Outcomes of Critically-Ill COVID Patients in NYC Save

Lancet has reported COVID outcomes from NewYork-Presbyterian hospitals in NYC during March 2020 showing high rates of hospitalization, ICU admission, mechanical ventilation and death. 

A prospective observational cohort study 2 2 NYC hospitals from March 2 to April 1, 2020, looking at laboratory-confirmed COVID-19 and were critically ill with acute hypoxaemic respiratory failure, and collected clinical, biomarker, and treatment data. The primary outcome was in-hospital death.

From a total of 1150 hospital admitted adults with laboratory-confirmed COVID-19, 22% met criterial for being "critically ill".  Such patients were older (mean 62 years), mostly men (67%)  and 82% had at least one comorbidity (HTN 63%, DM 36%, obesity 46%).

By April 28, 2020, 39% patients had died and 37% remained hospitalised.  Nearly 80% required mechanical ventilation (median 18 days), two-thirds received vasopressors and 31% required renal replacement therapy.

On average these patients quickly deteriorated (median 3 days).

In hospital mortality was associated with older age (adjusted hazard ratio 1·31 [1·09–1·57]), chronic cardiac disease (aHR 1·76), chronic pulmonary disease (aHR 2·94), higher interleukin-6 levels (aHR 1·11) and high D-dimers (aHR 1·10).

Older men, with comorbidities, who were infected with COVID-19 were most likely to be critically-ill in this cohort.