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23 april 2020: 

Een nieuwe studie toont aan dat bijna negen op de tien coronaviruspatiënten die beademing nodig hadden in de staat New York zijn overleden.
De studie, die woensdag in het Journal of the American Medical Association werd gepubliceerd, evalueerde gevallen van COVID-19-patiënten die werden opgenomen in 12 ziekenhuizen binnen het Northwell Health-systeem in New York City, Long Island en Westchester County. Onderzoekers evalueerden van 1 maart tot en met 4 april de elektronische medische dossiers van 5700 patiënten met de ziekte veroorzaakt door coronavirus.

In totaal stierf ongeveer 20% van de in het ziekenhuis opgenomen COVID-19-patiënten.

De medische dossiers bevestigen wat artsen steeds hebben gezegd over het coronavirus: de meeste mensen die ernstig ziek worden, hebben een zogenaamde onderliggende aandoening. Meer dan de helft, 57%, had een hoge bloeddruk, 41% had obesitas en 34% had diabetes', schrijven de onderzoekers. Van de patiënten die beademing nodig hadden (12 procent had beademing nodig)  stierf uiteindelijk 88 procent. 

"Van de patiënten die stierven, hadden degenen met diabetes meer kans om invasieve mechanische beademing nodig te hebben of verzorging op de IC - Intensive Care dan degenen die geen diabetes hadden", schreven de onderzoekers.
Ze bevestigden ook dat mannen meer kans hadden om te overlijden dan vrouwen, en dat niemand onder de 18 stierf.

Het studierapport: Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area is gratis in te zien.

Hier het abstract van de studie:

April 22, 2020

Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

JAMA. Published online April 22, 2020. doi:10.1001/jama.2020.6775

Key Points

Question  What are the characteristics, clinical presentation, and outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) in the US?

Findings  In this case series that included 5700 patients hospitalized with COVID-19 in the New York City area, the most common comorbidities were hypertension, obesity, and diabetes. Among patients who were discharged or died (n = 2634), 14.2% were treated in the intensive care unit, 12.2% received invasive mechanical ventilation, 3.2% were treated with kidney replacement therapy, and 21% died.

Meaning  This study provides characteristics and early outcomes of patients hospitalized with COVID-19 in the New York City area.

Abstract

Importance  There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).

Objective  To describe the clinical characteristics and outcomes of patients with COVID-19 hospitalized in a US health care system.

Design, Setting, and Participants  Case series of patients with COVID-19 admitted to 12 hospitals in New York City, Long Island, and Westchester County, New York, within the Northwell Health system. The study included all sequentially hospitalized patients between March 1, 2020, and April 4, 2020, inclusive of these dates.

Exposures  Confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample among patients requiring admission.

Main Outcomes and Measures  Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy, and death. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected.

Results  A total of 5700 patients were included (median age, 63 years [interquartile range {IQR}, 52-75; range, 0-107 years]; 39.7% female). The most common comorbidities were hypertension (3026; 56.6%), obesity (1737; 41.7%), and diabetes (1808; 33.8%). At triage, 30.7% of patients were febrile, 17.3% had a respiratory rate greater than 24 breaths/minute, and 27.8% received supplemental oxygen. The rate of respiratory virus co-infection was 2.1%. Outcomes were assessed for 2634 patients who were discharged or had died at the study end point. During hospitalization, 373 patients (14.2%) (median age, 68 years [IQR, 56-78]; 33.5% female) were treated in the intensive care unit care, 320 (12.2%) received invasive mechanical ventilation, 81 (3.2%) were treated with kidney replacement therapy, and 553 (21%) died. Mortality for those requiring mechanical ventilation was 88.1%. The median postdischarge follow-up time was 4.4 days (IQR, 2.2-9.3). A total of 45 patients (2.2%) were readmitted during the study period. The median time to readmission was 3 days (IQR, 1.0-4.5) for readmitted patients. Among the 3066 patients who remained hospitalized at the final study follow-up date (median age, 65 years [IQR, 54-75]), the median follow-up at time of censoring was 4.5 days (IQR, 2.4-8.1).

Conclusions and Relevance  This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID-19 in the New York City area.


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