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Given that New York City (NYC) is the epicenter of COVID-19 in United States, the outcomes of people there are of intense interest. Now, investigators provide information on 5700 people hospitalized with COVID-19 between March 1 and April 4, 2020, in 12 hospitals in the NYC area.
The median age was 63 years, and 60% were male. Almost 95% of patients had one or more comorbidities (median number, 4). Common comorbidities included hypertension (57%), obesity (42%), and diabetes (34%). Only 1% had a history of solid-organ transplantation and 0.8% had HIV. The first SARS-CoV-2 test was positive in 97%, and 3% had a negative first test but a positive second test. Respiratory co-pathogens were found in 2% of 1996 patients tested. At the time the data were analyzed, of the 1151 patients who required mechanical ventilation, 3.3% were discharged alive, 24.5% had died, and 72.2% were still in the hospital.
Richardson S et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA 2020 Apr 22; [e-pub]. (https://doi.org/10.1001/jama.2020.6775)
Comment
This study garnered headlines because it reported close to 90% mortality among those who required mechanical ventilation. A clarification and correction of the article were subsequently issued. Because most of the patients were still in the hospital at the time of analysis, the true rate of death cannot yet be assessed; depending on what happens to people who are still hospitalized, the mortality rate may go up or down. Advances in the respiratory management of COVID-19, and our own and others' experience, suggest that people on mechanical ventilation may recover even after several weeks on the ventilator. This report — and the clarification — remind us that COVID-19 is a rapidly evolving story. It is premature to make conclusions about outcomes until there is longer follow-up and more is known.