Clinical characteristics of patients with sars-cov-2 infection in san joaquin valley: A single center experience

Introduction: In December 2019 a new respiratory disease known as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) was identified in Wuhan, China. Three months later it was declared a pandemic by WHO. In the United States, the first case was identified on January 19, 2020, and in San Joaquin County, California on March 9, 2020. Since then the case count has surged to over 36,000 in San Joaquin county with more than 500 deaths and community transmission is believed to be widespread. Our aim was to study the patient's initial characteristics, presentation and outcomes at San Joaquin General Hospital providing care to underserved population. Methods: This was a retrospective observational study of patients with SARS-COV-2 infection in 150-bed county hospital between March-October 2020. Confirmed cases of SARS-COV-2 were defined by a positive result on a reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay from a nasopharyngeal swab. Clinical Characteristics of SARS-COV-2 were obtained through review of Electronic Medical Records. Results: Data was obtained from 1168 positive cases with SARS-COV-2 infection. Average age was 42 years, 54% were male, by ethnicity majority were Hispanic (60%), Asians (9%), African American (9%), White (9%) and others (11%). Of the overall positive cases, 28% (n=323) were hospitalized and 9% (n=102) were admitted to ICU. On admission, the most common symptom was cough (57%), followed by fever (50%) and dyspnea (38%). Average of Comorbidities among hospitalized patients was 3, most common was Obesity (36%, n=419), followed by hypertension (24%, n=275), diabetes (20%, n=236) and cardiovascular disease (excluding hypertension) (6%, n=72). Of the 323 hospitalizations, 31.5% patients were admitted to ICU for acute respiratory failure, and 21% patients required invasive mechanical ventilation. Mean ICU length of stay was 9.3 days and mean duration of invasive mechanical ventilation was 10.9 days. Overall mortality was 3% for all positive cases, 16% in hospitalized patients, 33% in ICU admits and was 49% in intubated patients. Conclusion: Major risk factors for SARS-COV-2 include male gender, Hispanic ethnicity, obesity and hypertension. Patients admitted to ICU, especially requiring invasive mechanical ventilation had the worse prognosis.