Comparison of hospitalized subjects from Wuhan and New York Cities by admission clinical co-variates
Subjects in Wuhan cohort were younger (median 59 years [IQR 45-68 years] versus 63 years [IQR 52-75]; Table 1), more likely female (50%,925/1859 versus 40%,2263/5700; P < 0.001) and less likely smokers (6%,111/1859 versus 16%,558/5700; P < 0.001). Wuhan subjects were less likely to have co-morbidities, such as ASCVD (14%,268/1859 versus 18%,966/5700; P < 0.001), hypertension (31%,579/1859 versus 57%,3026/5700; P < 0.001), diabetes (14%,262/1859 versus 34%,1808/5700; P < 0.001), chronic obstructive pulmonary disease (COPD; 3%,61/1859 versus 5%,287/5700; P < 0.001), cancer (3%,61/1859 versus 6%,320/5700; P < 0.001), chronic kidney disease (2%,45/1859 versus 9%,454/5700; P < 0.001), and to have > 1 co-morbidity (P < 0.001). Subjects from Wuhan were less likely to have temperature > 38°C on admission (10%,189/1859 versus 31%,1734/5700; P < 0.001).
Table 1
Hospital admission co-variates.
| Wuhan n = 1859 | New York n = 5700 | P-value |
Age, median (IQR*), years | 59 (45, 68) | 63 (52, 75) | |
Female | 925 (50) | 2263 (40) | <0.001 |
Smoker | 111 (6) | 558 (16) | <0.001 |
Co-morbidity | | | |
ASCVD* | 268 (14) | 966 (18) | <0.001 |
Hypertension | 579 (31) | 3026 (57) | <0.001 |
Diabetes | 262 (14) | 1808 (34) | <0.001 |
COPD* | 61 (3) | 287 (5) | <0.001 |
Cancer | 65 (3) | 320 (6) | <0.001 |
Chronic kidney disease | 45 (2) | 454 (9) | <0.001 |
Comorbidities | | | |
None | 954 (51) | 350 (6) | <0.001 |
1 | 537 (29) | 359 (6) | |
>1 | 368 (20) | 4991 (88) | |
Temperature >38°C | 189 (10) | 1734 (31) | <0.001 |
Temperature (°C) | 37 (37, 37) | 38 (37, 38) | |
Laboratory co-variates | | | |
Neutrophils ×10E+9/L | 3 (2, 5) | 5 (4, 8) | |
Lymphocytes ×10 E+9/L | 1 (0.8, 1.6) | 0.88 (0.6, 1.2) | |
Lymphocyte, <1000×10 E+9/L | 736 (40) | 3387 (60) | <0.001 |
CRP*, mg/L | 13 (3, 51) | 130 (64, 269) | |
Procalcitonin, ng/ml (< 0.5) | 0.06 (0.05, 0.1) | 0.2 (0.1, 0.6) | |
LDH*, U/L (109-245) | 212 (170, 292) | 404 (300, 552) | |
Ferritin, ng/ml (4.6-204) | 567 (246, 1218) | 798 (411, 1515) | |
ALT*, U/L (5-35) | 38 (22, 67) | 33 (21, 55) | |
ALT >60U/L | 533 (29) | 2176 (39) | <0.001 |
AST*, U/L (8-40) | 32 (22, 49) | 46 (31, 71) | |
AST >40U/L | 645 (35) | 3263 (58) | <0.001 |
Creatine kinase, U/L (26-140) | 88 (54, 165) | 171 (84, 397) | |
BNP*, pg/ml (< 100) | 61 (18, 242) | 386 (106, 1997) | |
Troponin I above test-specific upper limit of normal | 203 (19) | 801 (23) | 0.006 |
Data are median (IQR) or n (%). |
*IQR, interquartile range; *ASCVD, arterio-sclerotic cardio-vascular disease; *COPD, chronic obstructive pulmonary disease; *CRP: C-reactive protein; *LDH: lactate dehydrogenase; *ALT: alanine aminotransferase; *AST: aspartate aminotransferase; *BNP: B-type natriuretic peptide. |
On admission Wuhan subjects were less likely to have a blood lymphocyte concentration < 1×10E+9/L (40%,736/1859 versus 60%,3387/5700; P < 0.001), lower median blood neutrophil concentration (3 x 10 E+9/L [IQR 2-5 x 10 E+9/L] versus 5.3 x 10E+9/L [IQR 3.7-7.7 x 10 E+9/L], alanine aminotransferase (ALT) > 60 U/L (29%,533/1859 versus 39%,2176/5700; P < 0.001), serum aspartate aminotransferase (AST) > 40 U/L (35%,645/1859 versus 58%,3263/5700; P < 0.001), lactate dehydrogenase (LDH) (212 U/L [IQR 170-292 U/L] versus 404 U/L [IQR 300-552 U/L]), troponin-I > upper limit of normal (19%,203/1859 versus 23%,801/5700; P = 0.006), B-type natriuretic peptide (BNP; 61 pg/ml [IQR 18-242 pg/ml] versus 386 pg/ml, [IQR 106-1997 pg/ml]), creatine kinase (88 U/L [IQR 54-165 U/L] versus 171 U/L [IQR 84-397 U/L]), C-reactive protein (CRP)(13 mg/L [IQR 3-51 mg/L] versus 130 mg/L [IQR 64-269 mg/L], ferritin (567 ng/mL [IQR 246-1218] versus 798 ng/mL [IQR 411-1515 ng/mL]) and procalcitonin (0.06 ng/ml [IQR 0.05-0.1 ng/mL] versus 0.2 ng/ml [IQR 0.1-0.6 ng/mL]). These data are displayed in Table 1.
Comparison Of Outcomes By Co-variates After Admission
There were outcomes data on the 1859 Wuhan subjects and 2634 New York subjects (Table 2). Wuhan subjects had higher blood nadir median lymphocyte concentrations (1.0 ×10E+9/L [0.8-1.6 ×10E+9/L] versus 0.88 ×10 E+9/L [0.6-1.2 ×10 E+9/L]) and longer hospital stays (18 days [range, 12-23 days] versus 4 [range, 2-7 days]). They were less likely to receive invasive mechanical ventilation (5%,85/1859 versus 12%,320/2634; P < 0.001), ICU care (6%,106/1859 versus 14%,373/2634; P < 0.001), to have acute kidney injury (5%,99/1859 versus 22%,523/2634; P < 0.001) but not acute liver injury (1%,27/1859 versus 2%,56/2634; P = 0.116) and to receive therapy of kidney failure (1%,23/1859 versus 3%,81/2634; P < 0.001). Wuhan subjects were less likely to die (11%,209/1859 versus 21%,553/2634; P < 0.001). In subjects not receiving mechanical ventilation those in Wuhan were less likely to die compared with those in New York (8%,136/1774 versus 12%,271/2314; P < 0.001). In contrast, death rates were similar in subjects in both cities in subjects receiving mechanical ventilation (86%,73/85 versus 88%,282/320; P = 0.58).
Table 2
Hospital course and outcomes.
| Wuhan n = 1859 | New York n = 2634 | P-value |
Nadir lymphocyte concentration | 1.0 (0.6, 1.4) | 0.8 (0.5, 1.14) | |
IMV* | 85 (5) | 320 (12) | <0.001 |
ICU* admission | 106 (6) | 373 (14) | <0.001 |
Acute kidney injury | 99 (5) | 523 (22) | <0.001 |
Kidney replacement therapy | 23 (1) | 81 (3) | <0.001 |
Acute hepatic injury | 27 (1) | 56 (2) | 0.116 |
Length of stay | 18 (12, 23) | 4 (2, 7) | |
Died | 209 (11) | 553 (21) | <0.001 |
no IMV | 136/1774 (8) | 271/2314 (12) | <0.001 |
Died, received IMV | 73/85 (86) | 282/320 (88) | 0.576 |
Data are median (IQR) or n (%);
*IMV, invasive mechanical ventilation; *ICU, intensive care unit.
Comparison of deaths by sex and 10-year intervals of age
In the Wuhan cohort males ages 40-49, 80-89 and ≥ 90 years were less likely to die compared with similar age New York males whereas those > 49 years to < 80 years had similar risks of death (Table 3). In the Wuhan cohort females of all ages were less likely to die compared with New York. In subjects who died those in Wuhan had longer median hospital stays compared with those in New York. (Table 3).
Table 3
Deaths by age and sex and hospitalization interval
| Wuhan Male (%) | New York Male (%) | P-value | Wuhan Female (%) | New York Female (%) | P-value | Wuhan-Hospitalization median (IQR), d | New York-Hospitalization median (IQR), d |
Age intervals, y | | | | | | | | |
0-9 | 0/0 | 0/13 | - | 0/0 | 0/13 | - | NA | NA |
10-19 | 0/4 | 0/1 | - | 0/1 | 0/7 | - | NA | NA |
20-29 | 1/35 (3) | 3/42 (7) | 0.621 | 0/48 (0) | 1/55 (2) | 1.0 | 13 (13-13) | 4 (1-7) |
30-39 | 2/122 (2) | 6/130 (5) | 0.283 | 2/132 (2) | 2/81 (3) | 0.636 | 12 (7-24) | 3 (2-4) |
40-49 | 2/118 (2) | 19/233 (8) | 0.016 | 2/108 (2) | 3/119 (3) | 1.0 | 13 (3-43) | 6 (3-8) |
50-59 | 25/172 (15) | 40/327 (12) | 0.486 | 4/191 (2) | 13/188 (7) | 0.026 | 10 (6-18) | 6 (3-10) |
60-69 | 42/254 (17) | 56/300 (19) | 0.577 | 18/281 (6) | 28/233 (12) | 0.030 | 13 (7-20) | 6 (3-8) |
70-79 | 52/161 (32) | 91/254 (36) | 0.525 | 14/110 (13) | 54/197 (27) | 0.003 | 10 (6-19) | 5 (3-8) |
80-89 | 27/58 (47) | 94/155 (61) | 0.087 | 15/49 (31) | 76/158 (48) | 0.033 | 11 (6-19) | 4 (2-7) |
≥ 90 | 3/10 (30) | 28/44 (64) | 0.078 | 0/5 (0) | 39/84 (46) | 0.065 | 8 (7-NA) | 3 (1-6) |