Researchers Identify Top Underlying Conditions Associated With Extreme COVID-19 Cases

In an analysis of thousands of Covid-19 patients admitted to dozens of hospitals in the New York metropolitan area, a team of researchers has determined that those with preexisting hypertension, obesity, and diabetes are more likely to have severe cases of the respiratory disease.

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The infection rate in New York has exceeded every state in the US and as of April 20, it has nearly one-third of all cases in the nation, according to the Centers for Disease Control and Prevention.

To determine the characteristics and outcomes of patients hospitalized with Covid-19, researchers at the Feinstein Institutes for Medical Research analyzed 5,700 electronic health records of patients with confirmed SARS-CoV-2 infection between March 1 and April 4, including information on patient demographics, home medications, and laboratory tests, among other things. Most patients were male and the median age was 63 years old, one-third of whom had a high respiratory rate or required supplemental oxygen. Older people and men were also more commonly reported to have Covid-19 in data reported from China.

Several underlying factors were linked with the intensity of the disease. More than half of patients analyzed had a previous history of hypertension, while 41 percent were considered obese and 34 percent had diabetes. Those with diabetes were also more likely to receive invasive mechanical ventilation, treatment in the intensive care unit, or develop kidney disease.

About one-in-five of these patients died as a result of complications associated with Covid-19. On average, recovered patients were discharged within four days.

It is important to note several limitations with the study, one of which is that it is observational in nature and only analyzed data that was collected electronically, which excludes detailed information that can be obtained when dealing with a patient face-to-face. Furthermore, researchers only knew the clinical outcome data – that is, whether they recovered or died – for 46 percent of admitted patients, which may have biased the findings and resulted in the high mortality rate of at-risk patients.

Of the more than the 2,600 patients whose outcomes were known, 14 percent were treated in the intensive care unit, 12 percent had received ventilators, and 3 percent required kidney replacement therapy.

Currently, information on the characteristics and outcomes of patients in the US is limited and most of what American researchers know about the disease comes from case studies and reports from other nations. Still, the researchers add that their findings provide “crucial early insight” into New York’s fight against Covid-19 and what factors may make a person more at-risk.

“New York has become the epicenter of this epidemic. Clinicians, scientists, statisticians, and laboratory professionals are working tirelessly to provide [the] best care and comfort to the thousands of COVID-19 patients in our Northwell hospitals,” said Karina W. Davidson, PhD, MASc, professor and senior vice president at the Feinstein Institutes, in a statement. “Through our consortium, we will share our clinical and scientific insights as we evolve the ways to care for and treat COVID-19 patients.”

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