Factors associated with survival in patients with COVID -19 admitted to a community hospital in New York City

Introduction: COVID-19 has been associated with increased mortality in old age, hypertension and male gender. Higher prevalence of increased body mass index (BMI), mechanical ventilation and renal failure has been found in the patients admitted to our New York City community hospital; accordingly we aim to explore the association between these parameters and survival in our patients. Methods: Retrospective review of patients admitted with the COVID-19 disease March 14 to April 30 of 2020. Analysis using Cox regression models, Log rank tests and Kaplan Meier curves was done for a total of 326 patients that met our criteria. Results: The adjusted odds of death for those at least 75 years of age were higher than those within the age group of 18 to 44 years. The patients with over 92% oxygen saturation had lower adjusted odds of death than those with 88 to 92% oxygen saturation (Odds Ratio (OR)=0.2, 95% CI=0.06, 0.70), as well as lower adjusted hazard of dying (Hazard Ratio (HR)=0.4, 95% CI=0.21, 0.87). Intubation was associated with a higher adjusted odds ratio (OR=57.8, 95% CI=17.74, 188.30) and adjusted hazard ratio HR=5.4 (95% CI=2.59, 11.21) for death. After controlling for age and gender, neither levels of serum D-dimer nor creatinine were found to be significantly associated with mortality The factors that comprise metabolic syndrome, i.e., elevated BMI, diabetes, hypertension, and hyperlipidemia, were found to have no significant association with the outcome of death after controlling for age and sex and they also had no significant association with the time until death. Conclusions: In the study population, COVID-19 was associated with increased mortality in patients who required intubation, and in the elderly, which may be explained by changes in the immune system over time. Elevated BMI, though not statistically significant, was present in the majority of our study population, which may have contributed to the group's high mortality.