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CLINICAL CHARACTERISTICS OF 150 CRITICALLY ILL PATIENTS HOSPITALIZED WITH COVID-19 AT A SINGLE ACUTE CARE HOSPITAL IN QUEENS COUNTY BOROUGH OF NEW YORK CITY

      TOPIC: Critical Care
      TYPE: Late Breaking
      PURPOSE: Infection with the SARS-CoV-2 virus results in a wide spectrum of disease, ranging from a mild, self-limited condition to severe illness necessitating intensive care and an increase in mortality. This study highlights the demographic factors and clinical features of adult patients with confirmed Covid-19 hospitalized in an intensive care unit over a two week period in Queens, NY at the initial peak of the pandemic.
      METHODS: A retrospective review of the electronic health records (Sunrise, Allscripts Gateway) was performed and data was recorded and analyzed through Research Electronic Data Capture (REDCap). Data on patient demographics, presence of comorbid conditions, presenting symptoms, initial laboratory test values and peak laboratory test values were recorded.
      RESULTS: 150 patients (17%) patients who were admitted required ICU admission. The median age was 61 years (range 20- 95 years). A total of 94 patients were male (62.6%) compared to 56 females (37.3%). Hypertension was the most common comorbidity, affecting 51% of patients, followed by hypercholesterolemia in 41.3%, and, diabetes mellitus in 35.3% patients. Of patients requiring ICU admission, 92.6% required endotracheal intubation and mechanical ventilation. 37.3% underwent proning. The median PEEP applied was 15 cm H2O (5-32 cm H2O) and the median tidal volume was 500 mL (range of 350-630 mL). 6% patients developed pneumothorax, and 4.6% patients developed pneumomediastinum. 81.3% patients developed shock requiring pressors. 40% admitted to the ICU had a cardiac arrest. In terms of mortality, 64.7% patients died after admission to the ICU. 9.3% patients were transitioned to comfort care, and 14.6% underwent tracheostomy for prolonged mechanical ventilation.
      CONCLUSIONS: As Queens was at the center of the pandemic and had the largest number of cases by the end of April 2020, this study highlights the clinical presentation and outcomes of critically ill COVID-19 patients at the peak of the pandemic in Queens, NY; the most diverse county in the USA. The predominance of males, the high percentage of those requiring intubation, along with notable complications of lung fibrosis, and high mortality are notable for discussion.
      CLINICAL IMPLICATIONS: This study provides an insight into the presentation of critically ill COVID 19 patients in a diverse population along with associated complications.
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