Comparing morbidity and mortality across three different covid-19 waves at a tertiary care center in new jersey

SESSION TITLE: Chest Infections Posters 3 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: It has been well-established in the literature that an increase in body mass index (BMI) is correlated with comorbidities such as dyslipidemia, coronary artery disease, hypertension, and diabetes, putting patients at even further risk of other health conditions that could be detrimental to their overall health. In this retrospective study, we examined morbidity and mortality across three different COVID-19 waves at a tertiary care center in New Jersey. We compared outcomes across different age groups and BMI categories in regard to cardiac arrests, intensive care unit (ICU) transfers, and mortality. Establishing trends in age and BMI may help clinicians further risk-stratify critically ill patients. METHODS: Retrospective data analysis of hospital medical records with documented COVID-19 cases between March 2020 and January 2022. Data on three peaks of COVID-19 admissions where during each peak, many symptomatic patients were admitted to our hospital. The first peak included patients between March and May 2020, the second peak included data from October to December 2020 and the third included data from October to December 2021. Our study population included patients above the age of 18. We excluded patients younger than 18 years old, those discharged from the emergency department, and those who were transitioned to comfort care status on admission. We collected data on the following primary outcomes; incidence of cardiac arrests, transfers to the ICU, and mortality. Analysis with statistical software performed, across different BMI categories and age groups. Finally, we compared incidence rates to those of the pre-pandemic era documented in the literature. RESULTS: Our results did not demonstrate a significant increase in the risk of primary outcomes with increasing BMI (p-values 0.993, 0.250, and 0.325, respectively). However, we saw a significant increase in the risk of primary outcomes with age in regard to cardiac arrests, transfer to the ICU, and mortality (one sample z-test for proportions; p-values 0.00, 0.03, and 0.008, respectively). When compared to rates pre-pandemic, our data demonstrated increased ICU transfer rates (7% increase; p-value 0.00), increased in-hospital cardiac arrest events (6.2% increase; p-value 0.00), and increased mortality rates (15.3% increase; p-value 0.00). Mortality rates decreased with each peak (27%, 20%, and 13%, respectively). CONCLUSIONS: Age remains a significant factor when risk-stratifying patients. While BMI may increase individual risk, as previously seen in literature, overall aggregate data in our study did not show statistical significance. Increased ICU transfers, in-hospital cardiac arrests, and mortality rates further illustrated the impact of the pandemic on the healthcare system. The decrease in mortality rates with each subsequent peak likely resulted from improved treatment regimens, infection precautions, and evidence-based practices. CLINICAL IMPLICATIONS: As our data demonstrate, a patient's age may play a greater role than their BMI regarding their risk of poor outcomes. It is important for clinicians to recognize age as a significant factor in the risk elevation of morbidity when admitting patients with COVID-19 infection. Our data further demonstrated the significant impact of the pandemic on in-hospital cardiac arrests, ICU admission rates, and mortality rates overall. DISCLOSURES: No relevant relationships by Kareem Ebeid No relevant relationships by Utku Ekin No relevant relationships by Mourad Ismail No relevant relationships by yousef ksheboon No relevant relationships by Alexis Lordi No relevant relationships by Rajapriya Manickam No relevant relationships by Hussein Mhanna No relevant relationships by Rutwik Patel No relevant relationships by Antai Wang