Patient Characteristics and Outcomes of 11 721 Patients With Coronavirus Disease 2019 (COVID-19) Hospitalized Across the United States

Fried, Michael; Crawford, Julie M.; Mospan, Andrea R.; Watkins, Stephanie; Muñoz, Breda; Zink, Richard C.; Elliott, Sherry; Burleson, Kyle; Landis, Charles; Reddy, K. Rajender; Brown, Robert S.

doi:10.1093/cid/ciaa1268

Cited by 140 publications

(128 citation statements)

References 26 publications

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“…There was not a significant difference among the genders regarding mortality (p=0.6553). The male patient ratio is consistent with the US data [ 13 ]. In a study conducted in Iran, Raoufi et al reported no difference between genders in terms of mortality among 380 COVID-19 patients [ 14 ].…”

Section: Discussionsupporting

confidence: 91%

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Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department

Saçak¹,

Karacabey²,

Sanri³

et al. 2021

Cureus

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Introduction: A cluster of atypical pneumonia cases in Wuhan, China, turned out to be a highly contagious disease, swept across most of the countries, and soon after was announced as a pandemic. Therefore we aimed to investigate the demographics and factors associated with the disease outcome. Methods: In this retrospective chart review, we screened patients admitted to the emergency department with severe acute respiratory infection due to coronavirus disease 2019 (COVID-19) between March 15, 2020 and April 30, 2020. Age, gender, symptoms, laboratory data, and radiology data were obtained, as well as outcomes and length of stay. Results: We identified 177 patients (54.8% male). Seventy-eight percent of the cases were admitted into wards whereas 22% of the cases were admitted into the intensive care unit (ICU). Twenty-five percent of the cases needed invasive mechanical ventilation during their hospital stay and median length of hospital stay until death or discharge was eight days (interquartile range (IQR) 5.0 - 16.0). Among 177 patients, overall in-hospital mortality rate was 19.8% (n=35; male:female=18:17; p=0.6553). In-hospital mortality rates were statistically significantly higher in patients with higher age (64 vs. 74; p=0.0091), respiratory rate (RR) (28 vs. 36; p=0.0002), C-reactive protein (CRP) (54.7 vs. 104.0; p<0.0001), d-dimer (1.2 vs. 3.2; p<0.0001), ferritin (170 vs. 450.4; p<0.0001), fibrinogen (512 vs. 598; p=0.0349), international normalized ratio (INR) (1.1 vs. 1.3; p=0.0001), prothrombin time (PT) (14.8 vs. 17.4; p=0.0001), procalcitonin (0.1 vs. 0.3; p<0.0001), creatinine (0.9 vs. 1.1; p=0.0084), longer length of stay (LOS) (8.0 vs. 13.0; p=0.0251) with lower oxygen saturation (sO 2 ) (93.0% vs 87.5%; p<0.0001), diastolic blood pressure (DBP) (78 vs. 70; p=0.0039), lymphocyte (1.2 vs. 0.8; p=0.0136), and with positive polymerase chain reaction (PCR) results (28.6% vs. 12.8%; p=0.0118). Conclusion: Patients with older age, higher RR, lower sO 2 and DBP, higher creatinine, d-dimer, INR, CRP, procalcitonin, ferritin, and fibrinogen on initial admission were found to be less likely to survive COVID-19.

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Section: Discussionsupporting

confidence: 91%

“…Median LOS was significantly longer in non-survivors than in survivors (13.0 vs. 8.0, p=0.0251). US data revealed median LOS of 7.0 [ 13 ]. Pan et al reported longer median LOS in survivors than in non-survivors, with no significant difference (14.0 vs. 18.0, p=0.068) [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department

Saçak¹,

Karacabey²,

Sanri³

et al. 2021

Cureus

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“…Then, 315 records were excluded with reasons, including studies that were in-vitro/in-silico/animal experiments (n=96), investigating other medications (n=93), evaluating other diseases (n=68), review/systematic review and meta-analysis/editorial/commentary (n=18), irrelevant (n=17), unfinished/terminated/suspended clinical trials (n=13), duplicates (n=8), or case reports (n=2). Finally, ten studies, including five RCTs ( Beigel et al, 2020b ; Goldman et al, 2020 ; Pan et al, 2020 ; Spinner et al, 2020 ; Wang et al, 2020 ) and five NRSIs ( Antinori et al, 2020 ; Fried et al, 2020 ; Grein et al, 2020 ; Olender et al, 2020 ; Pasquini et al, 2020 ), were entered into the meta-analysis ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Remdesivir for treatment of COVID-19; an updated systematic review and meta-analysis

Rezagholizadeh

Khiali

Sarbakhsh

et al. 2021

European Journal of Pharmacology

100

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The coronavirus disease 2019 (COVID-19) pandemic has become a global health crisis. Considering the recent food and drug administration (FDA) approval of remdesivir as the first officially approved agent for COVID-19 treatment, we performed this systematic review and meta-analysis to evaluate the efficacy and safety of remdesivir administration in COVID-19 patients. A systematic literature search was done through MEDLINE, Google Scholar, Web of Science, Scopus, Science Direct, Cochrane Library, medRxiv, and bioRxiv from their inception to December 22th, 2020. Five randomized controlled trials (RCTs) and five non-randomized studies of intervention (NRSI) were entered into the meta-analysis. The results showed that remdesivir administration was associated with a significant improvement in the 28-day recovery (RR=1.09, 95%CI, 1.04-1.15), low flow oxygen support through days one to 14 (RR=2.88, 95%CI, 1.80-4.60), and invasive mechanical ventilation or extracorporeal membrane oxygenation requirement through days 14 to 28 of the follow-up time (RR=5.34, 95%CI, 2.37-12.05). The risk of experiencing serious adverse drug reactions (ADRs) was significantly lower (RR=0.75, 95%CI, 0.63-0.90) in the remdesivir group than the comparison/control group. The pooled median difference of the time to clinical improvement was 2.99 (95%CI=2.71-3.28), which did not remain significant during the sensitivity analysis. The clinical output comparison of the 5-day and 10-day remdesivir courses revealed that the 5-day regimen might provide similar benefits while causing fewer serious ADRs than 10-day. The current meta-analysis provided an updated evaluation of scientific evidence on the use of remdesivir in COVID-19 patients. Performing adequate well-designed RCTs are needed to show more accurate results.

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“…Most of our patients admitted to ICU received mechanical ventilation. The reported crude mortality of previous reports in the same population was 70% [7] , [8] , [9] . In our cohort, the in-hospital absolute mortality rate in those cases admitted to ICU was lower (48·98%).…”

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confidence: 66%

Cyclosporine A and COVID19 – The COQUIMA cohort – Author's reply

et al. 2021

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Thank you for your gentle comments about our manuscript under the format of a letter to the editor.These comments give positive feedback to our research. They also contribute to a scientific debate to boost the research on cyclosporine A for COVID-19.We thank Dr Mac e M Schuurmans and Dr Ren e Hage for their comments about our manuscript under the format of a letter to the editor. These comments give positive feedback to our research. They also contribute to a scientific debate to boost the research on cyclosporine A for COVID-19.Firstly, CsA might use in those patients in the second stage of SARS-CoV-2 infection, the pulmonary phase1 [1]. Hypoxemia and bilateral lung infiltrates or ground-glass opacities characterizes this phase. Most hospitals admit patients into wards during this disease phase. The hypoxemia -as mentioned in the manuscript-should be defined as saturation of oxygen below 94% or PaO 2 /FiO 2 < 300 mmHg. Typically, blood tests detect lymphopenia or transaminitis. A rise of inflammatory parameters, such as d-dimer, ferritin, and C-protein reactive, is also identified. Those cases in stage III, systemic hyperinflammation, are, of course, also suitable for CsA therapy. The transition between both phases is rather dynamic, and probable most hospitalized cases share features of both pulmonary and hyperinflammatory stages.Secondly, in our opinion, CsA therapy should start as soon as possible in hospitalized patients. It also might work as rescue therapy in those cases which do not improve after supportive measures. Nowadays, the best standard of care might include dexamethasone 6 mg q. i.d. intravenously [2] -and thrombosis prophylaxis with low-molecular-weight heparin.

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Patient Characteristics and Outcomes of 11 721 Patients With Coronavirus Disease 2019 (COVID-19) Hospitalized Across the United States

Cited by 140 publications

References 26 publications

Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department

Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department

Remdesivir for treatment of COVID-19; an updated systematic review and meta-analysis

Cyclosporine A and COVID19 – The COQUIMA cohort – Author's reply

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