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Clin Infect Dis . Adults Hospitalized with COVID-19 -United States, March-June and October-December 2020: Implications for the Potential Effects of

tetano

Editor, Senior Moderator
Clin Infect Dis


. 2021 May 12;ciab319.
doi: 10.1093/cid/ciab319. Online ahead of print.
Adults Hospitalized with COVID-19 -United States, March-June and October-December 2020: Implications for the Potential Effects of COVID-19 Tier-1 Vaccination on Future Hospitalizations and Outcomes


Samira Sami[SUP] 1 [/SUP], Mark W Tenforde[SUP] 1 2 [/SUP], H Keipp Talbot[SUP] 3 [/SUP], Christopher J Lindsell[SUP] 3 [/SUP], Jay S Steingrub[SUP] 4 [/SUP], Nathan I Shapiro[SUP] 5 [/SUP], Adit A Ginde[SUP] 6 [/SUP], David J Douin[SUP] 6 [/SUP], Matthew E Prekker[SUP] 7 [/SUP], Heidi L Erickson[SUP] 7 [/SUP], Samuel M Brown[SUP] 8 [/SUP], Ithan D Peltan[SUP] 8 [/SUP], Michelle N Gong[SUP] 9 [/SUP], Akram Khan[SUP] 10 [/SUP], Matthew C Exline[SUP] 11 [/SUP], D Clark Files[SUP] 12 [/SUP], Kevin W Gibbs[SUP] 12 [/SUP], Todd W Rice[SUP] 3 [/SUP], Jonathan D Casey[SUP] 3 [/SUP], Carlos G Grijalva[SUP] 3 [/SUP], William B Stubblefield[SUP] 3 [/SUP], Kelsey N Womack[SUP] 3 [/SUP], David N Hager[SUP] 13 [/SUP], Nida Qadir[SUP] 14 [/SUP], Steven Y Chang[SUP] 14 [/SUP], Daniel J Henning[SUP] 15 [/SUP], Jennifer G Wilson[SUP] 16 [/SUP], Wesley H Self[SUP] 3 [/SUP], Manish M Patel[SUP] 1 [/SUP], IVY Network Investigators



Affiliations

Abstract

Background: Because of the increased risk for severe coronavirus disease 2019 (COVID-19), the Advisory Committee on Immunization Practices (ACIP) initially prioritized COVID-19 vaccination for persons in long-term care facilities (LTCF), persons aged ?65 years, and persons aged 16-64 years with high-risk medical conditions when there is limited vaccine supply. We compared characteristics and severe outcomes of hospitalized patients with COVID-19 in the United States between early and later in the pandemic categorized by groups at higher risk of severe COVID-19.
Methods: Observational study of sampled patients aged ?18 years who tested positive for SARS-CoV-2 and admitted to one of 14 academic hospitals in the United States during March-June and October-December 2020. Demographic and clinical information were gathered from electronic health record data.
Results: Among 647 patients, 91% met ?1 of the following risk factors for severe COVID-19 [91% March-June (n=434); 90% October-December (n=213)]; 19% were LTCF residents, 45% were aged ?65-years, and 84% had ?1 high-risk condition. The proportion of patients who resided in a LTCF declined significantly (25% vs. 6%) from early to later pandemic periods. Compared with patients at lower risk for severe COVID-19, in-hospital mortality was higher among patients at high risk for severe COVID-19 (20% vs. 7%); these differences were consistently observed between March-June and October-December.
Conclusions: Most adults hospitalized with COVID-19 were those recommended to be prioritized for vaccination based on risk for developing severe COVID-19. These findings highlight the urgency to vaccinate patients at high risk for severe COVID-19 and monitor vaccination impact on hospitalizations and outcomes.

Keywords: COVID-19; SARS-CoV-2; United States; hospitalization; vaccination.
 
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