Characteristics and Outcomes of Coronavirus Disease Patients under Nonsurge Conditions, Northern California, USA, March–April 2020 - Volume 26, Number 8—August 2020 - Emerging Infectious Diseases journal - CDC

Characteristics and Outcomes of Coronavirus Disease Patients under Nonsurge Conditions, Northern California, USA, March–April 2020 - Volume 26, Number 8—August 2020 - Emerging Infectious Diseases journal - CDC

Volume 26, Number 8—August 2020

Synopsis

Characteristics and Outcomes of Coronavirus Disease Patients under Nonsurge Conditions, Northern California, USA, March–April 2020

Jessica Ferguson1, Joelle I. Rosser1, Orlando Quintero, Jake Scott, Aruna Subramanian, Mohammad Gumma, Angela Rogers, and Shanthi Kappagoda 

Author affiliations: Stanford Health Care, Stanford, California, USA (J. Ferguson, J.I. Rosser, O. Quintero, J. Scott, A. Subramanian, A. Rogers, S. Kappagoda); Stanford University, Stanford (M. Gumma)

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Abstract

Limited data are available on the clinical presentation and outcomes of coronavirus disease (COVID-19) patients in the United States hospitalized under normal-caseload or nonsurge conditions. We retrospectively studied 72 consecutive adult patients hospitalized with COVID-19 in 2 hospitals in the San Francisco Bay area, California, USA, during March 13–April 11, 2020. The death rate for all hospitalized COVID-19 patients was 8.3%, and median length of hospitalization was 7.5 days. Of the 21 (29% of total) intensive care unit patients, 3 (14.3% died); median length of intensive care unit stay was 12 days. Of the 72 patients, 43 (59.7%) had underlying cardiovascular disease and 19 (26.4%) had underlying pulmonary disease. In this study, death rates were lower than those reported from regions of the United States experiencing a high volume of COVID-19 patients.

Health officials in China first reported a cluster of cases of a new acute respiratory illness associated with a seafood market in Wuhan, China, on December 31, 2019 (1). Less than 1 month later, cases of what would become known as coronavirus disease (COVID-19) were reported in patients in northern California, USA (2). In the San Francisco Bay area counties of Alameda and Santa Clara, COVID-19 cases in travelers returning from Wuhan were confirmed on January 28 and January 31, respectively. As of May 5, 2020, a total of 1,809 laboratory-confirmed cases have occurred in Alameda County (population 1.7 million) and 2,555 cases in Santa Clara County (population 1.9 million); however, these numbers probably vastly underestimate the disease incidence because of the lack of widespread testing in the region early in the epidemic (3,4). Studies from China and Europe have described the clinical presentation of COVID-19, but data from the United States are still emerging (5–9). In addition, current data from the United States have primarily come from hospitals working under high-volume or surge conditions. In this study, we describe the characteristics and outcomes of patients hospitalized in northern California with COVID-19 early in the epidemic under nonsurge conditions.