MULTIPLE ORGAN SYSTEMS INVOLVEMENT IN COVID-19 IS ASSOCIATED WITH INCREASED IN MORTALITY

Lam, Eric; Gomez Paz, Sandra; Gonzalez-Mosquera, Luis; Mirabella, Steven; Cardenas-Maldonado, Diana; Fogel, Joshua; Rubinstein, Sofia

TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: Coronavirus disease 2019 (COVID-19) has multiple organ system involvement but the association of organ systems involvement with mortality has not been reported. We study the association of organ systems involved with mortality in COVID-19. METHODS: Retrospective study of 808 consecutive patients with confirmed-laboratory diagnosis of COVID-19 in a New York hospital from March 1 - May 15, 2020. We investigated involvement of eight organ systems: respiratory, neurologic, renal, cardiovascular, liver, endocrine, musculoskeletal, and hematologic. Respiratory was nadir oxygen saturation <95% or any new requirement of supplemental oxygenation from baseline. Neurologic was any new decrease of Glasgow Coma Scale (GCS). Renal was any absolute increase in serum creatinine level >0.3mg/dL or 1.5-fold increase from baseline. Cardiovascular was any new troponin elevation >0.04ng/mL, new onset of HF, acute on chronic HF, new or worsening of atrial fibrillation, supraventricular tachycardia, new AV block, new ventricular tachycardia, new inotrope use, or new vasopressor use. Liver was serum alanine aminotransferase more than 1.5 times normal limit (>60IU/L) or abnormal total serum bilirubin >1.1mg/dL. Endocrine was any blood glucose level <60 mg/dL or >140 mg/dL, or any new or higher (from baseline) insulin administration requirement. Musculoskeletal was any creatine kinase values >1,000 units/L. Hematologic was involvement of any one cell line: white blood cell count <4×10