Jean Y Ko1,2, Melissa L Danielson1, Machell Town3, Gordana Derado1, Kurt J Greenlund3, Pam Daily Kirley4, Nisha B Alden5, Kimberly Yousey-Hindes6, Evan J Anderson7,8,9, Patricia A Ryan10, Sue Kim11, Ruth Lynfield12, Salina M Torres13, Grant R Barney14, Nancy M Bennett15, Melissa Sutton16, H Keipp Talbot17, Mary Hill18, Aron J Hall1, Alicia M Fry1,2, Shikha Garg1,2, Lindsay Kim1,2. 1. COVID-NET Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 2. US Public Health Service, Rockville, Maryland, USA. 3. Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 4. California Emerging Infections Program, Oakland, California, USA. 5. Colorado Department of Public Health and Environment, Denver, Colorado, USA. 6. Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA. 7. Department of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA. 8. Emerging Infections Program, Georgia Department of Health, Atlanta, Georgia, USA. 9. Veterans Affairs Medical Center, Atlanta, Georgia, USA. 10. Maryland Department of Health, Baltimore, Maryland, USA. 11. Michigan Department of Health and Human Services, Lansing, Michigan, USA. 12. Minnesota Department of Health, St Paul, Minnesota, USA. 13. New Mexico Department of Health, Santa Fe, New Mexico, USA. 14. New York State Department of Health, Albany, New York, USA. 15. University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. 16. Oregon Health Authority, Portland, Oregon, USA. 17. Vanderbilt University School of Medicine, Nashville, Tennessee, USA. 18. Salt Lake County Health Department, Salt Lake City, Utah, USA.
Abstract
BACKGROUND: Data on risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization are needed to guide prevention efforts and clinical care. We sought to identify factors independently associated with COVID-19-associated hospitalizations. METHODS: Community-dwelling adults (aged ≥18 years) in the United States hospitalized with laboratory-confirmed COVID-19 during 1 March-23 June 2020 were identified from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), a multistate surveillance system. To calculate hospitalization rates by age, sex, and race/ethnicity strata, COVID-NET data served as the numerator and Behavioral Risk Factor Surveillance System estimates served as the population denominator for characteristics of interest. Underlying medical conditions examined included hypertension, coronary artery disease, history of stroke, diabetes, obesity, severe obesity, chronic kidney disease, asthma, and chronic obstructive pulmonary disease. Generalized Poisson regression models were used to calculate adjusted rate ratios (aRRs) for hospitalization. RESULTS: Among 5416 adults, hospitalization rates (all reported as aRR [95% confidence interval]) were higher among those with ≥3 underlying conditions (vs without) (5.0 [3.9-6.3]), severe obesity (4.4 [3.4-5.7]), chronic kidney disease (4.0 [3.0-5.2]), diabetes (3.2 [2.5-4.1]), obesity (2.9 [2.3-3.5]), hypertension (2.8 [2.3-3.4]), and asthma (1.4 [1.1-1.7]), after adjusting for age, sex, and race/ethnicity. Adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults aged ≥65 or 45-64 years (vs 18-44 years), males (vs females), and non-Hispanic black and other race/ethnicities (vs non-Hispanic whites). CONCLUSIONS: Our findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions. Published by Oxford University Press for the Infectious Diseases Society of America 2020.
BACKGROUND: Data on risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization are needed to guide prevention efforts and clinical care. We sought to identify factors independently associated with COVID-19-associated hospitalizations. METHODS: Community-dwelling adults (aged ≥18 years) in the United States hospitalized with laboratory-confirmed COVID-19 during 1 March-23 June 2020 were identified from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), a multistate surveillance system. To calculate hospitalization rates by age, sex, and race/ethnicity strata, COVID-NET data served as the numerator and Behavioral Risk Factor Surveillance System estimates served as the population denominator for characteristics of interest. Underlying medical conditions examined included hypertension, coronary artery disease, history of stroke, diabetes, obesity, severe obesity, chronic kidney disease, asthma, and chronic obstructive pulmonary disease. Generalized Poisson regression models were used to calculate adjusted rate ratios (aRRs) for hospitalization. RESULTS: Among 5416 adults, hospitalization rates (all reported as aRR [95% confidence interval]) were higher among those with ≥3 underlying conditions (vs without) (5.0 [3.9-6.3]), severe obesity (4.4 [3.4-5.7]), chronic kidney disease (4.0 [3.0-5.2]), diabetes (3.2 [2.5-4.1]), obesity (2.9 [2.3-3.5]), hypertension (2.8 [2.3-3.4]), and asthma (1.4 [1.1-1.7]), after adjusting for age, sex, and race/ethnicity. Adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults aged ≥65 or 45-64 years (vs 18-44 years), males (vs females), and non-Hispanic black and other race/ethnicities (vs non-Hispanic whites). CONCLUSIONS: Our findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions. Published by Oxford University Press for the Infectious Diseases Society of America 2020.
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