Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;36(1):17-26.
doi: 10.1007/s11606-020-05983-z. Epub 2020 Jun 30.

Risk Factors for Mortality in Patients with COVID-19 in New York City

Takahisa Mikami  1   2 , Hirotaka Miyashita  1   2 , Takayuki Yamada  1   2 , Matthew Harrington  1   2 , Daniel Steinberg  1   2 , Andrew Dunn  1   3 , Evan Siau  4   5
Affiliations

Risk Factors for Mortality in Patients with COVID-19 in New York City

Takahisa Mikami et al. J Gen Intern Med. 2021 Jan.

Abstract

Background: New York City emerged as an epicenter of the coronavirus disease 2019 (COVID-19) pandemic.

Objective: To describe the clinical characteristics and risk factors associated with mortality in a large patient population in the USA.

Design: Retrospective cohort study.

Participants: 6493 patients who had laboratory-confirmed COVID-19 with clinical outcomes between March 13 and April 17, 2020, who were seen in one of the 8 hospitals and/or over 400 ambulatory practices in the New York City metropolitan area MAIN MEASURES: Clinical characteristics and risk factors associated with in-hospital mortality.

Key results: A total of 858 of 6493 (13.2%) patients in our total cohort died: 52/2785 (1.9%) ambulatory patients and 806/3708 (21.7%) hospitalized patients. Cox proportional hazard regression modeling showed an increased risk of in-hospital mortality associated with age older than 50 years (hazard ratio [HR] 2.34, CI 1.47-3.71), systolic blood pressure less than 90 mmHg (HR 1.38, CI 1.06-1.80), a respiratory rate greater than 24 per min (HR 1.43, CI 1.13-1.83), peripheral oxygen saturation less than 92% (HR 2.12, CI 1.56-2.88), estimated glomerular filtration rate less than 60 mL/min/1.73m2 (HR 1.80, CI 1.60-2.02), IL-6 greater than 100 pg/mL (HR 1.50, CI 1.12-2.03), D-dimer greater than 2 mcg/mL (HR 1.19, CI 1.02-1.39), and troponin greater than 0.03 ng/mL (HR 1.40, CI 1.23-1.62). Decreased risk of in-hospital mortality was associated with female sex (HR 0.84, CI 0.77-0.90), African American race (HR 0.78 CI 0.65-0.95), and hydroxychloroquine use (HR 0.53, CI 0.41-0.67).

Conclusions: Among patients with COVID-19, older age, male sex, hypotension, tachypnea, hypoxia, impaired renal function, elevated D-dimer, and elevated troponin were associated with increased in-hospital mortality and hydroxychloroquine use was associated with decreased in-hospital mortality.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they do not have a conflict of interest.

Figures

Figure 1
Figure 1
a Temporal change of vital signs in patients with COVID-19. BP, blood pressure; SpO2, peripheral oxygen saturation. b Temporal change of laboratory values in patients with COVID-19. WBC, white blood cell count; eGFR, estimated glomerular filtration rate; ALT, alanine aminotransferase; AST, aspartate aminotransferase; CRP, C-reactive protein; IL-6, interleukin-6; LDH, lactate dehydrogenase.
Figure 1
Figure 1
a Temporal change of vital signs in patients with COVID-19. BP, blood pressure; SpO2, peripheral oxygen saturation. b Temporal change of laboratory values in patients with COVID-19. WBC, white blood cell count; eGFR, estimated glomerular filtration rate; ALT, alanine aminotransferase; AST, aspartate aminotransferase; CRP, C-reactive protein; IL-6, interleukin-6; LDH, lactate dehydrogenase.
See this image and copyright information in PMC

Comment in

References

    1. Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270–273. doi: 10.1038/s41586-020-2012-7. - DOI - PMC - PubMed
    1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. - PMC - PubMed
    1. World Health Organization. Coronavirus Disease (COVID-19) Pandemic. https://www.who.int. Accessed 04/18, 2020.
    1. New York City Department of Health and Mental Hygiene. COVID-19 Data. https://www1.nyc.gov/site/doh/covid/covid-19-data.page. Accessed 04/18, 2020.
    1. Grasselli G, Zangrillo A, Zanella A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region. JAMA: Italy; 2020. - PMC - PubMed

MeSH terms