Epidemiology, Clinical Features, and Outcomes of Hospitalized Adults with COVID-19: Early Experience from an Academic Medical Center in Mississippi.

Autor:	Lucar J; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Wingler MJB; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Cretella DA; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Ward LM; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Sims Gomillia CE; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Chamberlain N; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Shimose LA; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Brock JB; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Harvey J; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Wilhelm A; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Majors LT; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Jeter JB; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Bueno MX; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Albrecht S; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Navalkele B; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Mena LA; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson., Parham J; From the Department of Medicine, Divisions of Infectious Diseases, Pulmonary, and Critical Care, and Hospital Medicine, and the Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson.
Jazyk:	angličtina
Zdroj:	Southern medical journal [South Med J] 2021 Mar; Vol. 114 (3), pp. 144-149.
DOI:	10.14423/SMJ.0000000000001222
Abstrakt:	Objectives: To describe the demographics, clinical characteristics, and outcomes of hospitalized adults with coronavirus disease 2019 (COVID-19) in an academic medical center in the southern United States. Methods: Retrospective, observational cohort study of all adult patients (18 years and older) consecutively admitted with laboratory-confirmed severe acute respiratory syndrome-coronavirus-2 infection between March 13 and April 25, 2020 at the University of Mississippi Medical Center. All of the patients either survived to hospital discharge or died during hospitalization. Demographics, body mass index, comorbidities, clinical manifestations, and laboratory findings were collected. Patient outcomes (need for invasive mechanical ventilation and in-hospital death) were analyzed. Results: One hundred patients were included, 53% of whom were women. Median age was 59 years (interquartile range 44-70) and 66% were younger than 65. Seventy-five percent identified themselves as Black, despite representing 58% of hospitalized patients at our institution in 2019. Common comorbid conditions included hypertension (68%), obesity (65%), and diabetes mellitus (31%). Frequent clinical manifestations included shortness of breath (76%), cough (75%), and fever (64%). Symptoms were present for a median of 7 days (interquartile range 4-7) on presentation. Twenty-four percent of patients required mechanical ventilation and, overall, 19% died (67% of those requiring mechanical ventilation). Eighty-four percent of those who died were Black. On multivariate analysis, ever smoking (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.2-28.6) and history of diabetes mellitus (OR 5.9, 95% CI 1.5-24.3) were associated with mortality, and those admitted from home were less likely to die (vs outside facility, OR 0.2, 95% CI 0.0-0.7). Neither age, sex, race, body mass index, insurance status, nor rural residence was independently associated with mortality. Conclusions: Our study adds evidence that Black patients appear to be overrepresented in those hospitalized with and those who die from COVID-19, likely a manifestation of adverse social determinants of health. These findings should help guide preventive interventions targeting groups at higher risk of acquiring and developing severe COVID-19 disease.
Databáze:	MEDLINE
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