About: Clinical Mortality Review in a Large COVID-19 Cohort

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Clinical Mortality Review in a Large COVID-19 Cohort
Creator	Nelson, Karen Wang, Jason Zucker, Barbara De Geronimo, Marcella Jarrett, Mark Lyall, Julie Schultz, Susanne Stier, Lori
source	MedRxiv; Medline
abstract	Background: Northwell Health (Northwell), an integrated health system in New York, treated more than 15000 inpatients with coronavirus disease (COVID-19) at the US epicenter of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. We describe the demographic characteristics of COVID-19 mortalities, observation of frequent rapid response teams (RRT)/cardiac arrest (CA) calls for non-intensive care unit (ICU) patients, and factors that contributed to RRT/CA calls. Methods: A team of registered nurses reviewed medical records of inpatients who tested positive for SARS-CoV-2 via polymerase chain reaction (PCR) before or on admission and died between March 13 (first Northwell inpatient expiration) and April 30, 2020 at 15 Northwell hospitals. Findings for these patients were abstracted into a database and statistically analyzed. Findings: Of 2634 COVID-19 mortalities, 56.1% had oxygen saturation levels greater than or equal to 90% on presentation and required no respiratory support. At least one RRT/CA was called on 42.2% of patients at a non-ICU level of care. Before the RRT/CA call, the most recent oxygen saturation levels for 76.6% of non-ICU patients were at least 90%. At the time RRT/CA was called, 43.1% had an oxygen saturation less than 80%. Interpretation: This study represents one of the largest cohorts of reviewed mortalities that also captures data in non-structured fields. Approximately 50% of deaths occurred at a non-ICU level of care, despite admission to the appropriate care setting with normal staffing. The data imply a sudden, unexpected deterioration in respiratory status requiring RRT/CA in a large number of non-ICU patients. Patients admitted to a non-ICU level of care suffer rapid clinical deterioration, often with a sudden decrease in oxygen saturation. These patients could benefit from additional monitoring (eg, continuous central oxygenation saturation), although this approach warrants further study.
has issue date	2020-08-06(xsd:dateTime)
bibo:doi	10.1101/2020.08.05.20168146
bibo:pmid	32793915
has license	medrxiv
sha1sum (hex)	c28f48cdf51584e8654a66d615848f1a568545a4
schema:url	https://doi.org/10.1101/2020.08.05.20168146
resource representing a document's title	Clinical Mortality Review in a Large COVID-19 Cohort
has PubMed identifier	32793915
schema:publication	medRxiv : the preprint server for health sciences
resource representing a document's body	covid:c28f48cdf51584e8654a66d615848f1a568545a4#body_text
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