A new study released by the Journal of the American Medical Association this week found that 94% of people hospitalized within the Northwell Health system, the same system housing the most patients in the country throughout the pandemic, according to Fox News, displayed one or more underlying health issues.
The Northwell Health system serves approximately 11 million persons in Long Island, Westchester County, and New York City. The study examined 5,700 patients, roughly 60% of whom were male, who were admitted to 12 hospitals in New York City, Long Island, and Westchester County between March 1 and April 4.
The median age of patients was 63 years old; 56.6% of coronavirus patients suffered from hypertension; 41.7% whose body mass index (BMI) data could be found were obese and 33.8% were diabetic.
The study stated, “Patients were considered to have confirmed infection if the initial test result was positive or if it was negative but repeat testing was positive … 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%.”
Deaths under the age of 20 were non-existent; the study reported, “Mortality was 0% (0/20) for male and female patients younger than 20 years.” The study stated bluntly, “There were no deaths in the younger-than-18 age group.” Additionally, the disease hit men harder than women, as the study noted, “Mortality rates were higher for male compared with female patients at every 10-year age interval older than 20 years.”
2.2% of patients were readmitted during the study period.
The study indicated that if a person was admitted to the hospital and then discharged, it would be better to taken home rather than a facility for the elderly, noting, “For patients discharged alive, the readmission rates and the percentage of patients discharged to a facility (such as a nursing home or rehabilitation), as opposed to home, increased for progressively older age groups.”
Karina Davidson, one of the study’s authors, stated, “Having serious comorbidities increases your risk. This is a very serious disease with a very poor outcome for those who have severe infections from it. We want patients with serious chronic disease to take a special precaution and to seek medical attention early, should they start showing signs and symptoms of being infected. That includes knowing that they’ve been exposed to someone who has this virus.”
The study acknowledged it had limitations:
First, the study population only included patients within the New York metropolitan area. Second, the data were collected from the electronic health record database. This precluded the level of detail possible with a manual medical record review. Third, the median postdischarge follow-up time was relatively brief at 4.4 days (IQR, 2.2-9.3).
Fourth, subgroup descriptive statistics were unadjusted for potential confounders. Fifth, clinical outcome data were available for only 46.2% of admitted patients. The absence of data on patients who remained hospitalized at the final study date may have biased the findings, including the high mortality rate of patients who received mechanical ventilation older than age 65 years.
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