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. 2020 Oct 1;3(10):e2023934.
doi: 10.1001/jamanetworkopen.2020.23934.

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. JAMA Netw Open. .

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, setting, and participants: Retrospective cohort study of all individuals admitted to the hospital who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by polymerase chain reaction across these 6 hospitals through June 5, 2020, using hospital course, prior diagnoses, and laboratory values in emergency department and inpatient settings from 2 academic medical centers and 4 community hospitals. The data were extracted on June 11, 2020, and the analysis was conducted from June to July 2020.

Exposures: SARS-CoV-2.

Main outcomes and measures: Severe illness defined by admission to intensive care unit, mechanical ventilation, or death.

Results: Of 2511 hospitalized individuals who tested positive for SARS-CoV-2 (of whom 50.9% were male, 53.9% White, and 27.0% Hispanic, with a mean [SD ]age of 62.6 [19.0] years), 215 (8.6%) were admitted to the intensive care unit, 164 (6.5%) required mechanical ventilation, and 292 (11.6%) died. L1-regression models developed in 3 of these hospitals yielded an area under the receiver operating characteristic curve of 0.807 for severe illness and 0.847 for mortality in the 3 held-out hospitals. In total, 212 of 292 deaths (72.6%) 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.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Perlis has received consulting fees from Burrage Capital, Genomind, RID Ventures, and Takeda. He holds equity in Outermost Therapeutics and Psy Therapeutics. Dr McCoy has received research funding from the Stanley Center at the Broad Institute, the Brain and Behavior Research Foundation, National Institute of Mental Health, National Human Genome Research Institute Home, and Telefonica Alfa. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Model Performance in Test Set
A, Coronavirus Disease 2019 (COVID-19)–associated severe outcome. B, COVID-19–associated mortality. AUC indicates area under the curve.
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

Update of

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