Early clinical and sociodemographic experience with patients hospitalized with COVID-19 at a large American healthcare system

• Main Authors: Cian P. McCarthy, Sean Murphy, Maeve Jones-O'Connor, David S. Olshan, Jay R. Khambhati, Saad Rehman, John B. Cadigan, Jinghan Cui, Eric A. Meyerowitz, George Philippides, Lawrence S. Friedman, Aran Y. Kadar, Kathryn Hibbert, Pradeep Natarajan, Anthony F. Massaro, Erin A. Bohula, David A. Morrow, Ann E. Woolley, James L. Januzzi, Jr, Jason H. Wasfy
• Format: Article
• Language: English
• Published: Elsevier 2020-09-01
• Series: EClinicalMedicine
• Subjects: COVID-19; Outcomes research
• Online Access: http://www.sciencedirect.com/science/article/pii/S2589537020302480

Background: Despite over 4 million cases of novel coronavirus disease 2019 (COVID-19) in the United States, limited data exist including socioeconomic background and post-discharge outcomes for patients hospitalized with this disease. Methods: In this case series, we identified patients with COVID-19 admitted to 3 Partners Healthcare hospitals in Boston, Massachusetts between March 7th, 2020, and March 30th, 2020. Patient characteristics, treatment strategies, and outcomes were determined. Findings: A total of 247 patients hospitalized with COVID-19 were identified; the median age was 61 (interquartile range [IQR]: 50–76 years), 58% were men, 30% of Hispanic ethnicity, 21% enrolled in Medicaid, and 12% dual-enrolled Medicare/Medicaid. The median estimated household income was $66,701 [IQR: $50,336-$86,601]. Most patients were treated with hydroxychloroquine (72%), and statins (76%; newly initiated in 34%). During their admission, 103 patients (42%) required intensive care. At the end of the data collection period (June 24, 2020), 213 patients (86.2%) were discharged alive, 2 patients (0.8%) remain admitted, and 32 patients (13%) have died. Among those discharged alive (n = 213), 70 (32.9%) were discharged to a post-acute facility, 31 (14.6%) newly required supplemental oxygen, 19 (8.9%) newly required tube feeding, and 34 (16%) required new prescriptions for antipsychotics, benzodiazepines, methadone, or opioids. Over a median post-discharge follow-up of 80 days (IQR, 68–84), 22 patients (10.3%) were readmitted. Interpretation: Patients hospitalized with COVID-19 are frequently of vulnerable socioeconomic status and often require intensive care. Patients who survive COVID-19 hospitalization have substantial need for post-acute services.