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2 "Evan Leibner"
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Original Articles
Epidemiology
The fourth wave: vaccination status and intensive care unit mortality at a large hospital system in New York City
Pranai Tandon, Evan Leibner, Anna Hackett, Katherine Maguire, Kayla Leonardi, Matthew A. Levin, Roopa Kohli-Seth
Acute Crit Care. 2022;37(3):339-346.   Published online August 29, 2022
DOI: https://doi.org/10.4266/acc.2022.00675
  • 3,011 View
  • 171 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
We aim to describe the demographics and outcomes of patients with severe disease with the Omicron variant. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus continues to mutate, and the availability of vaccines and boosters continue to rise, it is important to understand the health care burden of new variants. We analyze patients admitted to intensive care units (ICUs) in a large Academic Health System during New York City’s fourth surge beginning on November 27, 2021.
Methods
All patients admitted to an ICU were included in the primary analysis. Key demographics and outcomes were retrospectively compared between patients stratified by vaccination status. Univariate and multivariate logistic regression was used to identify risk factors for in-hospital mortality.
Results
In-hospital mortality for all admitted patients during the fourth wave was significantly lower than in previous waves. However, among patients requiring intensive care, in-hospital mortality was high across all levels of vaccination status. In a multivariate model older age was associated with increased in-hospital mortality, vaccination status of overdue for booster was associated with decreased in hospital mortality, and vaccination status of up-to-date with vaccination showed a trend to reduced mortality.
Conclusions
In-hospital mortality of patients with severe respiratory failure from coronavirus disease 2019 (COVID-19) remains high despite decreasing overall mortality. Vaccination against SARS-CoV-2 was protective against mortality. Vaccination remains the best and safest way to protect against serious illness and death from COVID-19. It remains unclear that any other treatment will have success in changing the natural history of the disease.

Citations

Citations to this article as recorded by  
  • Need for ICU and outcome of critically ill patients with COVID-19 and haematological malignancies: results from the EPICOVIDEHA survey
    Tobias Lahmer, Jon Salmanton-García, Francesco Marchesi, Shaimaa El-Ashwah, Marcio Nucci, Caroline Besson, Federico Itri, Ozren Jaksic, Natasha Čolović, Barbora Weinbergerová, Guldane Cengiz Seval, Tatjana Adžić-Vukičević, Tomáš Szotkowski, Uluhan Sili, M
    Infection.2024; 52(3): 1125.     CrossRef
  • Outcomes of Elderly Patients Hospitalized with the SARS-CoV-2 Omicron B.1.1.529 Variant: A Systematic Review
    Roxana Manuela Fericean, Cristian Oancea, Akash Reddy Reddyreddy, Ovidiu Rosca, Felix Bratosin, Vlad Bloanca, Cosmin Citu, Satish Alambaram, Neeharika Gayatri Vasamsetti, Catalin Dumitru
    International Journal of Environmental Research and Public Health.2023; 20(3): 2150.     CrossRef
Pulmonary
The Mount Sinai Hospital Institute for critical care medicine response to the COVID-19 pandemic
Jennifer Wang, Evan Leibner, Jaime B. Hyman, Sanam Ahmed, Joshua Hamburger, Jean Hsieh, Neha Dangayach, Pranai Tandon, Umesh Gidwani, Andrew Leibowitz, Roopa Kohli-Seth
Acute Crit Care. 2021;36(3):201-207.   Published online August 10, 2021
DOI: https://doi.org/10.4266/acc.2021.00402
  • 5,658 View
  • 140 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary Material
Background
The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of critically ill patients. This was especially true in New York City. We present a roadmap for hospitals and healthcare systems to prepare for a Pandemic.
Methods
This was a retrospective review of how Mount Sinai Hospital (MSH) was able to rapidly prepare to handle the pandemic. MSH, the largest academic hospital within the Mount Sinai Health System, rapidly expanded the intensive care unit (ICU) bed capacity, including creating new ICU beds, expanded the workforce, and created guidelines.
Results
MSH a 1,139-bed quaternary care academic referral hospital with 104 ICU beds expanded to 1,453 beds (27.5% increase) with 235 ICU beds (126% increase) during the pandemic peak in the first week of April 2020. From March to June 2020, with follow-up through October 2020, MSH admitted 2,591 COVID-19-positive patients, 614 to ICUs. Most admitted patients received noninvasive support including a non-rebreather mask, high flow nasal cannula, and noninvasive positive pressure ventilation. Among ICU patients, 68.4% (n=420) received mechanical ventilation; among the admitted ICU patients, 42.8% (n=263) died, and 47.8% (n=294) were discharged alive.
Conclusions
Flexible bed management initiatives; teamwork across multiple disciplines; and development and implementation of guidelines were critical accommodating the surge of critically ill patients. Non-ICU services and staff were deployed to augment the critical care work force and open new critical care units. This approach to rapidly expand bed availability and staffing across the system helped provide the best care for the patients and saved lives.

Citations

Citations to this article as recorded by  
  • The COVID-19 Tracheostomy Experience at a Large Academic Medical Center in New York during the First Year
    Dhruv Patel, Anthony Devivo, Evan Leibner, Atinuke Shittu, Usha Govindarajulu, Pranai Tandon, David Lee, Randall Owen, Gustavo Fernandez-Ranvier, Robert Hiensch, Michael Marin, Roopa Kohli-Seth, Adel Bassily-Marcus
    Journal of Clinical Medicine.2024; 13(7): 2130.     CrossRef
  • Why are there so many hospital beds in Germany?
    Matthias Brunn, Torsten Kratz, Michael Padget, Marie-Caroline Clément, Marc Smyrl
    Health Services Management Research.2023; 36(1): 75.     CrossRef
  • Flow-Sizing Critical Care Resources*
    Joseph L. Nates, John M. Oropello, Neeraj Badjatia, Gregory Beilman, Craig M. Coopersmith, Neil A. Halpern, Daniel L. Herr, Judith Jacobi, Roozehra Kahn, Sharon Leung, Nitin Puri, Ayan Sen, Stephen M. Pastores
    Critical Care Medicine.2023; 51(11): 1552.     CrossRef
  • Sustaining the Australian respiratory workforce through the COVID‐19 pandemic: a scoping literature review
    Emily Stone, Louis B. Irving, Katrina O. Tonga, Bruce Thompson
    Internal Medicine Journal.2022; 52(7): 1115.     CrossRef
  • Outcomes of hip fracture surgery during the COVID-19 pandemic
    Sherrie Wang, MaKenzie Chambers, Kelsey Martin, Grace Gilbert, Pietro M. Gentile, Rock Hwang, Rakesh Mashru, Kenneth W. Graf, Henry J. Dolch
    European Journal of Orthopaedic Surgery & Traumatology.2022; 33(6): 2453.     CrossRef
  • Rapid communication for effective medical resource allocation in the COVID-19 pandemic
    Kwangha Lee
    Acute and Critical Care.2021; 36(3): 262.     CrossRef
  • Triage: Medical Details and Words Matter
    Jolion McGreevy, Rosamond Rhodes
    The American Journal of Bioethics.2021; 21(11): 64.     CrossRef

ACC : Acute and Critical Care