Patient Trajectories Among Persons Hospitalized for COVID-19 : A Cohort Study.
Brian T. Garibaldi,Jacob Fiksel,John Muschelli,Matthew L Robinson,Masoud Rouhizadeh,Jamie Perin,Grant Schumock,Paul Nagy,Josh H. Gray,Harsha Malapati,Mariam Ghobadi-Krueger,Timothy Niessen,Bo Soo Kim,Peter M. Hill,M. Shafeeq Ahmed,Eric D. Dobkin,Renee Blanding,Jennifer Abele,Bonnie Woods,Kenneth Harkness,David R. Thiemann,Mary G. Bowring,Aalok B. Shah,Mei Cheng Wang,Karen Bandeen-Roche,Antony Rosen,Scott L. Zeger,Amita Gupta +27 more
TLDR
This retrospective analysis from 5 Maryland and Washington, DC area hospitals determines factors on hospital admission predictive of severe disease or death from COVID-19 and describes patient trajectories and outcomes categorized using the WHO CO VID-19 disease severity scale.Abstract:
Background Risk factors for progression of coronavirus 2019 (COVID-19) to severe disease or death are underexplored in U.S. cohorts. Objective To determine the factors on hospital admission that are predictive of severe disease or death from COVID-19. Design Retrospective cohort analysis. Setting Five hospitals in the Maryland and Washington, DC, area. Patients 832 consecutive COVID-19 admissions from 4 March to 24 April 2020, with follow-up through 27 June 2020. Measurements Patient trajectories and outcomes, categorized by using the World Health Organization COVID-19 disease severity scale. Primary outcomes were death and a composite of severe disease or death. Results Median patient age was 64 years (range, 1 to 108 years); 47% were women, 40% were Black, 16% were Latinx, and 21% were nursing home residents. Among all patients, 131 (16%) died and 694 (83%) were discharged (523 [63%] had mild to moderate disease and 171 [20%] had severe disease). Of deaths, 66 (50%) were nursing home residents. Of 787 patients admitted with mild to moderate disease, 302 (38%) progressed to severe disease or death: 181 (60%) by day 2 and 238 (79%) by day 4. Patients had markedly different probabilities of disease progression on the basis of age, nursing home residence, comorbid conditions, obesity, respiratory symptoms, respiratory rate, fever, absolute lymphocyte count, hypoalbuminemia, troponin level, and C-reactive protein level and the interactions among these factors. Using only factors present on admission, a model to predict in-hospital disease progression had an area under the curve of 0.85, 0.79, and 0.79, at day 2, 4, and 7, respectively. Limitation The study was done in a single health care system. Conclusion A combination of demographic and clinical variables is strongly associated with severe COVID-19 disease or death and their early onset. The COVID-19 Inpatient Risk Calculator (CIRC), using factors present on admission, can inform clinical and resource allocation decisions. Primary funding source Hopkins inHealth and COVID-19 Administrative Supplement for the HHS Region 3 Treatment Center from the Office of the Assistant Secretary for Preparedness and Response.read more
Citations
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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
TL;DR: Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Journal ArticleDOI
Aging in COVID-19: Vulnerability, immunity and intervention.
Yiyin Chen,Sabra L. Klein,Brian T. Garibaldi,Huifen Li,Cunjin Wu,Nicole M. Osevala,Taisheng Li,Joseph B. Margolick,Graham Pawelec,Sean X. Leng +9 more
TL;DR: It is hypothesized that age-related decline and dysregulation of immune function, i.e., immunosenescence and inflammaging play a major role in contributing to heightened vulnerability to severe COVID-19 outcomes in older adults and partitioning all immunological outcome data by age to better understand disease heterogeneity and aging.
Journal ArticleDOI
Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis.
Shirley Sze,Daniel Pan,Clareece R. Nevill,Laura J. Gray,Christopher A Martin,Joshua Nazareth,Jatinder S. Minhas,Pip Divall,Kamlesh Khunti,Keith R. Abrams,Laura B Nellums,Manish Pareek +11 more
TL;DR: Individuals from Black and Asian ethnicities are at increased risk of COVID-19 infection compared to White individuals; Asians may be at higher risk of ITU admission and death.
Disparities in COVID-19 Outcomes by Race, Ethnicity, and Socioeconomic Status: A Systematic-Review and Meta-analysis.
Shruti Magesh,Shruti Magesh,Daniel John,Daniel John,Wei Tse Li,Wei Tse Li,Yuxiang Li,Yuxiang Li,Aidan Mattingly-App,Aidan Mattingly-App,Sharad Jain,Eric Y. Chang,Eric Y. Chang,Weg M. Ongkeko,Weg M. Ongkeko +14 more
TL;DR: In this article, the authors evaluated the association of race and ethnicity with COVID-19 outcomes and examined the association between race, ethnicity, COVID19 outcomes, and socioeconomic determinants.
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Longitudinal profiling of respiratory and systemic immune responses reveals myeloid cell-driven lung inflammation in severe COVID-19.
Peter A. Szabo,Pranay Dogra,Joshua I. Gray,Steven B. Wells,Thomas J. Connors,Stuart P. Weisberg,Izabela Krupska,Rei Matsumoto,Maya M.L. Poon,Emma Idzikowski,Sinead E. Morris,Chloé Pasin,Andrew J. Yates,Amy Ku,Michael Chait,Julia Davis-Porada,Xinzheng V. Guo,Jing Zhou,Matthew Steinle,Sean Mackay,Anjali Saqi,Matthew R. Baldwin,Peter A. Sims,Donna L. Farber +23 more
TL;DR: In this paper, the authors examined the relationship between immune processes in the respiratory tract and circulation through longitudinal phenotypic, transcriptomic, and cytokine profiling of paired airway and blood samples from patients with severe COVID-19 relative to heathy controls.
References
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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
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Dawei Wang,Bo Hu,Chang Hu,Fangfang Zhu,Xing Liu,Jing Zhang,Binbin Wang,Hui Xiang,Zhenshun Cheng,Yong Xiong,Yan Zhao,Yirong Li,Xinghuan Wang,Zhiyong Peng +13 more
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Regularization Paths for Generalized Linear Models via Coordinate Descent
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