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Mallipattu SK, Jawa R, Moffitt R, Hajagos J, Fries B, Nachman S, Gan TJ, Saltz M, Saltz J, Kaushansky K, Skopicki H, Abell-Hart K, Chaudhri I, Deng J, Garcia V, Gayen S, Kurc T, Bolotova O, Yoo J, Dhaliwal S, Nataraj N, Sun S, Tsai C, Wang Y, Abbasi S, Abdullah R, Ahmad S, Bai K, Bennett-Guerrero E, Chua A, Gomes C, Griffel M, Kalogeropoulos A, Kiamanesh D, Kim N, Koraishy F, Lingham V, Mansour M, Marcos L, Miller J, Poovathor S, Rubano J, Rutigliano D, Sands M, Santora C, Schwartz J, Shroyer K, Spitzer S, Stopeck A, Talamini M, Tharakan M, Vosswinkel J, Wertheim W, Mallipattu SK, Jawa R, Moffitt R, Hajagos J, Fries B, Nachman S, Gan TJ, Saltz M, Saltz J, Kaushansky K, Skopicki H, Abell-Hart K, Chaudhri I, Deng J, Garcia V, Gayen S, Kurc T, Bolotova O, Yoo J, Dhaliwal S, Nataraj N, Sun S, Tsai C, Wang Y, Abbasi S, Abdullah R, Ahmad S, Bai K, Bennett-Guerrero E, Chua A, Gomes C, Griffel M, Kalogeropoulos A, Kiamanesh D, Kim N, Koraishy F, Lingham V, Mansour M, Marcos L, Miller J, Poovathor S, Rubano J, Rutigliano D, Sands M, Santora C, Schwartz J, Shroyer K, Spitzer S, Stopeck A, Talamini M, Tharakan M, Vosswinkel J, Wertheim W. Geospatial Distribution and Predictors of Mortality in Hospitalized Patients With COVID-19: A Cohort Study. Open Forum Infect Dis 2020; 7:ofaa436. [PMID: 33117852 PMCID: PMC7543608 DOI: 10.1093/ofid/ofaa436] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/09/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The global coronavirus disease 2019 (COVID-19) pandemic offers the opportunity to assess how hospitals manage the care of hospitalized patients with varying demographics and clinical presentations. The goal of this study was to demonstrate the impact of densely populated residential areas on hospitalization and to identify predictors of length of stay and mortality in hospitalized patients with COVID-19 in one of the hardest hit counties internationally. METHODS This was a single-center cohort study of 1325 sequentially hospitalized patients with COVID-19 in New York between March 2, 2020, to May 11, 2020. Geospatial distribution of study patients' residences relative to population density in the region were mapped, and data analysis included hospital length of stay, need and duration of invasive mechanical ventilation (IMV), and mortality. Logistic regression models were constructed to predict discharge dispositions in the remaining active study patients. RESULTS The median age of the study cohort (interquartile range [IQR]) was 62 (49-75) years, and more than half were male (57%) with history of hypertension (60%), obesity (41%), and diabetes (42%). Geographic residence of the study patients was disproportionately associated with areas of higher population density (r s = 0.235; P = .004), with noted "hot spots" in the region. Study patients were predominantly hypertensive (MAP > 90 mmHg; 670, 51%) on presentation with lymphopenia (590, 55%), hyponatremia (411, 31%), and kidney dysfunction (estimated glomerular filtration rate < 60 mL/min/1.73 m2; 381, 29%). Of the patients with a disposition (1188/1325), 15% (182/1188) required IMV and 21% (250/1188) developed acute kidney injury. In patients on IMV, the median (IQR) hospital length of stay in survivors (22 [16.5-29.5] days) was significantly longer than that of nonsurvivors (15 [10-23.75] days), but this was not due to prolonged time on the ventilator. The overall mortality in all hospitalized patients was 15%, and in patients receiving IMV it was 48%, which is predicted to minimally rise from 48% to 49% based on logistic regression models constructed to project disposition in the remaining patients on ventilators. Acute kidney injury during hospitalization (odds ratioE, 3.23) was the strongest predictor of mortality in patients requiring IMV. CONCLUSIONS This is the first study to collectively utilize the demographics, clinical characteristics, and hospital course of COVID-19 patients to identify predictors of poor outcomes that can be used for resource allocation in future waves of the pandemic.
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Affiliation(s)
| | - S K Mallipattu
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - R Jawa
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - R Moffitt
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Hajagos
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - B Fries
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Nachman
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - T J Gan
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Saltz
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Saltz
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - K Kaushansky
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - H Skopicki
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - K Abell-Hart
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - I Chaudhri
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Deng
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - V Garcia
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Gayen
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - T Kurc
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - O Bolotova
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Yoo
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Dhaliwal
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - N Nataraj
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Sun
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - C Tsai
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - Y Wang
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Abbasi
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - R Abdullah
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Ahmad
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - K Bai
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - E Bennett-Guerrero
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - A Chua
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - C Gomes
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Griffel
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - A Kalogeropoulos
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - D Kiamanesh
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - N Kim
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - F Koraishy
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - V Lingham
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Mansour
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - L Marcos
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Miller
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Poovathor
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Rubano
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - D Rutigliano
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Sands
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - C Santora
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Schwartz
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - K Shroyer
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Spitzer
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - A Stopeck
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Talamini
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Tharakan
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Vosswinkel
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - W Wertheim
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S K Mallipattu
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - R Jawa
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - R Moffitt
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Hajagos
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - B Fries
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Nachman
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - T J Gan
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Saltz
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Saltz
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - K Kaushansky
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - H Skopicki
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - K Abell-Hart
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - I Chaudhri
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Deng
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - V Garcia
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Gayen
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - T Kurc
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - O Bolotova
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Yoo
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Dhaliwal
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - N Nataraj
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Sun
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - C Tsai
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - Y Wang
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Abbasi
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - R Abdullah
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Ahmad
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - K Bai
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - E Bennett-Guerrero
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - A Chua
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - C Gomes
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Griffel
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - A Kalogeropoulos
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - D Kiamanesh
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - N Kim
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - F Koraishy
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - V Lingham
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Mansour
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - L Marcos
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Miller
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Poovathor
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Rubano
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - D Rutigliano
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Sands
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - C Santora
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Schwartz
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - K Shroyer
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - S Spitzer
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - A Stopeck
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Talamini
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - M Tharakan
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - J Vosswinkel
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
| | - W Wertheim
- Renaissance School of Medicine at Stony Brook University, Stony Brook University, Stony Brook, New York, USA
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Moriera F, So K, Gould P, Kamnasaran D, Jensen RL, Hussain I, Gutmann DH, Gorovets D, Kastenhuber ER, Pentsova E, Nayak L, Huse JT, van den Bent MJ, Gravendeel LA, Gorlia T, Kros JM, Wesseling P, Teepen J, Idbaih A, Sanson M, Smitt PAS, French PJ, Zhang W, Zhang J, Hoadley K, Carter B, Li S, Kang C, You Y, Jiang C, Song S, Jiang T, Chen C, Grimm C, Weiler M, Claus R, Weichenhan D, Hartmann C, Plass C, Weller M, Wick W, Jenkins RB, Sicotte H, Xiao Y, Fridley BL, Decker PA, Kosel ML, Kollmeyer TM, Fink SR, Rynearson AL, Rice T, McCoy LS, Smirnov I, Tehan T, Hansen HM, Patoka JS, Prados MD, Chang SM, Berger MS, Lachance DH, Wiencke JK, Wiemels JL, Wrensch MR, Gephart MH, Lee E, Kyriazopoulou-Panagiotopoulou S, Milenkovic L, Xun X, Hou Y, Kui W, Edwards M, Batzoglou S, Jun W, Scott M, Hobbs JE, Tipton J, Zhou T, Kelleher NL, Chandler JP, Schwarzenberg J, Czernin J, Cloughesy T, Ellingson B, Geist C, Phelps M, Chen W, Nakada M, Hayashi Y, Obuchi W, Ohtsuki S, Watanabe T, Ikeda C, Misaki K, Kita D, Hayashi Y, Uchiyama N, Terasaki T, Hamada JI, Hiddingh L, Tops B, Hulleman E, Kaspers GJL, Vandertop WP, Wesseling P, Noske DP, Wurdinger T, Jeuken JW, See AP, Hwang T, Shin D, Shin JH, Gao Y, Lim M, Hutterer M, Michael M, Gerold U, Karin S, Ingrid G, Florian D, Armin M, Eugen T, Eberhard G, Gunther S, Cook RW, Oelschlager K, Sevim H, Chung L, Wheeler HT, Baxter RC, McDonald KL, Chaturbedi A, Yu L, Zhou YH, Chaturbedi A, Wong A, Fatuyi R, Linskey ME, Zhou YH, Lavon I, Shahar T, Zrihan D, Granit A, Ram Z, Siegal T, Brat DJ, Cooper LA, Gutman DA, Chisolm CS, Appin C, Kong J, Kurc T, Van Meir EG, Saltz JH, Moreno CS, Abuhusain HJ, McDonald KL, Don AS, Nagarajan RP, Johnson BE, Olshen AB, Smirnov I, Xie M, Wang J, Sundaram V, Paris P, Wang T, Costello JF, Sijben AE, Boots-Sprenger SH, Boogaarts J, Rijntjes J, Geitenbeek JM, van der Palen J, Bernsen HJ, Wesseling P, Jeuken JW, Schnell O, Adam SA, Eigenbrod S, Kretzschmar HA, Tonn JC, Schuller U, Schwarzenberg J, Cloughesy T, Czernin J, Geist C, Phelps M, Chen W, Sperduto PW, Kased N, Roberge D, Xu Z, Shanley R, Luo X, Sneed PK, Chao ST, Weil RJ, Suh J, Bhatt A, Jensen AW, Brown PD, Shih HA, Kirkpatrick J, Gaspar LE, Fiveash JB, Chiang V, Knisely JP, Sperduto CM, Lin N, Mehta MP, Kwatra MM, Porter TM, Brown KE, Herndon JE, Bigner DD, Dahlrot RH, Kristensen BW, Hansen S, Sulman EP, Cahill DP, Wang M, Won M, Hegi ME, Mehta MP, Aldape KD, Gilbert MR, Sadr ES, Tessier A, Sadr MS, Alshami J, Sabau C, Del Maestro R, Neal ML, Rockne R, Trister AD, Swanson KR, Maleki S, Back M, Buckland M, Brazier D, McDonald K, Cook R, Parker N, Wheeler H, Jalbert L, Elkhaled A, Phillips JJ, Yoshihara HA, Parvataneni R, Srinivasan R, Bourne G, Chang SM, Cha S, Nelson SJ, Aldape KD, Gilbert M, Cahill D, Wang M, Won M, Hegi M, Colman H, Mehta M, Sulman E, Elkhaled A, Jalbert L, Constantin A, Phillips J, Yoshihara H, Srinivasan R, Bourne G, Chang SM, Cha S, Nelson S, Gunn S, Reveles XT, Tirtorahardjo B, Strecker MN, Fichtel L. -OMICS AND PROGNOSTIC MARKERS. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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