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Clin Infect Dis ; 73(11): e4005-e4011, 2021 12 06.
Article in English | MEDLINE | ID: covidwho-1562130


BACKGROUND: Racial disparities are central in the national conversation about coronavirus disease 2019 (COVID-19) , with Black/African Americans being disproportionately affected. We assessed risk factors for death from COVID-19 among Black inpatients at an urban hospital in Detroit, Michigan. METHODS: This was a retrospective, single-center cohort study. We reviewed the electronic medical records of patients positive for severe acute respiratory syndrome coronavirus 2 (the COVID-19 virus) on qualitative polymerase chain reaction assay who were admitted between 8 March 2020 and 6 May 2020. The primary outcome was in-hospital mortality. RESULTS: The case fatality rate was 29.1% (122/419). The mean duration of symptoms prior to hospitalization was 5.3 (3.9) days. The incidence of altered mental status on presentation was higher among patients who died than those who survived, 43% vs 20.0%, respectively (P < .0001). From multivariable analysis, the odds of death increased with age (≥60 years), admission from a nursing facility, Charlson score, altered mental status, higher C-reactive protein on admission, need for mechanical ventilation, presence of shock, and acute respiratory distress syndrome. CONCLUSIONS: These demographic, clinical, and laboratory factors may help healthcare providers identify Black patients at highest risk for severe COVID-19-associated outcomes. Early and aggressive interventions among this at-risk population may help mitigate adverse outcomes.

COVID-19 , African Americans , Cohort Studies , Hospital Mortality , Hospitalization , Humans , Middle Aged , Retrospective Studies , Risk Factors , SARS-CoV-2
Am J Infect Control ; 49(11): 1441-1442, 2021 11.
Article in English | MEDLINE | ID: covidwho-1363851


We investigated the clinical implications of bacteremia among hospitalized COVID-19 patients. Higher rates (52.1%) of multidrug resistant organisms (MDRO) were noted on hospital admission compared to nosocomial acquisition (25%). Methicillin resistant Staphylococcus aureus was the predominant pathogen. Bacteremia with MDRO should be considered in the differential diagnosis among at risk populations especially those admitted from nursing facilities.

Bacteremia , COVID-19 , Cross Infection , Methicillin-Resistant Staphylococcus aureus , Bacteremia/epidemiology , Cross Infection/epidemiology , Drug Resistance, Multiple, Bacterial , Hospitals , Humans , SARS-CoV-2