Clinical and laboratory characteristics of patients hospitalized with severe COVID-19 in New Orleans, August 2020 to September 2021
Arnaud Drouin, Ian D Plumb, Matthew Mccullough, Jade James Gist, Sharon Liu, Marc Theberge, Joshua Katz, Matthew Moreida, Shelby Flaherty, Bhoomija Chatwani, Melissa Briggs Hagen, Claire M Midgley, Dahlene Fusco
Scientific Reports, doi:10.1038/s41598-024-57306-5
Louisiana experienced high morbidity and mortality from COVID-19. To assess possible explanatory factors, we conducted a cohort study (ClinSeqSer) of patients hospitalized with COVID-19 in New Orleans during August 2020-September 2021. Following enrollment, we reviewed medical charts, and performed SARS-CoV-2 RT-PCR testing on nasal and saliva specimens. We used multivariable logistic regression to assess associations between patient characteristics and severe illness, defined as ≥ 6 L/min oxygen or intubation. Among 456 patients, median age was 56 years, 277 (60.5%) were Black non-Hispanic, 436 (95.2%) had underlying health conditions, and 358 were unvaccinated (92.0% of 389 verified). Overall, 187 patients (40.1%) had severe illness; 60 (13.1%) died during admission. In multivariable models, severe illness was associated with age ≥ 65 years (OR 2.08, 95% CI 1.22-3.56), hospitalization > 5 days after illness onset (OR 1.49, 95% CI 1.01-2.21), and SARS CoV-2 cycle threshold (Ct) result of < 32 in saliva (OR 4.79, 95% CI 1.22-18.77). Among patients who were predominantly Black non-Hispanic, unvaccinated and with underlying health conditions, approximately 1 in 3 patients had severe COVID-19. Older age and delayed time to admission might have contributed to high case-severity. An association between case-severity and low Ct value in saliva warrants further investigation. Keywords COVID-19,
Ethical approval This study was reviewed and approved by the Tulane University School of Medicine Institutional Review Board, and was performed in accordance with relevant guidelines (see 45 C.F.R. part 46; 21 C.F.R. part 56). Informed consent was obtained from all participants and/or their legal guardians.
Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).
Author contributions The analysis was planned by A.D, D.F., I.P., and C.M. with input from other coauthors. Data preparation and analysis was conducted by D.F., M.M., and J.J.G. Data interpretation was conducted by D.F., C.M., and I.P. and manuscript writing was completed by D.F. and I.P. with critical input from all authors. D.F. had full access to all the data in the study and takes responsibility for the integrity of the data. All authors certify that they meet authorship criteria.
Competing interests DF has served on an Advisory Board for Gilead Sciences and for AXCELLA, and as site PI for clinical trials sponsored by Gilead Sciences, Regeneron, MetroBiotech LLC, and the NIH (DMID COVAIL). AD has served as co site-PI on clinical trials sponsored by Gilead Sciences, Regeneron, MetroBiotech LLC, and the NIH (DMID COVAIL). Other authors declare that they have no conflict of interest.
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