Lindsay Kim1,2, Shikha Garg1,2, Alissa O'Halloran1, Michael Whitaker1,3, Huong Pham1, Evan J Anderson4,5,6, Isaac Armistead7, Nancy M Bennett8, Laurie Billing9, Kathryn Como-Sabetti10, Mary Hill11, Sue Kim12, Maya L Monroe13, Alison Muse14, Arthur L Reingold15, William Schaffner16, Melissa Sutton17, H Keipp Talbot16, Salina M Torres18, Kimberly Yousey-Hindes19, Rachel Holstein1,20, Charisse Cummings1,21, Lynnette Brammer1, Aron J Hall1, Alicia M Fry1, Gayle E Langley1. 1. Coronavirus Disease 2019 (COVID-19) Associated Hospitalization Surveillance Network (COVID-NET) Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 2. US Public Health Service, Rockville, Maryland, USA. 3. Eagle Global Scientific, Atlanta, Georgia, USA. 4. Department of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA. 5. Emerging Infections Program, Georgia Department of Health, Atlanta, Georgia, USA. 6. Veterans Affairs Medical Center, Atlanta, Georgia, USA. 7. University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 8. University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. 9. Ohio Department of Health, Columbus, Ohio, USA. 10. Minnesota Department of Health, St. Paul, Minnesota, USA. 11. Salt Lake County Health Department, Salt Lake City, Utah, USA. 12. Michigan Department of Health and Human Services, Lansing, Michigan, USA. 13. Maryland Department of Health, Baltimore, Maryland, USA. 14. New York State Department of Health, Albany, New York, USA. 15. University of California, Berkeley, Berkeley, California, USA. 16. Vanderbilt University School of Medicine, Nashville, Tennessee, USA. 17. Oregon Health Authority, Portland, Oregon, USA. 18. New Mexico Department of Health, Santa Fe, New Mexico, USA. 19. Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA. 20. Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA. 21. Chickasaw Nation Industries, Norman, Oklahoma, USA.
Abstract
BACKGROUND: Currently, the United States has the largest number of reported coronavirus disease 2019 (COVID-19) cases and deaths globally. Using a geographically diverse surveillance network, we describe risk factors for severe outcomes among adults hospitalized with COVID-19. METHODS: We analyzed data from 2491 adults hospitalized with laboratory-confirmed COVID-19 between 1 March-2 May 2020, as identified through the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network, which comprises 154 acute-care hospitals in 74 counties in 13 states. We used multivariable analyses to assess associations between age, sex, race and ethnicity, and underlying conditions with intensive care unit (ICU) admission and in-hospital mortality. RESULTS: The data show that 92% of patients had ≥1 underlying condition; 32% required ICU admission; 19% required invasive mechanical ventilation; and 17% died. Independent factors associated with ICU admission included ages 50-64, 65-74, 75-84, and ≥85 years versus 18-39 years (adjusted risk ratios [aRRs], 1.53, 1.65, 1.84, and 1.43, respectively); male sex (aRR, 1.34); obesity (aRR, 1.31); immunosuppression (aRR, 1.29); and diabetes (aRR, 1.13). Independent factors associated with in-hospital mortality included ages 50-64, 65-74, 75-84, and ≥ 85 years versus 18-39 years (aRRs, 3.11, 5.77, 7.67, and 10.98, respectively); male sex (aRR, 1.30); immunosuppression (aRR, 1.39); renal disease (aRR, 1.33); chronic lung disease (aRR 1.31); cardiovascular disease (aRR, 1.28); neurologic disorders (aRR, 1.25); and diabetes (aRR, 1.19). CONCLUSIONS: In-hospital mortality increased markedly with increasing age. Aggressive implementation of prevention strategies, including social distancing and rigorous hand hygiene, may benefit the population as a whole, as well as those at highest risk for COVID-19-related complications. Published by Oxford University Press for the Infectious Diseases Society of America 2020.
BACKGROUND: Currently, the United States has the largest number of reported coronavirus disease 2019 (COVID-19) cases and deaths globally. Using a geographically diverse surveillance network, we describe risk factors for severe outcomes among adults hospitalized with COVID-19. METHODS: We analyzed data from 2491 adults hospitalized with laboratory-confirmed COVID-19 between 1 March-2 May 2020, as identified through the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network, which comprises 154 acute-care hospitals in 74 counties in 13 states. We used multivariable analyses to assess associations between age, sex, race and ethnicity, and underlying conditions with intensive care unit (ICU) admission and in-hospital mortality. RESULTS: The data show that 92% of patients had ≥1 underlying condition; 32% required ICU admission; 19% required invasive mechanical ventilation; and 17% died. Independent factors associated with ICU admission included ages 50-64, 65-74, 75-84, and ≥85 years versus 18-39 years (adjusted risk ratios [aRRs], 1.53, 1.65, 1.84, and 1.43, respectively); male sex (aRR, 1.34); obesity (aRR, 1.31); immunosuppression (aRR, 1.29); and diabetes (aRR, 1.13). Independent factors associated with in-hospital mortality included ages 50-64, 65-74, 75-84, and ≥ 85 years versus 18-39 years (aRRs, 3.11, 5.77, 7.67, and 10.98, respectively); male sex (aRR, 1.30); immunosuppression (aRR, 1.39); renal disease (aRR, 1.33); chronic lung disease (aRR 1.31); cardiovascular disease (aRR, 1.28); neurologic disorders (aRR, 1.25); and diabetes (aRR, 1.19). CONCLUSIONS: In-hospital mortality increased markedly with increasing age. Aggressive implementation of prevention strategies, including social distancing and rigorous hand hygiene, may benefit the population as a whole, as well as those at highest risk for COVID-19-related complications. Published by Oxford University Press for the Infectious Diseases Society of America 2020.
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