DOM COVID-19 Journal Club: Characteristics of Hospitalized Adults with COVID-19 in an Integrated Health Care System in California

Purpose: Research letter to describe the characteristics of hospitalized adults with COVID-19 from Kaiser Permanente Northern California (KPNC).

Study Design: Retrospective cohort study of adults >18 years with nasal/throat swabs (+) for SARS-CoV-2 by RT-PCR between March 1st–March 31st at 21 KNPC hospitals. Patients were triaged by clinician judgement and characterized by demographics, comorbid disease, severity of illness, ICU use, lab/chest film data and highest level of respiratory support.

Conclusion: Of the 16,201 adults tested, 8% (2199) were SARS-CoV2 (+). Of the positive patients, 377 (20%) were treated as inpatient and 113 (8.7%) were treated in the ICU. The median age was 61 years old and hypertension was the most common comorbidity (43.5%). None of the 164 patients tested for influenza A/B and respiratory syncytial virus (RSV) were positive. Bilateral chest infiltrates were seen in 64.4% of patients and 9% of patients received a prednisone-equivalent dosage of 20mg/d or more.

Of the patients treated on a general ward/intermediate care unit (n=264 or 70%), 54.9% received supplemental oxygen via a nasal cannula/face mask. 110 of the 113 ICU patients received invasive mechanical ventilation.

Limitation: This article was published during the early phase of COVID-19 transmission in California during the implementation of social distancing and testing speed so future results are expected to be affected by those implementations.

Context: This study highlights the importance of preventing the transmission of COVID-19 for the entire population to mitigate hospital surges because adults across all age groups required inpatient care.

Reference:

The Department of Medicine COVID-19 Journal Club is dedicated to understand and applying data on COVID-19 to inform prevention and management efforts for healthcare workers and patients.

This article by Shenikqua Bouges, MD, advanced geriatric fellow, Geriatrics and Gerontology. Reviewed by Nasia Safdar, MD, PhD, professor, Infectious Disease, vice chair for research, Department of Medicine.

Banner image: Centers for Disease Control and Prevention image library