Retrospective cohort study of clinical characteristics of 2199 hospitalised patients with COVID-19 in New York City

Ishan Paranjpe; Adam J Russak; Jessica K De Freitas; Anuradha Lala; Riccardo Miotto; Akhil Vaid; Kipp W Johnson; Matteo Danieletto; Eddye Golden; Dara Meyer; Manbir Singh; Sulaiman Somani; Arjun Kapoor; Ross O'Hagan; Sayan Manna; Udit Nangia; Suraj K Jaladanki; Paul O'Reilly; Laura M Huckins; Patricia Glowe; Arash Kia; Prem Timsina; Robert M Freeman; Matthew A Levin; Jeffrey Jhang; Adolfo Firpo; Patricia Kovatch; Joseph Finkelstein; Judith A Aberg; Emilia Bagiella; Carol R Horowitz; Barbara Murphy; Zahi A Fayad; Jagat Narula; Eric J Nestler; V Fuster; Carlos Cordon-Cardo; Dennis Charney; David L Reich; Allan Just; Erwin P Bottinger; Alexander W Charney; Benjamin S Glicksberg; Girish N Nadkarni; Mount Sinai COVID Informatics Center (MSCIC)

doi:10.1136/bmjopen-2020-040736

Retrospective cohort study of clinical characteristics of 2199 hospitalised patients with COVID-19 in New York City

BMJ Open. 2020 Nov 27;10(11):e040736. doi: 10.1136/bmjopen-2020-040736.

Authors

Ishan Paranjpe^#¹, Adam J Russak^#^{2

3}, Jessica K De Freitas^#^{2

4}, Anuradha Lala^#^{5

6}, Riccardo Miotto^{2

4}, Akhil Vaid^{2

4}, Kipp W Johnson^{2

4}, Matteo Danieletto^{2

4}, Eddye Golden^{2

4}, Dara Meyer⁴, Manbir Singh², Sulaiman Somani², Arjun Kapoor², Ross O'Hagan², Sayan Manna², Udit Nangia², Suraj K Jaladanki², Paul O'Reilly^{4

7}, Laura M Huckins^{4

7}, Patricia Glowe^{2

4}, Arash Kia^{6

8}, Prem Timsina^{6

8}, Robert M Freeman^{6

8}, Matthew A Levin^{4

6

8

9}, Jeffrey Jhang¹⁰, Adolfo Firpo¹⁰, Patricia Kovatch¹¹, Joseph Finkelstein⁶, Judith A Aberg^{12

13}, Emilia Bagiella^{5

6}, Carol R Horowitz^{6

13}, Barbara Murphy¹³, Zahi A Fayad^{14

15}, Jagat Narula^{13

16}, Eric J Nestler^{17

18}, V Fuster¹⁹, Carlos Cordon-Cardo¹⁰, Dennis Charney^{20

21}, David L Reich²², Allan Just^{23

24}, Erwin P Bottinger², Alexander W Charney^{4

7}, Benjamin S Glicksberg^{2

4

7}, Girish N Nadkarni^{2

13

25}; Mount Sinai COVID Informatics Center (MSCIC)

Affiliations

¹ The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York, USA [email protected].
² The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York, USA.
³ Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁴ Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁵ The Zena and Michael A. Wiener Cardiovascular Institute, New York, New York, USA.
⁶ Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁷ The Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁸ Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁹ Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
¹⁰ Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
¹¹ Mount Sinai Data Warehouse, Mount Sinai Health System, New York, New York, USA.
¹² Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
¹³ Icahn School of Medicine at Mount Sinai Department of Medicine, New York, New York, USA.
¹⁴ Icahn School of Medicine at Mount Sinai BioMedical Engineering and Imaging Institute, New York, New York, USA.
¹⁵ Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
¹⁶ Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
¹⁷ Icahn School of Medicine at Mount Sinai Friedman Brain Institute, New York, New York, USA.
¹⁸ The Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
¹⁹ Department of Medicine, Division of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
²⁰ Icahn School of Medicine at Mount Sinai Department of Psychiatry, New York, New York, USA.
²¹ The Office of the Dean, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
²² Icahn School of Medicine at Mount Sinai Department of Anesthesiology Perioperative and Pain Medicine, New York, New York, USA.
²³ Icahn School of Medicine at Mount Sinai Department of Environmental Medicine and Public Health, New York, New York, USA.
²⁴ Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
²⁵ The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

^# Contributed equally.

Abstract

Objective: The COVID-19 pandemic is a global public health crisis, with over 33 million cases and 999 000 deaths worldwide. Data are needed regarding the clinical course of hospitalised patients, particularly in the USA. We aimed to compare clinical characteristic of patients with COVID-19 who had in-hospital mortality with those who were discharged alive.

Design: Demographic, clinical and outcomes data for patients admitted to five Mount Sinai Health System hospitals with confirmed COVID-19 between 27 February and 2 April 2020 were identified through institutional electronic health records. We performed a retrospective comparative analysis of patients who had in-hospital mortality or were discharged alive.

Setting: All patients were admitted to the Mount Sinai Health System, a large quaternary care urban hospital system.

Participants: Participants over the age of 18 years were included.

Primary outcomes: We investigated in-hospital mortality during the study period.

Results: A total of 2199 patients with COVID-19 were hospitalised during the study period. As of 2 April, 1121 (51%) patients remained hospitalised, and 1078 (49%) completed their hospital course. Of the latter, the overall mortality was 29%, and 36% required intensive care. The median age was 65 years overall and 75 years in those who died. Pre-existing conditions were present in 65% of those who died and 46% of those discharged. In those who died, the admission median lymphocyte percentage was 11.7%, D-dimer was 2.4 μg/mL, C reactive protein was 162 mg/L and procalcitonin was 0.44 ng/mL. In those discharged, the admission median lymphocyte percentage was 16.6%, D-dimer was 0.93 μg/mL, C reactive protein was 79 mg/L and procalcitonin was 0.09 ng/mL.

Conclusions: In our cohort of hospitalised patients, requirement of intensive care and mortality were high. Patients who died typically had more pre-existing conditions and greater perturbations in inflammatory markers as compared with those who were discharged.

Keywords: infectious diseases; internal medicine; public health.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
C-Reactive Protein / metabolism
COVID-19 / blood*
COVID-19 / epidemiology
COVID-19 / mortality
Comorbidity
Critical Care* / statistics & numerical data
Female
Fibrin Fibrinogen Degradation Products / metabolism
Hospital Mortality*
Hospitalization*
Hospitals
Humans
Lymphocytes / metabolism
Male
Middle Aged
New York City / epidemiology
Pandemics*
Procalcitonin / blood
Retrospective Studies
Risk Factors
SARS-CoV-2
Young Adult

Substances

Fibrin Fibrinogen Degradation Products
Procalcitonin
fibrin fragment D
C-Reactive Protein

Abstract

Publication types

MeSH terms

Substances

Grants and funding