Reduction in risk of death among patients admitted with COVID-19 between first and second epidemic waves in New York City
Bowen et al.,
Reduction in risk of death among patients admitted with COVID-19 between first and second epidemic waves in..,
Open Forum Infectious Diseases, doi:10.1093/ofid/ofac436
Retrospective 4,631 hospitalized patients in New York, showing higher mortality with remdesivir, and lower mortality with HCQ. Authors suggest that increased mortality during the first epidemic wave was partly due to strain on hospital resources.
risk of death, 20.0% lower, HR 0.80, p = 0.007, treatment 1,317, control 3,314, Table S2, Cox proportional hazards.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Bowen et al., 25 Aug 2022, retrospective, USA, peer-reviewed, 10 authors, study period 1 March, 2020 - 31 March, 2021.
Contact:
ab5046@cumc.columbia.edu, jz2700@cumc.columbia.edu.
Abstract: 1
Reduction in risk of death among patients admitted with COVID-19 between first and
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second epidemic waves in New York City
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Running Title: Epidemic wave impacts COVID-19 mortality
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Corresponding Author:
Anthony Bowen, MD, PhD
622 West 168th Street 8th Floor, New York, NY, USA
Ab5046@cumc.columbia.edu
260-403-6964
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Alternate
Jason Zucker, MD, MS
622 West 168th Street 8th Floor, New York, NY, USA
Jz2700@cumc.columbia.edu
201-723-6637
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Keywords: COVID-19, Mortality, Cox regression, Epidemics
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Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical
Center, New York, USA.
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Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia
University Irving Medical Center, New York, USA.
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Contributed equally
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Anthony Bowen1,*, Jason Zucker1,*, Yanhan Shen2, Simian Huang1, Qiheng Yan2, Medini K.
Annavajhala1, Anne-Catrin Uhlemann1, Louise Kuhn2, Magdalena Sobieszczyk1,*, Delivette
Castor1,*
© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercialNoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial
reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed
in any way, and that the work is properly cited. For commercial re-use, please contact
journals.permissions@oup.com
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Abstract
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the emergence of SARS-CoV-2 with heterogeneous differences in mortality. Elucidating factors
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differentially associated with mortality between epidemic waves may inform clinical and public
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health strategies.
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Methods: We examined clinical and demographic data among patients admitted with COVID-19
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during the first (March-August 2020) and second (August 2020-March 2021) epidemic waves at
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an academic medical center in New York City.
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Results: Hospitalized patients (N=4631) had lower overall and 30-day in-hospital mortality,
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defined as death or discharge to hospice, during the second wave (14% and 11%) than the first
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(22% and 21%). The wave 2 in-hospital mortality decrease persisted after adjusting for several
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potential confounders. Adjusting for the volume of COVID-19 admissions, a measure of health
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system strain, accounted for the mortality difference between waves. Several demographic and
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clinical patient factors were associated with an increased risk of mortality independent of wave;
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SARS-CoV-2 cycle threshold, Do-Not-Intubate status, oxygen requirement, and intensive care
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unit admission.
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Conclusions: This work suggests that increased in-hospital mortality rates observed during the
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Background: Many regions have experienced successive epidemic waves of COVID-19 since
first epidemic wave were partly due to strain on hospital resources. Preparations for future
epidemics should prioritize evidence-based patient risks, treatment paradigms, and approaches to
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augment hospital capacity.
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