1866. Burden of Death Associated with SARS-CoV-2 Infection during the Pandemic in Flint, Michigan (MI): Mortality Trends over the 2-year time period

Abstract

Abstract Background Approximately 2.4 million cases of SARS-CoV-2 infection have been reported in MI, leading to 35,935 deaths. We aimed to study the mortality trends in patients with SARS-CoV-2 infection during the pandemic in Flint, MI. Methods Hurley Medical Center, is a 443-bed inner city teaching hospital in Flint, MI. We retrospectively collected basic demographics, treatment data, and outcomes on adults (≥ 18 years (yrs) of age) with confirmed SARS-CoV-2 infection, admitted and discharged from our facility from 03/2020 through 02/2022. The 2-year span was further divided into 6-time periods (Table 1). Results During the 2-year study period, the overall crude 90-day mortality rate was 16% (269/1668) and the In-hospital case fatality rate was 15% (244/1668). 90-day mortality was lowest in the time period 5 (Table 1). Men comprised 50% of the cohort and were 1.5 times more likely to die than women (p-value 0.001). African Americans comprised 51% and whites 44% of the cohort. A specific race was not associated with mortality (Table 2). Non-survivors tended to be older, mean age of 68 vs 57 yrs (p-value < .0001). See Table 3 for mean Body Mass Index (BMI). Hypertension (HTN) was the most common co-morbidity (61%), and was strongly associated with mortality (p-value < 0.005) (Table 4). During the study period, 12% of the cohort (207/1668) had received at least one dose of available COVID-19 vaccines (including single dose of Johnson and Johnson’s Jansen vaccine). 89% of non-survivors were unvaccinated (adjusted Odds ratio for mortality 1.61, 95% CI 1.03 - 2.53, p-value 0.038). Conclusion Despite substantial changes in supportive care and management, SARS-CoV-2 infection regardless of the circulating variants carried a significant mortality risk. Trend towards improving mortality can partly be attributed to better supportive care-treatments, and some background immunity from prior infection or vaccination. Immunization against COVID-19 is highly protective against severe disease. Vaccination coverage in this high-risk cohort was low, at only 12%. Vaccination coverage in Flint and surrounding areas remains low at less than 50% as reported by Genesee County health department. Public health efforts should be focused at overcoming the barriers to vaccine acceptance in this high-risk unique population. Disclosures All Authors: No reported disclosures.