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Outcomes of COVID-19 With the Mayo Clinic Model of Care and Research
Authors:John Charles O’Horo  James R. Cerhan  Elliot J. Cahn  Philippe R. Bauer  Zelalem Temesgen  Jon Ebbert  Andy Abril  Omar M. Abu Saleh  Mariam Assi  Elie F. Berbari  Dennis M. Bierle  Wendelyn Bosch  Charles D. Burger  Edison J. Cano Cevallos  Casey M. Clements  Eva M. Carmona Porquera  Natalia E. Castillo Almeida  Douglas W. Challener  Andrew D. Badley
Affiliation:1. Division of Infectious Diseases, Mayo Clinic, Rochester, MN;2. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN;3. Division of Health Science Research, Mayo Clinic, Rochester, MN;4. Division of Community Internal Medicine, Mayo Clinic, Rochester, MN;5. Division of General Internal Medicine, Mayo Clinic, Rochester, MN;6. Division of Pediatric Critical Care Medicine, Mayo Clinic, Rochester, MN;7. Division of Pediatric Infectious Diseases, Mayo Clinic, Rochester, MN;8. Division of Hospital Medicine, Mayo Clinic, Rochester, MN;9. Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN;10. Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN;11. Department of Emergency Medicine, Mayo Clinic, Rochester, MN;12. Department of Laboratory Medicine Pathology, Mayo Clinic, Rochester, MN;13. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN;14. Department of Neurology, Mayo Clinic, Rochester, MN;15. Department of Critical Care, Mayo Clinic, Rochester, MN;p. Department of Molecular Medicine, Mayo Clinic, Rochester, MN;q. Division of Intensive Care, Department of Anesthesia, Mayo Clinic, Rochester, MN;r. Division of Rheumatology, Mayo Clinic, Jacksonville, FL;s. Division of Infectious Diseases, Mayo Clinic, Jacksonville, FL;t. Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL;u. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL;v. Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL;w. Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL;x. Department of Internal Medicine, Mayo Clinic, Jacksonville, FL;y. Department of Laboratory Medicine Pathology, Mayo Clinic, Jacksonville, FL;z. Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL;11. Department of Family Medicine, Mayo Clinic Health System, Mankato, MN;22. Division of Occupational Medicine, Mayo Clinic Health System, Mankato, MN;33. Division of Infectious Diseases, Mayo Clinic, Scottsdale, AZ;44. Department of Critical Care Medicine, Mayo Clinic, Scottsdale, AZ
Abstract:ObjectiveTo report the Mayo Clinic experience with coronavirus disease 2019 (COVID-19) related to patient outcomes.MethodsWe conducted a retrospective chart review of patients with COVID-19 diagnosed between March 1, 2020, and July 31, 2020, at any of the Mayo Clinic sites. We abstracted pertinent comorbid conditions such as age, sex, body mass index, Charlson Comorbidity Index variables, and treatments received. Factors associated with hospitalization and mortality were assessed in univariate and multivariate models.ResultsA total of 7891 patients with confirmed COVID-19 infection with research authorization on file received care across the Mayo Clinic sites during the study period. Of these, 7217 patients were adults 18 years or older who were analyzed further. A total of 897 (11.4%) patients required hospitalization, and 354 (4.9%) received care in the intensive care unit (ICU). All hospitalized patients were reviewed by a COVID-19 Treatment Review Panel, and 77.5% (695 of 897) of inpatients received a COVID-19–directed therapy. Overall mortality was 1.2% (94 of 7891), with 7.1% (64 of 897) mortality in hospitalized patients and 11.3% (40 of 354) in patients requiring ICU care.ConclusionMayo Clinic outcomes of patients with COVID-19 infection in the ICU, hospital, and community compare favorably with those reported nationally. This likely reflects the impact of interprofessional multidisciplinary team evaluation, effective leveraging of clinical trials and available treatments, deployment of remote monitoring tools, and maintenance of adequate operating capacity to not require surge adjustments. These best practices can help guide other health care systems with the continuing response to the COVID-19 pandemic.
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