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Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | COVID-19 | Research

Characteristics and outcomes of a hospitalized cohort with reduced mortality from COVID-19, White Mountain apache tribal lands, April 1 – July 31, 2020

Authors: Ryan M. Close, Chelsea S. Lutz, T. Shaifer Jones, Myles Stone, Nicole Bratsch, Trevor Thompson, Christopher Jentoft, James B. McAuley

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

Widespread transmission of COVID-19 continues to threaten public health, particularly of rural, American Indian communities. Although COVID-19 risk factors for severe disease and clinical characteristics are well described in the general population, there has been little shared on hospitalized American Indian populations.

Methods

In this observational study, we performed chart extractions on all persons hospitalized with COVID-19 from April 1 through July 31, 2020 among an exclusively American Indian population living on or near Tribal lands in eastern Arizona. We provide descriptive statistics for the cohort stratified by presentation, comparing those who self-presented or were referred by an outreach program. Exploratory analyses were performed to identify risk factors for morbidity and mortality.

Results

During the observation period, 2262 persons were diagnosed with COVID-19 and 490 (22%) were hospitalized. Hospitalized persons had a median age of 54 years; 92% had at least one comorbidity, 72% had greater than one comorbidity, and 60% had a BMI of > 30. Most persons required supplemental oxygen (83%), but the majority (62%) only required nasal cannula and only 11% were intubated. The case fatality rates were 1.7% for the population, 7.1% among hospitalizations, and 9.3% among hospitalized patients 50 years and older. All rates that are significantly lower than those reported nationally during the same period.

Conclusions

We observed a cohort of American Indian patients hospitalized secondary to COVID-19 with greater number of comorbidities compared to the general population but with lower mortality rates. We posit that the primary driver of mortality reduction for this population and the hospitalized cohort was a community-based referral program that led to disproportionately lower fatality rates among the oldest persons.
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Literature
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go back to reference Close R, Enos L. Indian Health Service Community Health ECHO Session: case investigation and contact tracing. Presentation presented at the: Project ECHO. University of New Mexico; 2021. Close R, Enos L. Indian Health Service Community Health ECHO Session: case investigation and contact tracing. Presentation presented at the: Project ECHO. University of New Mexico; 2021.
Metadata
Title
Characteristics and outcomes of a hospitalized cohort with reduced mortality from COVID-19, White Mountain apache tribal lands, April 1 – July 31, 2020
Authors
Ryan M. Close
Chelsea S. Lutz
T. Shaifer Jones
Myles Stone
Nicole Bratsch
Trevor Thompson
Christopher Jentoft
James B. McAuley
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
COVID-19
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18098-5

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