Your browser doesn't support javascript.
Clinical Management of Hospitalized Coronavirus Disease 2019 Patients in the United States.
Mozaffari, Essy; Chandak, Aastha; Zhang, Zhiji; Liang, Shuting; Gayle, Julie; Thrun, Mark; Gottlieb, Robert L; Kuritzkes, Daniel R; Sax, Paul E; Wohl, David A; Casciano, Roman; Hodgkins, Paul; Haubrich, Richard.
  • Mozaffari E; Gilead Sciences, Foster City, California, USA.
  • Chandak A; Certara, New York, New York, USA.
  • Zhang Z; Certara, New York, New York, USA.
  • Liang S; Gilead Sciences, Foster City, California, USA.
  • Gayle J; Premier Inc., Charlotte, North Carolina, USA.
  • Thrun M; Gilead Sciences, Foster City, California, USA.
  • Gottlieb RL; Baylor University Medical Center, Dallas, Texas, USA.
  • Kuritzkes DR; Baylor Scott and White Heart and Vascular Hospital, , Dallas, Texas, USA.
  • Sax PE; Baylor Scott and White The Heart Hospital, Plano, Texas, USA.
  • Wohl DA; Baylor Scott and White Research Institute, Dallas, Texas, USA.
  • Casciano R; Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Hodgkins P; Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Haubrich R; University of North Carolina, Chapel Hill, North Carolina, USA.
Open Forum Infect Dis ; 9(1): ofab498, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1606723
ABSTRACT

BACKGROUND:

The objective of this study was to characterize hospitalized coronavirus disease 2019 (COVID-19) patients and describe their real-world treatment patterns and outcomes over time.

METHODS:

Adult patients hospitalized on May 1, 2020-December 31, 2020 with a discharge diagnosis of COVID-19 were identified from the Premier Healthcare Database. Patient and hospital characteristics, treatments, baseline severity based on oxygen support, length of stay (LOS), intensive care unit (ICU) utilization, and mortality were examined.

RESULTS:

The study included 295657 patients (847 hospitals), with median age of 66 (interquartile range, 54-77) years. Among each set of demographic comparators, the majority were male, white, and over 65. Approximately 85% had no supplemental oxygen charges (NSOc) or low-flow oxygen (LFO) at baseline, whereas 75% received no more than NSOc or LFO as maximal oxygen support at any time during hospitalization. Remdesivir (RDV) and corticosteroid treatment utilization increased over time. By December, 50% were receiving RDV and 80% were receiving corticosteroids. A higher proportion initiated COVID-19 treatments within 2 days of hospitalization in December versus May (RDV, 87% vs 40%; corticosteroids, 93% vs 62%; convalescent plasma, 68% vs 26%). There was a shift toward initiating RDV in patients on NSOc or LFO (68.0% [May] vs 83.1% [December]). Median LOS decreased over time. Overall mortality was 13.5% and it was highest for severe patients (invasive mechanical ventilation/extracorporeal membrane oxygenation [IMV/ECMO], 53.7%; high-flow oxygen/noninvasive ventilation [HFO/NIV], 32.2%; LFO, 11.7%; NSOc, 7.3%). The ICU use decreased, whereas mortality decreased for NSOc and LFO.

CONCLUSIONS:

Clinical management of COVID-19 is rapidly evolving. This large observational study found that use of evidence-based treatments increased from May to December 2020, whereas improvement in outcomes occurred over this time-period.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid