Outcomes of Hospitalized COVID-19 Patients by Risk Factors: Results from a United States Hospital Claims Database.

Peter Mallow,Michael Topmiller,Kathy Belk,Edmond Hooker

doi:10.36469/jheor.2020.17331

Abstract

Background/ObjectiveThe primary objective was to quantify the role of the number of Centers of Disease Control and Prevention (CDC) risk factors on in-hospital mortality. The secondary objective was to assess the associated hospital length of stay (LOS), intensive care unit (ICU) bed utilization, and ICU LOS with the number of CDC risk factors.MethodsA retrospective cohort study consisting of all hospitalizations with a confirmed COVID-19 diagnosis discharged between March 15, 2020 and April 30, 2020 was conducted. Data was obtained from 276 acute care hospitals across the United States. Cohorts were identified based upon the number of the CDC COVID-19 risk factors. Multivariable regression modeling was performed to assess outcomes and utilization. The odds ratio (OR) and incidence rate ratio (IRR) were reported.ResultsCompared with patients with no CDC risk factors, patients with risk factors were significantly more likely to die during the hospitalization: One risk factor (OR 2.08, 95% CI, 1.60–2.70; P < 0.001), two risk factors (OR 2.63, 95% CI, 2.00–3.47; P < 0.001), and three or more risk factors (OR 3.49, 95% CI, 2.53–4.80; P < 0.001). The presence of CDC risk factors was associated with increased ICU utilization, longer ICU LOS, and longer hospital LOS compared to those with no risk factors. Patients with hypertension (OR 0.77, 95% CI, 0.70–0.86; P < 0.001) and those administered statins were less likely to die (OR 0.54, 95% CI, 0.49–0.60; P < 0.001).ConclusionsQuantifying the role of CDC risk factors upon admission may improve risk stratification and identification of patients who may require closer monitoring and more intensive treatment.

Highlights

The novel coronavirus disease 2019 (COVID-19) reached the United States in early 2020.1,2 It has since spread through the community and overwhelmed health care resources in several communities.[3]
Data contained information on demographic and clinical characteristics of all patient visits, including pharmaceuticals administered, diagnostic tests, and procedures performed during the hospitalization
Centers for Disease Control and Prevention (CDC) risk factors associated with severe illness from COVID-19 were identified by International Classification of Diseases 10th Revision (ICD-10) codes with the exception of age (Table S1)

Summary

Introduction

The novel coronavirus disease 2019 (COVID-19) reached the United States in early 2020.1,2 It has since spread through the community and overwhelmed health care resources in several communities.[3]. Several studies have attempted to describe the presenting characteristics and associated hospital utilization by gender, age, and geography.[6,7,8,9] These initial studies have described COVID-19 hospitalized mortality rates ranging from 5% to 64% based on age and lengths of stay varying from 4–13 days. These studies were limited to narrow geographic areas of New York City, New York; Toronto, Canada; and Wuhan, China.

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Conclusion