Risk Factors for Mortality in Patients with COVID-19 in New York City
HCQ decreases mortality, HR 0.53 (CI 0.41–0.67). IPTW adjustment does not significantly change HR 0.53 (0.41-0.68). Retrospective 6,000 patients in New York City.
risk of death, 47.0% lower, HR 0.53, p < 0.001, treatment 575 of 2,077 (27.7%), control 231 of 743 (31.1%), adjusted per study.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mikami et al., 30 Jun 2020, retrospective, USA, peer-reviewed, 7 authors.
Abstract: Risk Factors for Mortality in Patients with COVID-19 in New
Takahisa Mikami, M.D.1,2, Hirotaka Miyashita, M.D.1,2, Takayuki Yamada, M.D.1,2,
Matthew Harrington, M.D.1,2, Daniel Steinberg, M.D.1,2, Andrew Dunn, M.D.1,3, and
Evan Siau, M.D.1,2
Department of Medicine, Icahn School of Medicine at Mount SinaiNew York, NY, USA; 2Department of Medicine, Mount Sinai Beth Israel 281 First
Ave, Box #218, New York, NY, USA; 3Department of Medicine, Mount Sinai HospitalNew York, NY, USA.
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 laboratoryconfirmed 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–
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
Electronic supplementary material The online version of this article
(https://doi.org/10.1007/s11606-020-05983-z) contains supplementary
material, which is available to authorized users.
Received May 6, 2020
Accepted June 11, 2020
Published online June 30, 2020
J Gen Intern Med 36(1):17–26
© Society of General Internal Medicine 2020
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