveur d'exploration sur la COVID chez les séniors
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Risk factors for severe illness in hospitalized Covid-19 patients at a regional hospital.

Risk factors for severe illness in hospitalized Covid-19 patients at a regional hospital.

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