covid city
216075793
Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID 19 in the New York City Area.
Importance There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID 19) Objective To describe the clinical characteristics and outcomes of patients with COVID 19 hospitalized in a US health care system. Design, Setting, and Participants Case series of patients with COVID 19 admitted to 12 hospitals in New York City, Long Island, and Westchester County, New York, within the Northwell Health system. The study included all sequentially hospitalized patients between March 1, 2020, and April 4, 2020, inclusive of these dates. Exposures Confirmed severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample among patients requiring admission. Main Outcomes and Measures Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy, and death. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected. Results A total of 5700 patients were included (median age, 63 years [interquartile range {IQR} 52 75; range, 0 107 years] 39.7% female) The most common comorbidities were hypertension (3026; 56.6% obesity (1737; 41.7% and diabetes (1808; 33.8% At triage, 30.7% of patients were febrile, 17.3% had a respiratory rate greater than 24 breaths/minute, and 27.8% received supplemental oxygen. The rate of respiratory virus co infection was 2.1% Outcomes were assessed for 2634 patients who were discharged or had died at the study end point. During hospitalization, 373 patients (14.2% (median age, 68 years [IQR, 56 78] 33.5% female) were treated in the intensive care unit care, 320 (12.2% received invasive mechanical ventilation, 81 (3.2% were treated with kidney replacement therapy, and 553 (21% died. Mortality for those requiring mechanical ventilation was 88.1% The median postdischarge follow up time was 4.4 days (IQR, 2.2 9.3) A total of 45 patients (2.2% were readmitted during the study period. The median time to readmission was 3 days (IQR, 1.0 4.5) for readmitted patients. Among the 3066 patients who remained hospitalized at the final study follow up date (median age, 65 years [IQR, 54 75] the median follow up at time of censoring was 4.5 days (IQR, 2.4 8.1) Conclusions and Relevance This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID 19 in the New York City area.
JAMA
Safiya Richardson Jamie S Hirsch Mangala Narasimhan James M Crawford Thomas G McGinn Karina W Davidson Douglas P Barnaby Lance B Becker John Chelico Stuart Lance Cohen Jennifer Cookingham Kevin Coppa Michael A Diefenbach Andrew J Dominello Joan Duer-Hefele Louise Falzon Jordan S Gitlin Negin Hajizadeh Tiffany G Harvin David Hirschwerk Eun Ji Kim Zachary Kozel Lyndonna Marrast Jazmin N Mogavero Gabrielle A Osorio Michael Qiu Theodoros P Zanos
215803226
Clinical Characteristics of Covid 19 in New York City
Covid 19 in New York City In this series of 393 consecutive patients admitted with Covid 19 to two New York City hospitals from March 3 to March 27, a third of patients received invasive mechanical.
The New England journal of medicine
Parag Goyal Justin J Choi Laura C Pinheiro Edward J Schenck Ruijun Chen Assem Jabri Michael J Satlin Thomas R Campion Musarrat Nahid Joanna Bryan Ringel Katherine L Hoffman Mark N Alshak Han A Li Graham T Wehmeyer Mangala Rajan Evgeniya Reshetnyak Nathaniel Hupert Evelyn M Horn Fernando J Martinez Roy M Gulick Monika M Safford
216035666
Epidemiology, clinical course, and outcomes of critically ill adults with COVID 19 in New York City: a prospective cohort study
Background: Nearly 30,000 patients with coronavirus disease 2019 (COVID 19) have been hospitalized in New York City as of April 14th, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill patients with COVID 19 in this setting are needed. Methods: We prospectively collected clinical, biomarker, and treatment data on critically ill adults with laboratory confirmed COVID 19 admitted to two hospitals in northern Manhattan between March 2nd and April 1st, 2020. The primary outcome was in hospital mortality. Secondary outcomes included frequency and duration of invasive mechanical ventilation, frequency of vasopressor use and renal replacement therapy, and time to clinical deterioration following hospital admission. The relationship between clinical risk factors, biomarkers, and in hospital mortality was modeled using Cox proportional hazards regression. Each patient had at least 14 days of observation. Results: Of 1,150 adults hospitalized with COVID 19 during the study period, 257 (22% were critically ill. The median age was 62 years (interquartile range [IQR] 51 72) 170 (66% were male. Two hundred twelve (82% had at least one chronic illness, the most common of which were hypertension (63% 162/257) and diabetes mellitus (36% 92/257) One hundred thirty eight patients (54% were obese, and 13 (5% were healthcare workers. As of April 14th, 2020, in hospital mortality was 33% (86/257) 47% (122/257) of patients remained hospitalized. Two hundred one (79% patients received invasive mechanical ventilation (median 13 days [IQR 9 17] and 54% (138/257) and 29% (75/257) required vasopressors and renal replacement therapy, respectively. The median time to clinical deterioration following hospital admission was 3 days (IQR 1 6) Older age, hypertension, chronic lung disease, and higher concentrations of interleukin 6 and d dimer at admission were independently associated with in hospital mortality. Conclusions: Critical illness among patients hospitalized with COVID 19 in New York City is common and associated with a high frequency of invasive mechanical ventilation, extra pulmonary organ dysfunction, and substantial in hospital mortality.
medRxiv
Matthew J Cummings Matthew R Baldwin Darryl Abrams Samuel D Jacobson Benjamin J Meyer Elizabeth M Balough Justin G Aaron Jan Claassen Leroy E Rabbani Jonathan Hastie Beth R Hochman John Salazar-Schicchi Natalie Yip Daniel Brodie Max Roe O'Donnell
221910552
There will be no Post COVID city
Helen Couclelis
229516913
Post Covid city: what are we talking about?
As the pandemic progresses towards all corners of the globe, it becomes more noticeable how this crisis is undermining some of the central aspects that give meaning to urban life. In this scenario, future urban planning must learn to implement city models capable of responding to this kind of challenge. The constant reflections that appear regularly coincide in pointing out that COVID 19 has disrupted the dynamics of the contemporary city unveiling significant weaknesses in terms of management, social cohesion, and planning. From this evidence, scholars argue that a new model of the city will emerge once we overcome this crisis. But what kind of city? Through a literature review this paper identifies four central areas that underpin the construction of the new Post COVID city, urging for a global and multidisciplinary debate and joint reflection on the opportunities that open in this context of global crisis.
Alberto Rodriguez-Barcon
226512982
EPIDEMIC RESILIENCE LABEL FOR A POST COVID CITY (ERL Project)
The development of a label that evaluates the epidemic resistance capacity of places of social exchange can be an invaluable tool in determining prevention policies on the one hand and social containment and distancing measures on the other. Policies that protect the health of citizens as much as possible while allowing develop human activities. The research project will work on the evaluation of the safety of buildings and urban spaces in cities in the context of a pandemic such as Covid 19 through the development of the so called Epidemic Resilience Label. Passive site labelling measures will promote synergies for the development of the economy of this new normality. Citizens will choose the most protected sites; businesses will therefore want to improve their labeling and containment phases can be decided based on site ratings.
Nuria Vallespin Toro Jorge Arribas Castaneyra
220825431
THE POST COVID CITY: LESSONS FOR THE FUTURE IN LAW AND DEVELOPMENT
211729129
Clinical predictors of mortality due to COVID 19 based on an analysis of data of 150 patients from Wuhan, China
Dear Editor, The rapid emergence of COVID 19 in Wuhan city, Hubei Province, China, has resulted in thousands of deaths [1] Many infected patients, however, presented mild flu like symptoms and quickly recover [2] To effectively prioritize resources for patients with the highest risk, we identified clinical predictors of mild and severe patient outcomes. Using the database of Jin Yin tan Hospital and Tongji Hospital, we conducted a retrospective multicenter study of 68 death cases (68/150, 45% and 82 discharged cases (82/150, 55% with laboratory confirmed infection of SARS CoV 2. Patients met the discharge criteria if they had no fever for at least 3 days, significantly improved respiratory function, and had negative SARS CoV 2 laboratory test results twice in succession. Case data included demographics, clinical characteristics, laboratory results, treatment options and outcomes. For statistical analysis, we represented continuous measurements as means (SDs) or as medians (IQRs) which compared with Student's t test or the Mann Whitney Wilcoxon test. Categorical variables were expressed as numbers and compared by the kh2 test or Fisher's exact test. The distribution of the enrolled patients' age is shown in Fig. 1a. There was a significant difference in age between the death group and the discharge group (p 0.001) but no difference in the sex ratio (p 0.43) A total of 63% (43/68) of patients in the death group and 41% (34/82) in the discharge group had underlying diseases (p 0.0069) It should be noted that patients with cardiovascular diseases have a significantly increased risk of death when they are infected with SARS CoV 2 (p 0.001) A total of 16% (11/68) of the patients in the death group had secondary infections, and 1% (1/82) of the patients in the discharge group had secondary infections (p 0.0018) Laboratory results showed that there were significant differences in white blood cell counts, absolute values of lymphocytes, platelets, albumin, total bilirubin, blood urea nitrogen, blood creatinine, myoglobin, cardiac troponin, C reactive protein (CRP) and interleukin 6 (IL 6) between the two groups (Fig. 1b and Supplementary Table 1) The survival times of the enrolled patients in the death group were analyzed. The distribution of survival time from disease onset to death showed two peaks, with the first one at approximately 14 days (22 cases) and the second one at approximately 22 days (17 cases) (Fig. 1c) An analysis of the cause of death was performed. Among the 68 fatal cases, 36 patients (53% died of respiratory failure, five patients (7% with myocardial damage died of circulatory failure, 22 patients (33% died of both, and five remaining died of an unknown cause (Fig. 1d) Based on the analysis of the clinical data, we confirmed that some patients died of fulminant myocarditis. In this study, we first reported that the infection of SARS CoV 2 may cause fulminant myocarditis. Given that fulminant myocarditis is characterized by a rapid progress and a severe state of illness [3] our results should alert physicians to pay attention not only to the symptoms of respiratory dysfunction but also the symptoms of cardiac injury. *Correspondence: songsingsjx@sina.com 4 Department of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, Hubei, China Full author information is available at the end of the article
Intensive Care Medicine
Qiurong Ruan Kun Yang Wenxia Wang Lingyu Jiang Jianxing Song
215818846
Impact of meteorological factors on the COVID 19 transmission: A multi city study in China
Abstract The purpose of the present study is to explore the associations between novel coronavirus disease 2019 (COVID 19) case counts and meteorological factors in 30 provincial capital cities of China. We compiled a daily dataset including confirmed case counts, ambient temperature (AT) diurnal temperature range (DTR) absolute humidity (AH) and migration scale index (MSI) for each city during the period of January 20th to March 2nd, 2020. First, we explored the associations between COVID 19 confirmed case counts, meteorological factors, and MSI using non linear regression. Then, we conducted a two stage analysis for 17 cities with more than 50 confirmed cases. In the first stage, generalized linear models with negative binomial distribution were fitted to estimate city specific effects of meteorological factors on confirmed case counts. In the second stage, the meta analysis was conducted to estimate the pooled effects. Our results showed that among 13 cities that have less than 50 confirmed cases, 9 cities locate in the Northern China with average AT below 0 degC, 12 cities had average AH below 4 g/m3, and one city (Haikou) had the highest AH (14.05 g/m3) Those 17 cities with 50 and more cases accounted for 90.6% of all cases in our study. Each 1 degC increase in AT and DTR was related to the decline of daily confirmed case counts, and the corresponding pooled RRs were 0.80 (95% CI: 0.75, 0.85) and 0.90 (95% CI: 0.86, 0.95) respectively. For AH, the association with COVID 19 case counts were statistically significant in lag 07 and lag 014. In addition, we found the all these associations increased with accumulated time duration up to 14 days. In conclusions, meteorological factors play an independent role in the COVID 19 transmission after controlling population migration. Local weather condition with low temperature, mild diurnal temperature range and low humidity likely favor the transmission.
Science of The Total Environment
Jiangtao Liu Ji Zhou Jinxi Yao Xiuxia Zhang Lanyu Li Xiaocheng Xu Xiaotao He Bo Wang Shihua Fu Tingting Niu Jun Yan Yanjun Shi Xiaowei Ren Jingping Niu Weihao Zhu Sheng Li Bin Luo Kai Zhang
211230694
Presumed Asymptomatic Carrier Transmission of COVID 19.
This study describes possible transmission of novel coronavirus disease 2019 (COVID 19) from an asymptomatic Wuhan resident to 5 family members in Anyang, a Chinese city in the neighboring province of Hubei.
JAMA
Yan Bai Lingsheng Yao Tao Wei Fei Tian Dong-Yan Jin Lijuan Chen Meiyun Wang