Characteristics and Outcomes Based on Perceived Illness Severity in SARS-CoV-2. Issue 12 (December 2020)

• Record Type: Journal Article
• Authors: Snipelisky, David; Johnson, Rachel; Prasad, Rajnish; Lakhani, Baqir; Ellington, Jeffrey
• Is Part Of: Southern medical journal. Volume 113:Issue 12(2020)
• Publication Date: 2020-12
• Subjects: coronavirus disease 2019 (COVID-19) -- critical care -- intensive care -- prognosis -- severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2); Medicine -- Periodicals; 610.5
• DOI: 10.14423/SMJ.0000000000001182
• Languages: English
• ISSNs: 0038-4348

Abstract

Abstract: Objectives: The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) epidemic is characterized by a global sense of uncertainty, partly driven by the paucity of real-life clinical data. This study assessed whether admission patient characteristics were associated with need for intensive care unit (ICU) care. Methods: The observational study included consecutive patients admitted to a large community teaching hospital with a diagnosis of SARS-CoV-2 between March 6, 2020 and March 31, 2020. Comparisons were made based on the need for ICU admission. Results: A total of 156 patients were admitted, 42 of whom (26.9%) required ICU admission and 114 (73.1%) did not. No difference in age (61.9 years vs 60.5 years, P = 0.67), race/ethnicity, or comorbidities were noted, except that patients requiring ICU care had lower serum albumin levels and lymphocyte counts and higher liver function tests, white blood cell count, and absolute neutrophil count on admission. The average time from admission to death was similar (10 days in an ICU subset vs 9.2 days in a non-ICU subset, P = 0.78), yet patients necessitating ICU care had longer hospital lengths of stay (10.2 vs 5.1 days, P = 0.0002). At the time of data extraction, 15 patients in the ICU had died, 7 were discharged from the hospital, and 20 were still admitted while 5 patients died in the non-ICU cohort with 97 discharged and 12 patients admitted. Conclusions: This is the largest study assessing clinical differences based on the need for ICU admission in inpatients with SARS-CoV-2. It found few major differences in clinical variables between subsets. Among patients admitted to the ICU, outcomes were generally poor. Abstract : Uncertainty surrounding the COVID-19 epidemic exists, partly driven by the difficulty in prognostication and understanding risk factors that portend worse outcomes. This study examines whether differences in clinical characteristics on admission result in the need for intensive care unit (ICU)–level care and demonstrates few differences among patients needing ICU care and those that did not. Furthermore, patients admitted to the ICU generally have poor outcomes.