COVID-19 in China and the US: Differences in hospital admission co-variates and outcomes

Background Although there are extensive data on admission co-variates and outcomes of persons with coronavirus infectious disease-2019 (COVID-19) at diverse geographic sites there are few if any subject-level comparisons between sites in regions and countries. We aim to comparatively investigate differences in hospital admission co-variates and outcomes of hospitalized people with COVID-19 between Wuhan City, China and the New York City region, USA. Methods We retrospectively collected clinical data on 1859 Hospitalized subjects with COVID-19 in Wuhan City, China 20 January to 4 April, 2020. Data on those 5700 hospitalized subjects with COVID-19 in the New York City region, USA 1 March to 4 April, 2020 was drawn from a published article by Richardson et al. Hospital admission co-variates (epidemiological, demographic and laboratory co-variates) and outcomes (rate of intensive care unit(ICU) admission, invasive mechanical ventilation(IMV), major organ failure and death and length of hospital stay) were compared between the two cohorts. Results Wuhan subjects were younger, more likely female, less likely to have co-morbidities and fever, more likely to have a blood lymphocyte concentration > 1×10E+9/L and less likely to have abnormal liver and cardiac function tests compared with the New York subjects. There were outcomes data on all Wuhan subjects and 2,634 New York subjects. Wuhan subjects had higher blood nadir median lymphocyte concentrations and longer hospitalizations, were less likely to receive IMV, ICU hospitalization and kidney replacement therapy. Amongst subjects not receiving IMV those in Wuhan were less likely to die compared with New York subjects. In contrast, risk of death was similar in subjects receiving IMV at both sites. Conclusions We found different hospital admission co-variates and outcomes between hospitalized persons with COVID-19 between Wuhan City and the New York region, which should be useful developing a comprehensive global understanding of the SARS-CoV-2 pandemic and COVID-19.