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BMC Infect Dis . COVID-19 hospitalizations in five California hospitals: a retrospective cohort study

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  • BMC Infect Dis . COVID-19 hospitalizations in five California hospitals: a retrospective cohort study


    BMC Infect Dis


    . 2021 Sep 10;21(1):938.
    doi: 10.1186/s12879-021-06640-4.
    COVID-19 hospitalizations in five California hospitals: a retrospective cohort study


    Miriam Nuño 1 2 , Yury García 3 4 , Ganesh Rajasekar 5 , Diego Pinheiro 6 , Alec J Schmidt 3



    AffiliationsFree article

    Abstract

    Background: The novel coronavirus pandemic has had a differential impact on communities of color across the US. The University of California hospital system serves a large population of people who are often underrepresented elsewhere. Data from hospital stays can provide much-needed localized information on risk factors for severe cases and/or death.
    Methods: Patient-level retrospective case series of laboratory-confirmed COVID-19 hospital admissions at five UC hospitals (N = 4730). Odds ratios of ICU admission, death, and a composite of both outcomes were calculated with univariate and multivariate logistic regression based on patient characteristics, including sex, race/ethnicity, and select comorbidities. Associations between comorbidities were quantified and visualized with a correlation network.
    Results: Overall mortality rate was 7.0% (329/4,730). ICU mortality rate was 18.8% (225/1,194). The rate of the composite outcome (ICU admission and/or death) was 27.4% (1298/4730). Comorbidity-controlled odds of a composite outcome were increased for age 75-84 (OR 1.47, 95% CI 1.11-1.93) and 85-59 (OR 1.39, 95% CI 1.04-1.87) compared to 18-34 year-olds, males (OR 1.39, 95% CI 1.21-1.59) vs. females, and patients identifying as Hispanic/Latino (OR 1.35, 95% CI 1.14-1.61) or Asian (OR 1.43, 95% CI 1.23-1.82) compared to White. Patients with 5 or more comorbidities were exceedingly likely to experience a composite outcome (OR 2.74, 95% CI 2.32-3.25).
    Conclusions: Males, older patients, those with multiple pre-existing comorbidities, and those identifying as Hispanic/Latino or Asian experienced an increased risk of ICU admission and/or death. These results are consistent with reported risks among the Hispanic/Latino population elsewhere in the United States, and confirm multiple concerns about heightened risk among the Asian population in California.

    Keywords: Comorbidities; Composite outcome; Coronavirus disease 2019; Hospitalization; In-hospital mortality; Intensive care unit; Severe acute respiratory syndrome coronavirus 2.

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