Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study

Cummings, Matthew J.; Baldwin, Matthew R.; Abrams, Darryl; Jacobson, Samuel D.; Meyer, Benjamin; Balough, Elizabeth M.; Aaron, Justin G.; Claassen, Jan; Rabbani, LeRoy E.; Hastie, Jonathan; Hochman, Beth; Salazar-Schicchi, John; Yip, Natalie; Brodie, Daniel; O’Donnell, Max R

doi:10.1101/2020.04.15.20067157

Cited by 403 publications

(654 citation statements)

References 21 publications

Supporting

Mentioning

559

Contrasting

Unclassified

Order By: Relevance

“…In this study, 17 of the 24 patients received mechanical ventilation for less than 2 weeks, with the exception of 4 patients that required tracheostomy and prolonged ventilation. The intubation rate of 71% in the ICU setting was lower than the 88% reported in a multicenter study in Italy [4] and 93% reported in a large single institutional study in New York,[14] but was similar to the rates of 71 to 79% reported in multiple multicenter studies in the United States [15][16][17] and was higher than the rates of 30 to 47%…”

Section: Discussionsupporting

confidence: 59%

“…The median BMI of 24.7 kg/m 2 in our study was signi cantly lower than the mean of kg/m 2 reported in New York [14,15] although it was similar to that of Chinese patients [23]. According to previous studies, obesity has been associated with worse outcomes.…”

Section: Discussioncontrasting

confidence: 46%

“…[18][19][20] The median PaO 2 /F I O 2 ratio of the intubated patients was 169, which was close to the value of 160 in the Italian study [4] although higher than that reported in most American studies. [15,17] The median duration of mechanical ventilation was 7 days, and the extubation rate was 77%. The 8% mortality rate in the current study was signi cantly lower than the rates of 26 to 78% reported in other affected cities or regions [4, 14-17, 19, 21, 22].…”

Section: Discussionmentioning

confidence: 99%

“…This practice may explain the relatively low SOFA, APACHE-, and SAPS-scores on ICU admission. Unlike in the Lombardy Region or New York, [4,15] Tokyo did not experience a severe outbreak of COVID-19. Therefore, the ICU capacity and the need for ventilators were not overwhelmed.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical Characteristics and Outcomes of Critically Ill COVID-19 Patients in Tokyo: A Single-Center Observational Study

Banno

Hifumi

Okamoto

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Japan has been successful in maintaining low mortality rates during the coronavirus disease 2019 (COVID-19) pandemic. We sought to investigate the characteristics, inflammatory laboratory finding trends, and outcomes among critically ill Japanese patients who were admitted to the intensive care unit (ICU) with COVID-19. Methods: A retrospective observational study was performed in a single institution in the center of Tokyo. Laboratory-confirmed COVID-19 patients admitted to the ICU from March 19 to April 30, 2020 were included. Trends for significant inflammatory laboratory findings were analyzed. In-hospital death, days of mechanical ventilation or oxygen supplementation, days of ICU or hospital stay were followed until May 26, 2020. Results: Twenty-four patients were included. Median age was 57.5 years, and 79% were male. The neutrophil-to-lymphocyte ratio was elevated to a median of 10.1 on admission and peaked on Day 10 of illness. Seventeen patients were intubated on Day 11 of illness and received mechanical ventilation. One patient underwent extracorporeal membrane oxygenation. The majority (88%) received systemic steroids, including 16 patients who received high dose methylprednisolone (500-1000 mg). Favipiravir was used in 38% of patients. Two patients, including 1 who refused intensive care, died. Eighteen patients were discharged. Median length of ICU and hospital stay for all patients was 6 and 22 days, respectively. Median length of ventilator dependency was 7 days. Four patients underwent a tracheostomy and received prolonged ventilation for more than 21 days. One patient receiving mechanical ventilation died. All survivors discontinued ventilator use. Mortality was remarkably low and prolonged ventilation was inevitable yet discontinued.Conclusions: Mortality was remarkably low in our single institutional study. Prolonged ventilation was inevitable yet discontinued. Trends of systemic inflammatory laboratory markers reflected the clinical course of COVID-19.

show abstract

Section: Discussionsupporting

confidence: 59%

Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Characteristics and Outcomes of Critically Ill COVID-19 Patients in Tokyo: A Single-Center Observational Study

Banno

Hifumi

Okamoto

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…None of the BioRxiv posts were relevant to our topic. Of the 86 pre-prints in MedRxiv, 14 non-duplicate studies included information on asthma [27][28][29][30][31][32][33][34][35][36][37][38][39][40], but none of them included specific information in children.…”

Section: Resultsmentioning

confidence: 99%

Asthma and COVID-19 in children – a systematic review and call for data

Castro-Rodriguez

Forno

2020

Preprint

View full text Add to dashboard Cite

Rationale:Whether asthma constitutes a risk factor for COVID-19 is unclear. Methods:We performed a systematic literature search in three stages: First, we reviewed PubMed, EMBASE and CINAHL for systematic reviews of SARS-CoC-2 and COVID-19 in pediatric populations, and reviewed their primary articles; next, we searched PubMed for studies on COVID-19 or SARS-CoV-2 and asthma/wheeze, and evaluated whether the resulting studies included pediatric populations; lastly, we repeated the second search in BioRxiv.org and MedRxiv.org to find pre-prints that may have information on pediatric asthma. Results:In the first search, eight systematic reviews were found, of which five were done in pediatric population; after reviewing 67 primary studies we found no data on pediatric asthma as a comorbidity for COVID-19. In the second search, we found 25 results in PubMed, of which five reported asthma in adults, but none included data on children. In the third search, 14 preprints in MedRxiv were identified with data on asthma, but again none with pediatric data. We found only one report by the U.S. CDC stating that 40/345 (~11.5%) children with data on chronic conditions had "chronic lung diseases including asthma". Conclusion:There is scarcely any data on whether childhood asthma (or other pediatric respiratory diseases) constitute risk factors for SARS-CoV-2 infection or COVID-19 severity. Studies are needed that go beyond counting the number of cases in the pediatric age range.

show abstract

Multidisciplinary Guidance to Manage Comatose Patients with Severe COVID‐19

Waldman

Thakur

Spektor

et al. 2020

Annals of Neurology

Self Cite

View full text Add to dashboard Cite

I n Spring 2020, New York City (NYC) rapidly became an epicenter of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (COVID-19) global pandemic, with a reported 200,547 cases between March 8 and May 31, 2020. 1 Over one fifth of hospitalized patients in NYC were critically ill, many on mechanical ventilation with multi-organ failure requiring prolonged sedation. 2 The neurology consultation service quickly became an integral part of the care for the many critically ill patients with COVID-19 with impaired consciousness. The mechanism of these disorders of consciousness in patients infected by COVID-19 is poorly understood and may be due to multi-organ failure, hypoxia, systemic inflammation, hypercoagulability, and possible neuro-invasion. 3 Uncertainty about the trajectory of this novel disease as well as concerns for health care worker safety created challenges in relying on standard behavioral, electrophysiological, imaging, and laboratory data that guides diagnostic workup and prognostication in patients with disorders of consciousness. To provide a comprehensive weighing of the rapidly evolving body of evidence in an area of great uncertainty, we instituted a multidisciplinary COVID-19 Coma Board modeled after the tumor board concept. 4 This biweekly, secure web-based multidisciplinary conference first met on May 13, 2020, with participants representing neurocritical care, epilepsy, stroke, neuroradiology, neurovascular, neurohospitalist, neuroinfectious disease, rehabilitation medicine, and pharmacology. Data was presented by the consult team using a standardized data collection format (Table). This study was approved by the institutional review board at Columbia University Irving Medical Center. The requirement for written informed consent was waived because the observational study design involves no more than minimal risk. In our first 8 case discussions, 5 patients were above 60 years old (53%), 3 were women (38%), 4 had episodes of hypoxia (defined as at least one documented arterial blood gas with a PO2 below 55 mmHg), 1 suffered cardiopulmonary arrest, and

show abstract

Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study

Cited by 403 publications

References 21 publications

Clinical Characteristics and Outcomes of Critically Ill COVID-19 Patients in Tokyo: A Single-Center Observational Study

Clinical Characteristics and Outcomes of Critically Ill COVID-19 Patients in Tokyo: A Single-Center Observational Study

Asthma and COVID-19 in children – a systematic review and call for data

Multidisciplinary Guidance to Manage Comatose Patients with Severe COVID‐19

Contact Info

Product

Resources

About