EClinicalMedicine (Sep 2020)

Early clinical and sociodemographic experience with patients hospitalized with COVID-19 at a large American healthcare system

  • Cian P. McCarthy,
  • Sean Murphy,
  • Maeve Jones-O'Connor,
  • David S. Olshan,
  • Jay R. Khambhati,
  • Saad Rehman,
  • John B. Cadigan,
  • Jinghan Cui,
  • Eric A. Meyerowitz,
  • George Philippides,
  • Lawrence S. Friedman,
  • Aran Y. Kadar,
  • Kathryn Hibbert,
  • Pradeep Natarajan,
  • Anthony F. Massaro,
  • Erin A. Bohula,
  • David A. Morrow,
  • Ann E. Woolley,
  • James L. Januzzi, Jr,
  • Jason H. Wasfy

Journal volume & issue
Vol. 26
p. 100504

Abstract

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Background: Despite over 4 million cases of novel coronavirus disease 2019 (COVID-19) in the United States, limited data exist including socioeconomic background and post-discharge outcomes for patients hospitalized with this disease. Methods: In this case series, we identified patients with COVID-19 admitted to 3 Partners Healthcare hospitals in Boston, Massachusetts between March 7th, 2020, and March 30th, 2020. Patient characteristics, treatment strategies, and outcomes were determined. Findings: A total of 247 patients hospitalized with COVID-19 were identified; the median age was 61 (interquartile range [IQR]: 50–76 years), 58% were men, 30% of Hispanic ethnicity, 21% enrolled in Medicaid, and 12% dual-enrolled Medicare/Medicaid. The median estimated household income was $66,701 [IQR: $50,336-$86,601]. Most patients were treated with hydroxychloroquine (72%), and statins (76%; newly initiated in 34%). During their admission, 103 patients (42%) required intensive care. At the end of the data collection period (June 24, 2020), 213 patients (86.2%) were discharged alive, 2 patients (0.8%) remain admitted, and 32 patients (13%) have died. Among those discharged alive (n = 213), 70 (32.9%) were discharged to a post-acute facility, 31 (14.6%) newly required supplemental oxygen, 19 (8.9%) newly required tube feeding, and 34 (16%) required new prescriptions for antipsychotics, benzodiazepines, methadone, or opioids. Over a median post-discharge follow-up of 80 days (IQR, 68–84), 22 patients (10.3%) were readmitted. Interpretation: Patients hospitalized with COVID-19 are frequently of vulnerable socioeconomic status and often require intensive care. Patients who survive COVID-19 hospitalization have substantial need for post-acute services.

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