This study reviewed 395 young adults, 18–35 year-old, admitted for COVID-19 to one of the eleven hospitals in New York City public health system. Demographics, comorbidities, clinical course, outcomes and characteristics linked to hospitalization were analyzed including temporal survival analysis. Fifty-seven percent of patients had a least one major comorbidity. Mortality without comorbidity was in 3.8% patients. Further investigation of admission features and medical history was conducted. Comorbidities associated with mortality were diabetes (n = 54 deceased/73 diagnosed,74% tested POS;98.2% with diabetic history deceased; Wilcoxon p (Wp) = .044), hypertension (14/44,32% POS, 25.5%; Wp = 0.030), renal (6/16, 37.5% POS,11%; Wp = 0.000), and cardiac (6/21, 28.6% POS,11%; Wp = 0.015). Kaplan survival plots were statistically significant for these four indicators. Data suggested glucose >215 or hemoglobin A1c >9.5 for young adults on admission was associated with increased mortality. Clinically documented respiratory distress on admission was statistically significant outcome related to mortality (X2 = 236.6842, df = 1, p < .0001). Overall, 28.9% required supportive oxygen beyond nasal cannula. Nasal cannula oxygen alone was required for 71.1%, who all lived. Non-invasive ventilation was required for 7.8%, and invasive mechanical ventilation 21.0% (in which 7.3% lived, 13.7% died). Temporal survival analysis demonstrated statistically significant response for Time to Death <10 days (X2 = 18.508, df = 1, p = .000); risk lessened considerably for 21 day cut off (X2 = 3.464, df = 1, p = .063), followed by 31 or more days of hospitalization (X2 = 2.212, df = 1, p = .137).

Background In the midst of the coronavirus disease pandemic, emerging clinical data across the world has equipped frontline health care workers, policy makers, and researchers to better understand and combat the illness. Objective The aim of this study is to report the correlation of clinical and laboratory parameters with patients requiring mechanical ventilation and the mortality in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We did a 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 nonintubated, and subgrouped to alive and deceased. A comprehensive analysis using the following parameters were performed: age, sex, ethnicity, BMI, comorbidities, inflammatory markers, laboratory values, cardiac and renal function, electrocardiogram (EKG), chest x-ray findings, temperature, treatment groups, and hospital-acquired patients with SARS-CoV-2. Results A total of 184 patients were included in our study with ages ranging from 28-97 years (mean 64.72 years) and including 73 females (39.67%) and 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%), and 1 Caucasian (0.54%), with a mean of 1.70 comorbidities. Overall, the mortality rate was 17.39% (n=32), 16.30% (n=30) of our patients required mechanical ventilation, and 11.41% (n=21) had hospital-acquired SARS-CoV-2 infection. Pertinent and statistically significant results were found in the intubated versus nonintubated patients with confirmed SARS-CoV-2 for the following parameters: age (P=.01), BMI (P=.07), African American ethnicity (P<.001), Hispanic ethnicity (P=.02), diabetes mellitus (P=.001), creatinine (P=.29), blood urea nitrogen (BUN; P=.001), procalcitonin (P=.03), C-reactive protein (CRP; P=.007), lactate dehydrogenase (LDH; P=.001), glucose (P=.01), temperature (P=.004), bilateral pulmonary infiltrates in chest x-rays (P<.001), and bilateral patchy opacity (P=.02). The results between the living and deceased subgroups of patients with confirmed SARS-CoV-2 (linking to or against mortality) were BMI (P=.04), length of stay (P<.001), hypertension (P=.02), multiple comorbidity (P=.045), BUN (P=.04), and EKG findings with arrhythmias or blocks (P=.02). Conclusions We arrived at the following conclusions 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 chest x-rays. Those intubated exhibited increased disease severity with significantly elevated levels of serum procalcitonin, CRP, LDH, mean glucose, creatinine, and BUN. Mortality was strongly correlated with BMI, African American ethnicity, hypertension, presence of multiple comorbidities (with a mean of 2.32), worsening renal function with acute kidney injury or acute chronic kidney injury, and EKG findings of arrhythmias and heart blocks.

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.

Intestinal nonrotation is a subtype of malrotation occurring when the midgut fails to rotate before returning to the peritoneal cavity between weeks 8-10 of development. Though sometimes presenting as volvulus during the neonatal period, a subset of patients remains asymptomatic and are identified incidentally as adults. When patients with intestinal nonrotation present with abdominal symptoms, there exists a diagnostic dilemma for the treating surgeon. We present the case of a patient who presented with acute abdominal pain and vomiting, with radiographic findings of intestinal nonrotation and no other acute pathology. Symptoms spontaneously resolved with conservative management for likely etiology of viral gastroenteritis. At the one-month follow-up, the patient had no residual or recurrent symptoms, with no further interventions planned.

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