Benjamin Diaczok, Girish Nair, Chun-Hui Lin, James H Paxton, Amr Abbas, Greg Barkley, Brian O'Neil, William O'Neil, Kirit Patel, Matthew Sims, Laila Poisson, Anupam Ashutosh Sule
{"title":"大都市地区 COVID-19 大流行中处方做法和结果的演变。","authors":"Benjamin Diaczok, Girish Nair, Chun-Hui Lin, James H Paxton, Amr Abbas, Greg Barkley, Brian O'Neil, William O'Neil, Kirit Patel, Matthew Sims, Laila Poisson, Anupam Ashutosh Sule","doi":"10.53854/liim-3001-10","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>We wanted to characterize the evolution of the COVID-19 pandemic in a typical metropolitan area.</p><p><strong>Methods: </strong>Data were extracted from the Detroit COVID-19 Consortium database for hospitalized COVID-19 patients treated in Southeast Michigan over the 12-month period from March 2020 to February 2021. Demographic and outcomes data were compared to CDC data.</p><p><strong>Results: </strong>A total of 4,775 patients were enrolled during the study period. We divided the pandemic into three phases: Phase-1 (Spring Surge); Phase-2 (Summer Lull); and Phase-3 (Fall Spike). Changes in hydroxychloroquine, remdesivir, corticosteroid, antibiotic and anticoagulant use closely followed publication of landmark studies. Mortality in critically-ill patients decreased significantly from Phase-1 to Phase-3 (60.3% vs. 47.9%, Chisq p=0.0110). Monthly mortality of all hospitalized patients ranged between 14.8% - 21.5% during Phase-1 and 9.7 to 13.4% during Phase 3 (NS).</p><p><strong>Discussion: </strong>The COVID-19 pandemic presented in three unique phases in Southeast Michigan. Medical systems rapidly modified treatment plans, often preceding CDC and NIH recommendations. Despite improved treatment regimens, intubation rates and mortality for hospitalized patients remained elevated.</p><p><strong>Conclusion: </strong>Preventive measures aimed at reducing hospitalizations for COVID-19 should be emphasized.</p>","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929739/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evolution of prescribing practices and outcomes in the COVID-19 pandemic in metropolitan areas.\",\"authors\":\"Benjamin Diaczok, Girish Nair, Chun-Hui Lin, James H Paxton, Amr Abbas, Greg Barkley, Brian O'Neil, William O'Neil, Kirit Patel, Matthew Sims, Laila Poisson, Anupam Ashutosh Sule\",\"doi\":\"10.53854/liim-3001-10\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>We wanted to characterize the evolution of the COVID-19 pandemic in a typical metropolitan area.</p><p><strong>Methods: </strong>Data were extracted from the Detroit COVID-19 Consortium database for hospitalized COVID-19 patients treated in Southeast Michigan over the 12-month period from March 2020 to February 2021. Demographic and outcomes data were compared to CDC data.</p><p><strong>Results: </strong>A total of 4,775 patients were enrolled during the study period. We divided the pandemic into three phases: Phase-1 (Spring Surge); Phase-2 (Summer Lull); and Phase-3 (Fall Spike). Changes in hydroxychloroquine, remdesivir, corticosteroid, antibiotic and anticoagulant use closely followed publication of landmark studies. Mortality in critically-ill patients decreased significantly from Phase-1 to Phase-3 (60.3% vs. 47.9%, Chisq p=0.0110). Monthly mortality of all hospitalized patients ranged between 14.8% - 21.5% during Phase-1 and 9.7 to 13.4% during Phase 3 (NS).</p><p><strong>Discussion: </strong>The COVID-19 pandemic presented in three unique phases in Southeast Michigan. Medical systems rapidly modified treatment plans, often preceding CDC and NIH recommendations. Despite improved treatment regimens, intubation rates and mortality for hospitalized patients remained elevated.</p><p><strong>Conclusion: </strong>Preventive measures aimed at reducing hospitalizations for COVID-19 should be emphasized.</p>\",\"PeriodicalId\":17977,\"journal\":{\"name\":\"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929739/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.53854/liim-3001-10\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.53854/liim-3001-10","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Evolution of prescribing practices and outcomes in the COVID-19 pandemic in metropolitan areas.
Introduction: We wanted to characterize the evolution of the COVID-19 pandemic in a typical metropolitan area.
Methods: Data were extracted from the Detroit COVID-19 Consortium database for hospitalized COVID-19 patients treated in Southeast Michigan over the 12-month period from March 2020 to February 2021. Demographic and outcomes data were compared to CDC data.
Results: A total of 4,775 patients were enrolled during the study period. We divided the pandemic into three phases: Phase-1 (Spring Surge); Phase-2 (Summer Lull); and Phase-3 (Fall Spike). Changes in hydroxychloroquine, remdesivir, corticosteroid, antibiotic and anticoagulant use closely followed publication of landmark studies. Mortality in critically-ill patients decreased significantly from Phase-1 to Phase-3 (60.3% vs. 47.9%, Chisq p=0.0110). Monthly mortality of all hospitalized patients ranged between 14.8% - 21.5% during Phase-1 and 9.7 to 13.4% during Phase 3 (NS).
Discussion: The COVID-19 pandemic presented in three unique phases in Southeast Michigan. Medical systems rapidly modified treatment plans, often preceding CDC and NIH recommendations. Despite improved treatment regimens, intubation rates and mortality for hospitalized patients remained elevated.
Conclusion: Preventive measures aimed at reducing hospitalizations for COVID-19 should be emphasized.
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