tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2023 Jan 10;10(1)
fad011.
doi: 10.1093/ofid/ofad011. eCollection 2023 Jan.
Correlates of Coronavirus Disease 2019 Inpatient Mortality at a Southern California Community Hospital With a Predominantly Hispanic/Latino Adult Population
Nicole M Gatto[SUP] 1 2 3 4 [/SUP], Debbie Freund[SUP] 5 6 7 [/SUP], Pamela Ogata[SUP] 5 [/SUP], Lisa Diaz[SUP] 3 [/SUP], Ace Ibarrola[SUP] 3 [/SUP], Mamta Desai[SUP] 3 [/SUP], Thor Aspelund[SUP] 4 [/SUP], Daniel Gluckstein[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Studies of inpatient coronavirus disease 2019 (COVID-19) mortality risk factors have mainly used data from academic medical centers or large multihospital databases and have not examined populations with large proportions of Hispanic/Latino patients. In a retrospective cohort study of 4881 consecutive adult COVID-19 hospitalizations at a single community hospital in Los Angeles County with a majority Hispanic/Latino population, we evaluated factors associated with mortality.
Methods: Data on demographic characteristics, comorbidities, laboratory and clinical results, and COVID-19 therapeutics were abstracted from the electronic medical record. Cox proportional hazards regression modeled statistically significant, independently associated predictors of hospital mortality.
Results: Age ≥65 years (hazard ratio
= 2.66; 95% confidence interval [CI] = 1.90-3.72), male sex (HR = 1.31; 95% CI = 1.07-1.60), renal disease (HR = 1.52; 95% CI = 1.18-1.95), cardiovascular disease (HR = 1.45; 95% CI = 1.18-1.78), neurological disease (HR = 1.84; 95% CI = 1.41-2.39), D-dimer ≥500 ng/mL (HR = 2.07; 95% CI = 1.43-3.0), and pulse oxygen level <88% (HR = 1.39; 95% CI = 1.13-1.71) were independently associated with increased mortality. Patient household with (1) multiple COVID-19 cases and (2) Asian, Black, or Hispanic compared with White non-Hispanic race/ethnicity were associated with reduced mortality. In hypoxic COVID-19 inpatients, remdesivir, tocilizumab, and convalescent plasma were associated with reduced mortality, and corticosteroid use was associated with increased mortality.
Conclusions: We corroborate several previously identified mortality risk factors and find evidence that the combination of factors associated with mortality differ between populations.
Keywords: COVID-19; Hispanic; Latino; community hospital; mortality.
. 2023 Jan 10;10(1)
fad011.doi: 10.1093/ofid/ofad011. eCollection 2023 Jan.
Correlates of Coronavirus Disease 2019 Inpatient Mortality at a Southern California Community Hospital With a Predominantly Hispanic/Latino Adult Population
Nicole M Gatto[SUP] 1 2 3 4 [/SUP], Debbie Freund[SUP] 5 6 7 [/SUP], Pamela Ogata[SUP] 5 [/SUP], Lisa Diaz[SUP] 3 [/SUP], Ace Ibarrola[SUP] 3 [/SUP], Mamta Desai[SUP] 3 [/SUP], Thor Aspelund[SUP] 4 [/SUP], Daniel Gluckstein[SUP] 3 [/SUP]
Affiliations
- PMID: 36726553
- PMCID: PMC9887269
- DOI: 10.1093/ofid/ofad011
Abstract
Background: Studies of inpatient coronavirus disease 2019 (COVID-19) mortality risk factors have mainly used data from academic medical centers or large multihospital databases and have not examined populations with large proportions of Hispanic/Latino patients. In a retrospective cohort study of 4881 consecutive adult COVID-19 hospitalizations at a single community hospital in Los Angeles County with a majority Hispanic/Latino population, we evaluated factors associated with mortality.
Methods: Data on demographic characteristics, comorbidities, laboratory and clinical results, and COVID-19 therapeutics were abstracted from the electronic medical record. Cox proportional hazards regression modeled statistically significant, independently associated predictors of hospital mortality.
Results: Age ≥65 years (hazard ratio
= 2.66; 95% confidence interval [CI] = 1.90-3.72), male sex (HR = 1.31; 95% CI = 1.07-1.60), renal disease (HR = 1.52; 95% CI = 1.18-1.95), cardiovascular disease (HR = 1.45; 95% CI = 1.18-1.78), neurological disease (HR = 1.84; 95% CI = 1.41-2.39), D-dimer ≥500 ng/mL (HR = 2.07; 95% CI = 1.43-3.0), and pulse oxygen level <88% (HR = 1.39; 95% CI = 1.13-1.71) were independently associated with increased mortality. Patient household with (1) multiple COVID-19 cases and (2) Asian, Black, or Hispanic compared with White non-Hispanic race/ethnicity were associated with reduced mortality. In hypoxic COVID-19 inpatients, remdesivir, tocilizumab, and convalescent plasma were associated with reduced mortality, and corticosteroid use was associated with increased mortality.
Conclusions: We corroborate several previously identified mortality risk factors and find evidence that the combination of factors associated with mortality differ between populations.
Keywords: COVID-19; Hispanic; Latino; community hospital; mortality.