Characteristics, Clinical Course, and Outcomes of Veterans Admitted With Covid-19 in Detroit, Michigan

Abstract

Background The deaths due to coronavirus disease (Covid-19) in Michigan have been disproportionately centered in the city of Detroit. We sought to characterize hospitalized veterans with Covid-19 infection in Detroit, MI and compare them to inpatients previously reported. Methods A retrospective observational study of 79 veterans admitted to a veteran's hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between March 10, through April 6, 2020. Each patient had at least 30 days of follow-up. Results The median age of 79 enrolled patients was 69.0 years (interquartile range, 57.0–75.0 years) and 74 (94%) were men. Twenty-four (30%) had a recent emergency department visit. Respiratory symptoms were present in 67 (85%). Gastrointestinal symptoms were common (49 [62%]), including diarrhea (27 [34%]) and loss of appetite (31 [39%]). Only 30 (38%) patients had fever on admission. Comorbidities included hypertension (73 [92%]), diabetes (48 [61%]), obesity (42 [53%]), chronic obstructive pulmonary disease (30 [38%]), coronary disease (28 [35%]), and obstructive sleep apnea (25 [32%]). Nine patients were admitted to the intensive care unit, and 18 (26%) of 70 required intensive care unit transfer. Twenty-Four (30%) were intubated; of which 3 were extubated and 20 (83%) died. Of the 57 (72%) patients discharged alive, 22 (39%) required supplemental oxygen and 8 (14%) were readmitted within 30 days. Conclusions Detroit veterans were primarily older African American men with more comorbidities than inpatients previously described. Gastrointestinal symptoms were twice as common as fever. Rates of mortality and readmission were higher than those previously reported in populations with shorter follow up.