527 - Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York

Background: The area of New York was hit hard by the COVID 19 pandemic with Suffolk county in Long Island numbering >40 thousand cases and 1900 deaths by the end of May 2020. The Veterans Affairs Medical Center (VAMC) at Northport NY serves over 30000 Veterans. We report our institution’s experience during the COVID 19 outbreak

Methods: Retrospective chart review of hospitalized Veterans (VETS) with COVID-19 from March 1^st to May 31^st 2020 at Northport VAMC

Results: A total of 141 VETS had laboratory confirmed SARS-CoV-2 infection, 67 got hospitalized, and 20/67 died.  The median age of the hospitalized cohort was 73 years (33 to 94).  Figure 1 shows the dates of tests, Tables 1 &2 summarize the demographic characteristics, medical history and laboratory findings. No co-infection with influenza or other respiratory viruses were identified. The deceased group was older 77.5 vs 71 years P 0.007, had lower oxygen saturation and higher respiratory rate on presentation, had longer length of stay P 0.091, more likely to be in ICU and intubated, had lower bicarbonate levels,  higher SAPS P < 0.001, higher lactate dehydrogenase, blood urea nitrogen, potassium levels, and higher peak procalcitonin, CRP, ferritin, ESR levels. There was no difference between recovered and deceased in terms of comorbidities except atrial fibrillation. Also, no difference in use of ACE inhibitors, statins, famotidine, hydroxychloroquine (HCQ), azithromycin, doxycycline, steroids.  Beta lactam antibiotics and tocilizumab were given more in the deceased group.  HCQ was stopped in 1 patient due to QTc prolongation.  No bacteremia identified in the recovered group contrary to two occasions in the deceased, E. faecalis and S. mitis. Six pneumonias in intubated deceased patients were identified (3 had received steroids and one tocilizumab) and 4 in recovered (2 intubated/steroids and 1 tocilizumab). 12 recovered patients had persistent positive nasopharyngeal PCR for SARS-CoV-2 for average 29 days (14 to 79 days), and 4 of them were checked and had detectable IgG antibodyDates of Tests for Hospitalized Veterans with COVID-19
Comparison of Demographic Data and Comorbidities in Recovered vs Diseased Hospitalized Veterans with COVID - 19
Comparison of Laboratory Data in Recovered vs Diseased Hospitalized Veterans with COVID - 19


Conclusion: The inpatient mortality of hospitalized VETS with COVID-19 in our institution was 30%. Mortality was associated with older age. Ongoing monitoring of outcomes in hospitalized patients will be important to understand the evolving epidemiology of COVID-19 among US VETS.