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Published in: BMC Infectious Diseases 1/2021

Open Access 01-12-2021 | SARS-CoV-2 | Research

COVID-19 hospitalizations in five California hospitals: a retrospective cohort study

Authors: Miriam Nuño, Yury García, Ganesh Rajasekar, Diego Pinheiro, Alec J. Schmidt

Published in: BMC Infectious Diseases | Issue 1/2021

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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.
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Literature
3.
go back to reference Ko JY, Danielson ML, Town M, Derado G, Greenlund KJ, Kirley PD, Alden NB, Yousey-Hindes K, Anderson EJ, Ryan PA, Kim S, Lynfield R, Torres SM, Barney GR, Bennett NM, Sutton M, Talbot HK, Hill M, Hall AJ, Fry AM, Garg S, Kim L; COVID-NET Surveillance Team. Risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization: COVID-19-associated hospitalization surveillance network and behavioral risk factor surveillance system. Clin Infect Dis. 2021;72(11):e695–e703. https://doi.org/10.1093/cid/ciaa1419. Ko JY, Danielson ML, Town M, Derado G, Greenlund KJ, Kirley PD, Alden NB, Yousey-Hindes K, Anderson EJ, Ryan PA, Kim S, Lynfield R, Torres SM, Barney GR, Bennett NM, Sutton M, Talbot HK, Hill M, Hall AJ, Fry AM, Garg S, Kim L; COVID-NET Surveillance Team. Risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization: COVID-19-associated hospitalization surveillance network and behavioral risk factor surveillance system. Clin Infect Dis. 2021;72(11):e695–e703. https://​doi.​org/​10.​1093/​cid/​ciaa1419.
4.
go back to reference Grasselli G, Greco M, Zanella A, et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern Med. 2020;180(10):1345–55.CrossRefPubMed Grasselli G, Greco M, Zanella A, et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern Med. 2020;180(10):1345–55.CrossRefPubMed
5.
go back to reference Rosenthal N, Cao Z, Gundrum J, Sianis J, Safo S. Risk factors associated with in-hospital mortality in a US National sample of patients with COVID-19. JAMA Netw Open. 2020;3(12):e2029058.CrossRefPubMedPubMedCentral Rosenthal N, Cao Z, Gundrum J, Sianis J, Safo S. Risk factors associated with in-hospital mortality in a US National sample of patients with COVID-19. JAMA Netw Open. 2020;3(12):e2029058.CrossRefPubMedPubMedCentral
6.
go back to reference Izurieta HS, Graham DJ, Jiao Y, et al. Natural history of COVID-19: risk factors for hospitalizations and deaths among >26 million U.S. Medicare beneficiaries. J Infect Dis. 2020;223:945.CrossRef Izurieta HS, Graham DJ, Jiao Y, et al. Natural history of COVID-19: risk factors for hospitalizations and deaths among >26 million U.S. Medicare beneficiaries. J Infect Dis. 2020;223:945.CrossRef
7.
go back to reference Fan Y, Wang X, Jun Z, Mo D, Xiao X. The risk factors for the exacerbation of COVID-19 disease: a case-control study. J Clin Nurs. 2020;30:725.CrossRefPubMed Fan Y, Wang X, Jun Z, Mo D, Xiao X. The risk factors for the exacerbation of COVID-19 disease: a case-control study. J Clin Nurs. 2020;30:725.CrossRefPubMed
8.
go back to reference Garg S, Kim L, Whitaker M, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 - COVID-NET, 14 States, March 1–30, 2020. MMWR. 2020;69(15):458–64.PubMedPubMedCentral Garg S, Kim L, Whitaker M, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 - COVID-NET, 14 States, March 1–30, 2020. MMWR. 2020;69(15):458–64.PubMedPubMedCentral
10.
go back to reference Ji D, Zhang D, Xu J, et al. Prediction for progression risk in patients with COVID-19 pneumonia: the CALL score. Clin Infect Dis. 2020;71(6):1393–9.CrossRefPubMed Ji D, Zhang D, Xu J, et al. Prediction for progression risk in patients with COVID-19 pneumonia: the CALL score. Clin Infect Dis. 2020;71(6):1393–9.CrossRefPubMed
11.
go back to reference Kabarriti R, Brodin NP, Maron MI, et al. Association of race and ethnicity with comorbidities and survival among patients with COVID-19 at an urban medical center in New York. JAMA Netw Open. 2020;3(9):e2019795.CrossRefPubMedPubMedCentral Kabarriti R, Brodin NP, Maron MI, et al. Association of race and ethnicity with comorbidities and survival among patients with COVID-19 at an urban medical center in New York. JAMA Netw Open. 2020;3(9):e2019795.CrossRefPubMedPubMedCentral
12.
go back to reference Hamer M, Gale CR, Kivimäki M, Batty GD. Overweight, obesity, and risk of hospitalization for COVID-19: a community-based cohort study of adults in the United Kingdom. Proc Natl Acad Sci U S A. 2020;117(35):21011–3.CrossRefPubMedPubMedCentral Hamer M, Gale CR, Kivimäki M, Batty GD. Overweight, obesity, and risk of hospitalization for COVID-19: a community-based cohort study of adults in the United Kingdom. Proc Natl Acad Sci U S A. 2020;117(35):21011–3.CrossRefPubMedPubMedCentral
13.
go back to reference Sun H, Jain A, Leone MJ, et al. CoVA: an acuity score for outpatient screening that predicts coronavirus disease 2019 prognosis. J Infect Dis. 2021;223(1):38–46.CrossRefPubMed Sun H, Jain A, Leone MJ, et al. CoVA: an acuity score for outpatient screening that predicts coronavirus disease 2019 prognosis. J Infect Dis. 2021;223(1):38–46.CrossRefPubMed
14.
go back to reference Bhargava A, Fukushima EA, Levine M, et al. Predictors for severe COVID-19 infection. Clin Infect Dis. 2020;71(8):1962–8.CrossRefPubMed Bhargava A, Fukushima EA, Levine M, et al. Predictors for severe COVID-19 infection. Clin Infect Dis. 2020;71(8):1962–8.CrossRefPubMed
16.
go back to reference Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–62.CrossRefPubMedPubMedCentral Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–62.CrossRefPubMedPubMedCentral
17.
18.
19.
go back to reference Scott AJ, Knott M. A cluster analysis method for grouping means in the analysis of variance. Biometrics. 1974;30(3):507–12.CrossRef Scott AJ, Knott M. A cluster analysis method for grouping means in the analysis of variance. Biometrics. 1974;30(3):507–12.CrossRef
20.
go back to reference Sen A, Srivastava MS. On tests for detecting change in mean. Ann Stat. 1975;3(1):98–108.CrossRef Sen A, Srivastava MS. On tests for detecting change in mean. Ann Stat. 1975;3(1):98–108.CrossRef
21.
go back to reference Price-Haywood EG, Burton J, Fort D, Seoane L. Hospitalization and mortality among black patients and white patients with Covid-19. N Engl J Med. 2020;382(26):2534–43.CrossRefPubMed Price-Haywood EG, Burton J, Fort D, Seoane L. Hospitalization and mortality among black patients and white patients with Covid-19. N Engl J Med. 2020;382(26):2534–43.CrossRefPubMed
22.
go back to reference Sze S, Pan D, Nevill CR, et al. Ethnicity and clinical outcomes in COVID-19: a systematic review and meta-analysis. EClinicalMedicine. 2020;29:100630.CrossRefPubMed Sze S, Pan D, Nevill CR, et al. Ethnicity and clinical outcomes in COVID-19: a systematic review and meta-analysis. EClinicalMedicine. 2020;29:100630.CrossRefPubMed
Metadata
Title
COVID-19 hospitalizations in five California hospitals: a retrospective cohort study
Authors
Miriam Nuño
Yury García
Ganesh Rajasekar
Diego Pinheiro
Alec J. Schmidt
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-021-06640-4

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