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Risk Factors for Mortality and Progression to Severe COVID-19 Disease in the Southeast United States (US): A Report from the SEUS Study Group

Published online by Cambridge University Press:  11 January 2021

Athena L. V. Hobbs*
Affiliation:
Department of pharmacy, Baptist Memorial Hospital-Memphis, TN, 38120, United States of America (USA)
Nicholas Turner
Affiliation:
Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA
Imad Omer
Affiliation:
Department of Medicine, Baptist Memorial Hospital-Memphis, TN, 38120, United States of America (USA)
Morgan K. Walker
Affiliation:
Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
Ronald M. Beaulieu
Affiliation:
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
Muhammad Sheikh
Affiliation:
Department of Medicine, Baptist Memorial Hospital-Memphis, TN, 38120, United States of America (USA)
S. Shaefer Spires
Affiliation:
Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA
Christina T. Fiske
Affiliation:
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
Ryan Dare
Affiliation:
Department of Medicine, University of Arkansas for Medical Sciences Medical Center, Little Rock, AR, 72205, USA
Salil Goorha
Affiliation:
Department of Medicine, Baptist Memorial Hospital-Memphis, TN, 38120, United States of America (USA)
Priyenka Thapa
Affiliation:
Department of Medicine, University of Arkansas for Medical Sciences Medical Center, Little Rock, AR, 72205, USA
John Gnann
Affiliation:
Department of Medicine, The Medical University of South Carolina University Medical Center, Charleston, SC, 29425, USA
Jeffrey Wright
Affiliation:
Department of Medicine, Baptist Memorial Hospital-Memphis, TN, 38120, United States of America (USA)
George E. Nelson
Affiliation:
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
*Corresponding
Corresponding author Athena L. V. Hobbs, PharmD, BCIDP 6019 Walnut Grove Rd Memphis, TN 38120 Tel: 901-226-4756 Fax: 901-226-5792 Athena.hobbs@bmhcc.org
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Abstract

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Objective

Identify risk factors that could increase progression to severe disease and mortality in hospitalized SARS-CoV-2 patients in the Southeast US.

Design, Setting, and Participants

Multicenter, retrospective cohort including 502 adults hospitalized with laboratory-confirmed COVID-19 between March 1, 2020 and May 8, 2020 within one of 15 participating hospitals in 5 health systems across 5 states in the Southeast US.

Methods

The study objectives were to identify risk factors that could increase progression to hospital mortality and severe disease (defined as a composite of intensive care unit admission or requirement of mechanical ventilation) in hospitalized SARS-CoV-2 patients in the Southeast US.

Results

A total of 502 patients were included, and the majority (476/502, 95%) had clinically evaluable outcomes. Hospital mortality was 16% (76/476), while 35% (177/502) required ICU admission, and 18% (91/502) required mechanical ventilation. By both univariate and adjusted multivariate analysis, hospital mortality was independently associated with age (adjusted odds ratio [aOR] 2.03 for each decade increase, 95% CI 1.56-2.69), male sex (aOR 2.44, 95% CI: 1.34-4.59), and cardiovascular disease (aOR 2.16, 95% CI: 1.15-4.09). As with mortality, risk of severe disease was independently associated with age (aOR 1.17 for each decade increase, 95% CI: 1.00-1.37), male sex (aOR 2.34, 95% CI 1.54-3.60), and cardiovascular disease (aOR 1.77, 95% CI 1.09-2.85).

Conclusions

In an adjusted multivariate analysis, advanced age, male sex, and cardiovascular disease increased risk of severe disease and mortality in patients with COVID-19 in the Southeast US. In-hospital mortality risk doubled with each subsequent decade of life.

Type
Original Article
Copyright
© 2021 by The Society for Healthcare Epidemiology of America. All rights reserved.

Footnotes

1

The Southeast United States (SEUS) COVID-19 Outbreak Investigation Team members can be found at the end of this manuscript

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