Clinical and sociodemographic features of early COVID-19 patients in Massachusetts
Study suggests vulnerable populations are hardest hit

Date:
August 19, 2020
Source:
Massachusetts General Hospital
Summary:
Data from the first COVID-19 patients treated at three large
Massachusetts hospitals reveal important trends, including
disproportionate representation of vulnerable populations,
high rates of disease-related complications, and the need for
post-discharge, post- acute care and monitoring.



FULL STORY ==========================================================================
Data from the first COVID-19 patients treated at three large Massachusetts hospitals reveal important trends, including disproportionate
representation of vulnerable populations, high rates of disease-related complications, and the need for post-discharge, post-acute care and
monitoring.


==========================================================================
"Our medium follow-up revealed that many of these patients are very sick
even after leaving the hospital," says senior author Jason H. Wasfy, MD,
MPhil, director of Quality and Outcomes Research at the Massachusetts
General Hospital (MGH) Heart Center. The study was published today in EClinicalMedicine.

For the study, the group created a detailed registry based on physician
review of 247 patient charts for demographics, baseline characteristics, symptoms, home medications, laboratory data, electrocardiogram (EKG)
data, imaging, and treatment.

Patients were included if they were admitted from March 7 through
30, 2020, with confirmed SARS-CoV-2 infection, to one of three Mass
General Brigham (formerly Partners HealthCare) system's hospitals --
MGH, Brigham and Women's Hospital (BWH), and Newton-Wellesley Hospital
(NWH). These represent three of the largest hospitals in New England's
largest integrated health care system.

MGH and BWH are both academic medical centers, and Newton-Wellesley is
a community hospital.

"I'm glad we got that mix because we need data from across different
kinds of settings," says Wasfy, who is also an assistant professor of
Medicine at Harvard Medical School (HMS).

Most of the study patients were initially treated with hydroxychloroquine
(72 percent) and statins (76 percent, with 34 percent of those newly initiated), a practice that has since changed. "We don't use either
of those treatments at our institutions anymore, which highlights the
dynamic nature of COVID-19 patient care," says study lead author Cian
P. McCarthy, MD, investigator in the Division of Cardiology at MGH.

Another trend that stood out was the ethnic and socio-economic mix: 30
percent of patients were Hispanic, 21 percent were enrolled in Medicaid,
and 12 percent were dual-enrolled Medicare/Medicaid. "This strongly
suggests that there are some built in disadvantages that fall on these populations' shoulders," says Wasfy. "They may have more family members
living in one home, have greater difficulty accessing care, or other circumstances making them more likely to become infected and sick."
The study patients also showed a surprising range of symptoms and
outcomes.

More than 100 patients (42 percent) required intensive care during
their stay.

At the end of the data collection period, 213 patients (86.2 percent) were discharged alive, 2 patients (0.8 percent) were still in the hospital,
and 32 patients (13 percent) had died. Among those discharged alive,
70 (32.9 percent) were discharged to a post-acute facility, 31 (14.6
percent) newly required supplemental oxygen, 19 (8.9 percent) newly
required tube feeding, and 34 (16 percent) required new prescriptions for antipsychotics, benzodiazepines, methadone or opioids. About 10 percent
of the study patients were readmitted when followed for an average of
80 days after discharge.

"Our data demonstrates that the road to recovery extends far beyond the hospital and we must ensure we are supporting our patients physical and emotional needs after discharge," says McCarthy.


========================================================================== Story Source: Materials provided by Massachusetts_General_Hospital. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Cian P. McCarthy, Sean Murphy, Maeve Jones-O'Connor, David
S. Olshan, Jay
R. Khambhati, Saad Rehman, John B. Cadigan, Jinghan Cui, Eric A.

Meyerowitz, George Philippides, Lawrence S. Friedman, Aran
Y. Kadar, Kathryn Hibbert, Pradeep Natarajan, Anthony F. Massaro,
Erin A. Bohula, David A. Morrow, Ann E. Woolley, James L. Januzzi,
Jason H. Wasfy. Early clinical and sociodemographic experience
with patients hospitalized with COVID-19 at a large American
healthcare system. EClinicalMedicine, 2020; 100504 DOI:
10.1016/j.eclinm.2020.100504 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200819144105.htm

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