Clinical Features and Outcomes of 105 Hospitalized patients with COVID-19 in Seattle, Washington

Clin Infect Dis. 2020 May 22;ciaa632. doi: 10.1093/cid/ciaa632. Online ahead of print.

Abstract

Background: Washington State served as the initial epicenter of the SARS-CoV-2 pandemic in the United States. An understanding of the risk factors and clinical outcomes of hospitalized patients with COVID-19 may provide guidance for management.

Methods: All laboratory-confirmed COVID-19 cases in adults admitted to an academic medical center in Seattle, WA between March 2 and March 26, 2020 were included. We evaluated individuals with and without severe disease, defined as admission to the intensive care unit or death.

Results: One-hundred-five COVID-19 patients were hospitalized. Thirty-five percent were admitted from a senior home or skilled nursing facility. The median age was 69 years and half were women.Three or more comorbidities were present in 55% of patients, with hypertension (59%), obesity (47%), cardiovascular disease (38%) and diabetes (33%) being the most prevalent. Most (63%) had symptoms for 5 days or longer prior to admission. Only 39% had fever in the first 24 hours, whereas 41% had hypoxia at admission. Seventy-three percent of patients had lymphopenia. Of 50 samples available for additional testing, no viral coinfections were identified. Severe disease occurred in 49%. Eighteen percent of patients were placed on mechanical ventilation and the overall mortality rate was 33%.

Conclusions: During the early days of the COVID-19 epidemic in Washington State, the disease had its greatest impact on elderly patients with medical comorbidities. We observed high rates of severe disease and mortality in our hospitalized patients.

Keywords: COVID-19; SARS-CoV-2; comorbidities; hospitalized; outcomes.