Management and outcomes of patients hospitalized with severe COVID-19 at a tertiary care center in midwestern United States

Monaldi Arch Chest Dis. 2020 Oct 8;90(4). doi: 10.4081/monaldi.2020.1592.

Abstract

Knowledge of treatment regimens and outcomes for novel coronavirus disease 2019 (COVID-19) is evolving. Recent studies have reported mortality rates ranging from 39-50% among hospitalized patients with COVID-19. We report our experience ofmanagement and outcomes of hospitalized patients with COVID-19 at a large tertiary-care center in Midwestern United States. Of 658 patients presenting to our tertiary care center, 217 needed hospitalization, majority (77%) of whom were severely sick requiring admission to the intensive care unit (ICU). All received corticosteroids, and 78% of the patients received tocilizumab. More than two-thirds of the patients received anticoagulation and 80% of patients in the ICU had prone-positioning. The median duration of hospitalization was 12 days (interquartile range, 8 to16), median duration of intensive care unit stay was 7 days (interquartile range, 5 to 9) and requirement of mechanical ventilation was 6 days (interquartile range, 5 to 8) in our cohort. Of the 217 patients, 27 died (12% mortality). The majority of our patients received corticosteroids, tocilizumab, anticoagulation and prone positioning. While higher mortality rates of >30% have been reported in various studies among hospitalized patients with COVID-19, the majority of hospitalized patients in our cohort survived with a low mortality rate. The majority of our patients received corticosteroids, tocilizumab, anticoagulation and prone positioning. While higher mortality rates of >30% have been reported in various studies among hospitalized patients with COVID-19, the majority of hospitalized patients in our cohort survived with a low mortality rate.

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives
  • Adenosine Monophosphate / therapeutic use
  • Alanine / analogs & derivatives
  • Alanine / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Anticoagulants / therapeutic use
  • Antiviral Agents / therapeutic use
  • Betacoronavirus*
  • COVID-19
  • COVID-19 Drug Treatment
  • COVID-19 Serotherapy
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / therapy*
  • Critical Care*
  • Glucocorticoids / therapeutic use
  • Hospitalization*
  • Humans
  • Immunization, Passive
  • Midwestern United States
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / therapy*
  • Respiration, Artificial
  • Retrospective Studies
  • SARS-CoV-2
  • Tertiary Care Centers
  • Tertiary Healthcare*

Substances

  • Antibodies, Monoclonal, Humanized
  • Anticoagulants
  • Antiviral Agents
  • Glucocorticoids
  • remdesivir
  • Adenosine Monophosphate
  • tocilizumab
  • Alanine