Laboratory Findings Associated With Severe Illness and Mortality Among Hospitalized Individuals With Coronavirus Disease 2019 in Eastern Massachusetts.

Tytuł:: Laboratory Findings Associated With Severe Illness and Mortality Among Hospitalized Individuals With Coronavirus Disease 2019 in Eastern Massachusetts.
Autorzy:: Castro VM; Center for Quantitative Health, Division of Clinical Research, Massachusetts General Hospital, Boston, Massachusetts.; Research Information Science and Computing, Mass General Brigham, Somerville, Massachusetts.
McCoy TH; Center for Quantitative Health, Division of Clinical Research, Massachusetts General Hospital, Boston, Massachusetts.
Perlis RH; Center for Quantitative Health, Division of Clinical Research, Massachusetts General Hospital, Boston, Massachusetts.
Źródło:: JAMA network open [JAMA Netw Open] 2020 Oct 01; Vol. 3 (10), pp. e2023934. Date of Electronic Publication: 2020 Oct 01.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Chicago, IL : American Medical Association, [2018]-
MeSH Terms:: Critical Illness*/epidemiology
Coronavirus Infections/*complications
Hospital Mortality/*trends
Pneumonia, Viral/*complications
Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Betacoronavirus/pathogenicity ; Blood Urea Nitrogen ; C-Reactive Protein/analysis ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Cohort Studies ; Coronavirus Infections/blood ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/physiopathology ; Coronavirus Infections/urine ; Creatinine/analysis ; Creatinine/blood ; Eosinophils ; Erythrocyte Count/methods ; Female ; Glucose/analysis ; Hospitalization/statistics & numerical data ; Humans ; Hydro-Lyases/analysis ; Hydro-Lyases/blood ; Lymphocyte Count/methods ; Male ; Massachusetts/epidemiology ; Middle Aged ; Monocytes ; Neutrophils ; Pandemics ; Platelet Count/methods ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/physiopathology ; Polymerase Chain Reaction/methods ; ROC Curve ; Retrospective Studies ; SARS-CoV-2 ; Troponin T/analysis ; Troponin T/blood
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Substance Nomenclature:: 0 (Troponin T)
9007-41-4 (C-Reactive Protein)
AYI8EX34EU (Creatinine)
EC 4.2.1.- (Hydro-Lyases)
EC 4.2.1.54 (lactate dehydratase)
IY9XDZ35W2 (Glucose)
Entry Date(s):: Date Created: 20201030 Date Completed: 20201116 Latest Revision: 20201218
Update Code:: 20240105
PubMed Central ID:: PMC7599467
DOI:: 10.1001/jamanetworkopen.2020.23934
PMID:: 33125498
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Importance: The coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented stress on health systems across the world, and reliable estimates of risk for adverse hospital outcomes are needed.
Objective: To quantify admission laboratory and comorbidity features associated with critical illness and mortality risk across 6 Eastern Massachusetts hospitals.
Design, Setting, and Participants: Retrospective cohort study of all individuals admitted to the hospital who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by polymerase chain reaction across these 6 hospitals through June 5, 2020, using hospital course, prior diagnoses, and laboratory values in emergency department and inpatient settings from 2 academic medical centers and 4 community hospitals. The data were extracted on June 11, 2020, and the analysis was conducted from June to July 2020.
Exposures: SARS-CoV-2.
Main Outcomes and Measures: Severe illness defined by admission to intensive care unit, mechanical ventilation, or death.
Results: Of 2511 hospitalized individuals who tested positive for SARS-CoV-2 (of whom 50.9% were male, 53.9% White, and 27.0% Hispanic, with a mean [SD ]age of 62.6 [19.0] years), 215 (8.6%) were admitted to the intensive care unit, 164 (6.5%) required mechanical ventilation, and 292 (11.6%) died. L1-regression models developed in 3 of these hospitals yielded an area under the receiver operating characteristic curve of 0.807 for severe illness and 0.847 for mortality in the 3 held-out hospitals. In total, 212 of 292 deaths (72.6%) occurred in the highest-risk mortality quintile.
Conclusions and Relevance: In this cohort, specific admission laboratory studies in concert with sociodemographic features and prior diagnosis facilitated risk stratification among individuals hospitalized for COVID-19.

Update of: medRxiv. 2020 Aug 28;:. (PMID: 32869044)

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