• James Brogan, Melissa Fazzari, Kaitlyn Philips, Boudewijn Aasman, Parsa Mirhaji, and GongMichelle NgMNMichelle Ng Gong is a professor, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, chief, Division of Critical Care Medicine, Montefiore Medical Center, Bronx, New York, and chief, Division of Pulmonar.
• James Brogan is a medical student, Albert Einstein College of Medicine, Bronx, New York.
• Am. J. Crit. Care. 2022 Jul 1; 31 (4): 283292283-292.

BackgroundUnderstanding the distribution of organ failure before and during the COVID-19 pandemic surge can provide a deeper understanding of how the pandemic strained health care systems and affected outcomes.ObjectiveTo assess the distribution of organ failure in 3 New York City hospitals during the COVID-19 pandemic.MethodsA retrospective cohort study of adult admissions across hospitals from February 1, 2020, through May 31, 2020, was conducted. The cohort was stratified into those admitted before March 17, 2020 (prepandemic) and those admitted on or after that date (SARS-CoV-2-positive and non-SARS-CoV-2). Sequential Organ Failure Assessment scores were computed every 2 hours for each admission.ResultsA total of 1 794 975 scores were computed for 20 704 admissions. Before and during the pandemic, renal failure was the most common type of organ failure at admission and respiratory failure was the most common type of hospital-onset organ failure. The SARS-CoV-2-positive group showed a 231% increase in respiratory failure compared with the prepandemic group. More than 65% of hospital-onset organ failure in the prepandemic group and 83% of hospital-onset respiratory failure in the SARS-CoV-2-positive group occurred outside intensive care units. The SARS-CoV-2-positive group showed a 341% increase in multiorgan failure compared with the prepandemic group. Compared with the prepandemic and non-SARS-CoV-2 patients, SARS-CoV-2-positive patients had significantly higher mortality for the same admission and maximum organ failure score.ConclusionMost hospital-onset organ failure began outside intensive care units, with a marked increase in multiorgan failure during pandemic surge conditions and greater hospital mortality for the severity of organ failure.©2022 American Association of Critical-Care Nurses.

9 keywords...

hide…