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[Preprint]. 2020 Aug 28:2020.05.04.20090555.
doi: 10.1101/2020.05.04.20090555.

Laboratory findings associated with severe illness and mortality among hospitalized individuals with coronavirus disease 2019 in Eastern Massachusetts

Victor M Castro  1   2 , Thomas H McCoy  1 , Roy H Perlis  1
Affiliations

Laboratory findings associated with severe illness and mortality among hospitalized individuals with coronavirus disease 2019 in Eastern Massachusetts

Victor M Castro et al. medRxiv. .

Update in

Abstract

Importance: The coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented stress on health systems across the world, and reliable estimates of risk for adverse hospital outcomes are needed.

Objective: To quantify admission laboratory and comorbidity features associated with critical illness and mortality risk across 6 Eastern Massachusetts hospitals.

Design: Retrospective cohort study using hospital course, prior diagnoses, and laboratory values.

Setting: Emergency department and inpatient settings from 2 academic medical centers and 4 community hospitals.

Participants: All individuals with hospital admission and positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by PCR testing across these 6 hospitals through June 5, 2020.

Exposure: Coronavirus 2 (SARS-CoV-2).

Main outcome measures: Severe illness defined by ICU admission, mechanical ventilation, or death.

Results: Among 2,511 hospitalized individuals who tested positive for SARS-CoV-2 (of whom 50.9% were male, 53.9% white, and 27.0% Hispanic, with mean age 62.6 years), 215 (8.6%) were admitted to the ICU, 164 (6.5%) required mechanical ventilation, and 292 (11.6%) died. L1-regression models developed in 3 of these hospitals yielded area under ROC curve (AUC) of 0.807 for severe illness and 0.847 for mortality in the 3 held-out hospitals. In total, 212/292 (78%) of the deaths occurred in the highest-risk mortality quintile.

Conclusions and relevance: In this cohort, specific admission laboratory studies in concert with sociodemographic features and prior diagnosis facilitated risk stratification among individuals hospitalized for COVID-19.

Funding: 1R56MH115187-01 Trial Registration: None.

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Figures

Figure 1.
Figure 1.
Model Performance in Test Set A: COVID Severe Outcome B: COVID mortality model
Figure 2.
Figure 2.
Quintile Plots of outcomes in independent testing cohort
Figure 3.
Figure 3.
Kaplan-Meier curves in independent testing cohort
See this image and copyright information in PMC

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