A Retrospective Longitudinal Study of COVID-19 as Seen by a Large Urban Hospital in Chicago

Haotian Chen, Yogatheesan Varatharajah, Sarah A Stewart de Ramirez, Paul Arnold, Casey Frankenberger, Bala Hota, Ravishankar Iyer

Research output: Working paper

Abstract

The rapid spread of the novel coronavirus disease 2019 (COVID-19) has created a high demand for medical resources, including personnel, intensive care unit beds, and ventilators. As thousands of patients are hospitalized, the disease has shown remarkable diversity in its manifestation; many patients with mild to no symptoms recover from the disease requiring minimal care, but some patients with severe disease progression require mechanical ventilation support in intensive care units (ICU) with an increased risk of death. Studying the characteristics of patients in these various strata can help us understand the varied progression of this disease, enable earlier interventions for at-risk patients, and help manage medical resources more efficiently. This paper presents a retrospective analysis of 10,123 COVID-19 patients treated at the Rush University Medical Center in Chicago, including their demographics, symptoms, comorbidities, laboratory values, vital signs, and clinical history. Specifically, we present a staging scheme based on discrete clinical events (i.e., admission to the hospital, admission to the ICU, mechanical ventilation, and death), and investigate the temporal trend of clinical variables and the effect of comorbidities in each of those stages. We then developed a prognostic model to predict ventilation demands at an individual patient level by analyzing baseline clinical variables, which entails (1) a least absolute shrinkage and selection operator (LASSO) regression and a decision tree model to identify predictors for mechanical ventilation; and (2) a logistic regression model based on these risk factors to predict which patients will eventually need ventilatory support. Our results indicate that the prognostic model achieves an AUC of 0.823 (95 0.765-0.880) in identifying patients who will eventually require mechanical ventilation.Competing Interest StatementThe authors have declared no competing interest.Funding StatementJump ARCHES endowment through the Health Care Engineering Systems Center at the University of IllinoisAuthor DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Rush University Medical CenterAll necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesThe data is not publicly available.
Original languageEnglish (US)
PublisherCold Spring Harbor Laboratory Press
Number of pages28
DOIs
StateIn preparation - Nov 30 2020

Publication series

NamemedRxiv
PublisherCold Spring Harbor Laboratory Press

Keywords

  • Coronavirus
  • COVID-19
  • severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
  • Novel coronavirus
  • 2019-nCoV
  • Pandemic

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