Clinical Features and Outcomes of 105 Hospitalized Patients With COVID-19 in Seattle, Washington

Abstract

Background Washington State served as the initial epicenter of the SARS-CoV-2 pandemic in the United States. An understanding of the risk factors and clinical outcomes of hospitalized patients with COVID-19 may provide guidance for management. Methods All laboratory-confirmed COVID-19 cases in adults admitted to an academic medical center in Seattle, WA between March 2 and March 26, 2020 were included. We evaluated individuals with and without severe disease, defined as admission to the intensive care unit or death. Results One-hundred-five COVID-19 patients were hospitalized. Thirty-five percent were admitted from a senior home or skilled nursing facility. The median age was 69 years and half were women. Three or more comorbidities were present in 55% of patients, with hypertension (59%), obesity (47%), cardiovascular disease (38%) and diabetes (33%) being the most prevalent. Most (63%) had symptoms for 5 days or longer prior to admission. Only 39% had fever in the first 24 hours, whereas 41% had hypoxia at admission. Seventy-three percent of patients had lymphopenia. Of 50 samples available for additional testing, no viral coinfections were identified. Severe disease occurred in 49%. Eighteen percent of patients were placed on mechanical ventilation and the overall mortality rate was 33%. Conclusions During the early days of the COVID-19 epidemic in Washington State, the disease had its greatest impact on elderly patients with medical comorbidities. We observed high rates of severe disease and mortality in our hospitalized patients.

WITHDRAWN: The Negative Impact of Obesity on the Occurrence and Prognosis of the 2019 Novel Coronavirus (COVID-19) Disease: A Systematic Review and Meta-Analysis

“…1); some studies reported data on > 1 pertinent outcome. Of these, there were 52 studies reporting results on obesity prevalence among patients with COVID-19 involving a total of 504,556 cases (8,9,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) (Table 2). There was signi cant evidence for heterogeneity across studies in all analyzes (Table 2).…”

“…The retrieval publications were screened and abstracted if they met the following inclusion criteria: a) Observational studies (cohort, case-control, cross-sectional, case series); b) Studies providing su cient information for the calculation of relative risk (RR) and / or odds ratio (OR), in cases which critical data were not reported in the eligible articles, we contacted authors; c) Studies reporting the prevalence of obesity in COVID-19 patients (primary outcome) and/or data on the association between obesity and following secondary outcomes: COVID-19 and COVID-19 severity (severe COVID-19 was de ned based on international guidelines or hospitalization, ICU (Intensive Care Unit) admission, need for mechanical ventilator, mortality due to COVID-19 or a combination of these) (16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Duplicates, case reports, reviews, studies with insu cient data after contacting with authors, and abstracts were all excluded, but letters were included.…”

Early prediction of level-of-care requirements in patients with COVID-19

“…Much of the modeling work related to the pandemic has focused on spread dynamics ( Kucharski et al, 2020 ). Others have described patients who were hospitalized ( Richardson et al, 2020 ) (n = 5700) and ( Buckner et al, 2020 ) (n = 105), became critically ill ( Gong et al, 2020 ) (n = 372), or succumbed to the disease (n = 1625 ( Onder et al, 2020 ), n = 270 [ Wu et al, 2020 ]). In data from the New York City, 14.2% required ICU treatment and 12.2% mechanical ventilation ( Richardson et al, 2020 ).…”

Overcoming Limitations in the Availability of Swabs Systems Used for SARS-CoV-2 Laboratory Diagnostics

“…Once collected, respiratory specimens are most commonly analyzed in diagnostic laboratories by reverse transcription polymerase chain reaction (RT-PCR) to detect viral RNA 8,9 . Some RT-PCR tests are developed in-house, often following recommendations of reference laboratories and o cial institutions [10][11][12] . Other tests are commercially available and are in research use only (RUO) status or certi ed as invitro diagnostics (IVD) [13][14][15][16] .…”