The COVID19 Experience: Preliminary Results in 1651 Patients at Two Multi-Ethnic Community Hospitals in NYC

K. Cervellione, J. Shakil, F. Bagheri, J. Robitsek, V. Zafonte, D. Wisa, M. Walczyszyn, K. Gafoor, A. Solinas, R. Mendelson
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Abstract

New York City was one of the first epicenters of the COVID19 pandemic in the United States, and continues to be the hardest hit in terms of the number of total hospitalizations and deaths. As the pandemic has spread, it has become evident that the virus disproportionately affects minority populations and may result in more adverse outcomes. The multi-ethnic communities of Queens, NY, some of which include large proportions of low socio-economic and immigrant families, provide a unique opportunity to observe the COVID19 experience at the height of the pandemic. This information allows clinicians and researchers to learn more about the presentation and course of disease in a diverse sample. An estimated 2800 patients admitted for COVID19 were seen between March 10 and May 31 2020 (not including asymptomatic positive patients). A sample of 1651 were included in these preliminary analyses (806 from hospital A and 845 from hospital B).Most patients were male(62%) with mean age 67(16.1). Ethnicities were 33% Hispanic, 24% Black, 18% Asian, 17% White, and 8% other/unknown. At presentation, half had HR>100 and/or RR>20;25% had fever>100.5F. Symptoms included dyspnea(69%), cough(60%), fever(58%), weakness/fatigue(42%), myalgia(24%), AMS/confusion(21%), and GI complaints(20%). Comorbidities were HTN(65%), DM(43%), HLD(43%), CAD(19%), CKD(15%), CVA(10%) and COPD/asthma(10%). Complications included sepsis(44%), AKI/ARF(36%), intubation(24%), and arrhythmias(7%). Disposition included 29% home, 18% to skilled nursing facility, and 36% expired.In our cohort of mainly minority patients from low to middle class urban neighborhoods, presence of comorbidies was higher than in other reported cohorts in the region. Though presenting symptoms were similar to other New York City hospitals, clinical course was poorer, with over 1/3 of patients expiring. Further analyses will concentrate on predictors of poor outcome within and between racial/ethnic groups in the complete cohort of eligible patients.
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covid - 19经验:纽约市两家多民族社区医院1651名患者的初步结果
纽约市是美国首批covid - 19大流行的中心之一,就住院和死亡人数而言,纽约市仍然是受灾最严重的地区。随着大流行病的蔓延,很明显,该病毒对少数群体的影响不成比例,并可能导致更多的不良后果。纽约皇后区的多民族社区,其中一些包括大量低社会经济和移民家庭,提供了一个独特的机会,可以在疫情最严重的时候观察covid - 19的经历。这些信息使临床医生和研究人员能够更多地了解不同样本中疾病的表现和病程。2020年3月10日至5月31日期间,估计有2800名新冠肺炎患者入院(不包括无症状阳性患者)。这些初步分析包括1651例样本(806例来自A医院,845例来自B医院)。大多数患者为男性(62%),平均年龄为67岁(16.1岁)。种族为33%西班牙裔,24%黑人,18%亚洲人,17%白人,8%其他/未知。在就诊时,半数患者的体温为100和/或20%;25%患者的体温为100.5华氏度。症状包括呼吸困难(69%)、咳嗽(60%)、发烧(58%)、虚弱/疲劳(42%)、肌痛(24%)、AMS/精神错乱(21%)和胃肠道不适(20%)。合并症为HTN(65%)、DM(43%)、HLD(43%)、CAD(19%)、CKD(15%)、CVA(10%)和COPD/哮喘(10%)。并发症包括败血症(44%)、AKI/ARF(36%)、插管(24%)和心律失常(7%)。处置包括29%回家,18%到专业护理机构,36%过期。在我们的队列中,主要是来自城市中低阶层社区的少数民族患者,合并症的发生率高于该地区其他已报道的队列。虽然表现出的症状与纽约市其他医院相似,但临床病程较差,超过1/3的患者死亡。进一步的分析将集中在符合条件的患者的完整队列中种族/民族群体内部和之间的不良预后预测因素。
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