The research team assessed three primary outcomes: inpatient hospitalization; critical illness (defined as care in the intensive care unit, the use of mechanical ventilation, discharge to hospice, or death); and discharge to hospice or death among hospitalized patients. The study was conducted between March 1, 2020 and April 8, 2020. The final date of follow up was May 5, 2020.

Study Findings

Of 5,279 patients who tested positive for COVID-19, 2,741 (51.9 percent) were hospitalized, 1,904 (69.5 percent) were discharged, and 665 (24.3 percent) died or were discharged to hospice.

Of 647 (23.6 percent) hospitalized patients who required ventilators, 391 (60.4 percent) died and 170 (26.2 percent) were discharged.

The strongest risk for hospitalization was age (40 percentage points increased risk for patients 65-74, and 58 percentage points increased risk for patients 75 years or older).

The strongest risk factors for developing critical illness -- besides age -- were heart failure, chronic kidney disease, body mass index greater than 40, and sex (male over female). However, blood oxygen levels below 88 percent upon admission and markers of inflammation were more strongly associated with critical illness than age and comorbidities.

53 percent of hospitalized adult patients were younger than 65 years of age.

Risk of critical illness and death among hospitalized patients decreased significantly during the study period--suggesting that the ability to care for these patients improved, even without definitive "game changing" drugs.
Certain findings, according to lead author Christopher M. Petrilli, MD, assistant professor, Department of Medicine at NYU Langone Health, and colleagues, were more difficult to explain.

"We were expecting that asthma or COPD would increase risk of both hospitalization and critical illness, but the risk was much smaller than what we were expecting," said Petrilli. "Meanwhile, patients with heart failure and chronic kidney disease were at much higher risk. We still don't really understand why certain diseases seem to put people at more risk than others."

"While we continue to study outcomes in patients who tested positive for COVID-19 to create reliable real-time tools, the next phase of investigation will be development of predictive risk models to build into provider workflows, analyzing differences in outcomes across different hospitals to identify best clinical practices, and, finally, looking at non-COVID patients who may have delayed medical care from being fearful to come to the hospital," Petrilli says.

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