Risk Factors for Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization: COVID-19-Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
01 06 2021
Historique:
received: 03 08 2020
accepted: 16 09 2020
pubmed: 19 9 2020
medline: 5 6 2021
entrez: 18 9 2020
Statut: ppublish

Résumé

Data on risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization are needed to guide prevention efforts and clinical care. We sought to identify factors independently associated with COVID-19-associated hospitalizations. Community-dwelling adults (aged ≥18 years) in the United States hospitalized with laboratory-confirmed COVID-19 during 1 March-23 June 2020 were identified from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), a multistate surveillance system. To calculate hospitalization rates by age, sex, and race/ethnicity strata, COVID-NET data served as the numerator and Behavioral Risk Factor Surveillance System estimates served as the population denominator for characteristics of interest. Underlying medical conditions examined included hypertension, coronary artery disease, history of stroke, diabetes, obesity, severe obesity, chronic kidney disease, asthma, and chronic obstructive pulmonary disease. Generalized Poisson regression models were used to calculate adjusted rate ratios (aRRs) for hospitalization. Among 5416 adults, hospitalization rates (all reported as aRR [95% confidence interval]) were higher among those with ≥3 underlying conditions (vs without) (5.0 [3.9-6.3]), severe obesity (4.4 [3.4-5.7]), chronic kidney disease (4.0 [3.0-5.2]), diabetes (3.2 [2.5-4.1]), obesity (2.9 [2.3-3.5]), hypertension (2.8 [2.3-3.4]), and asthma (1.4 [1.1-1.7]), after adjusting for age, sex, and race/ethnicity. Adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults aged ≥65 or 45-64 years (vs 18-44 years), males (vs females), and non-Hispanic black and other race/ethnicities (vs non-Hispanic whites). Our findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions.

Sections du résumé

BACKGROUND
Data on risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization are needed to guide prevention efforts and clinical care. We sought to identify factors independently associated with COVID-19-associated hospitalizations.
METHODS
Community-dwelling adults (aged ≥18 years) in the United States hospitalized with laboratory-confirmed COVID-19 during 1 March-23 June 2020 were identified from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), a multistate surveillance system. To calculate hospitalization rates by age, sex, and race/ethnicity strata, COVID-NET data served as the numerator and Behavioral Risk Factor Surveillance System estimates served as the population denominator for characteristics of interest. Underlying medical conditions examined included hypertension, coronary artery disease, history of stroke, diabetes, obesity, severe obesity, chronic kidney disease, asthma, and chronic obstructive pulmonary disease. Generalized Poisson regression models were used to calculate adjusted rate ratios (aRRs) for hospitalization.
RESULTS
Among 5416 adults, hospitalization rates (all reported as aRR [95% confidence interval]) were higher among those with ≥3 underlying conditions (vs without) (5.0 [3.9-6.3]), severe obesity (4.4 [3.4-5.7]), chronic kidney disease (4.0 [3.0-5.2]), diabetes (3.2 [2.5-4.1]), obesity (2.9 [2.3-3.5]), hypertension (2.8 [2.3-3.4]), and asthma (1.4 [1.1-1.7]), after adjusting for age, sex, and race/ethnicity. Adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults aged ≥65 or 45-64 years (vs 18-44 years), males (vs females), and non-Hispanic black and other race/ethnicities (vs non-Hispanic whites).
CONCLUSIONS
Our findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions.

Identifiants

pubmed: 32945846
pii: 5908300
doi: 10.1093/cid/ciaa1419
pmc: PMC7543371
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e695-e703

Subventions

Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States

Investigateurs

Michael Whitaker (M)
Alissa O'Halloran (A)
Rachel Holstein (R)
William Garvin (W)
Shua J Chai (SJ)
Breanna Kawasaki (B)
James Meek (J)
Kyle P Openo (KP)
Maya L Monroe (ML)
Justin Henderson (J)
Kathy Como-Sabetti (K)
Sarah Shrum Davis (SS)
Nancy L Spina (NL)
Christina B Felsen (CB)
Nicole West (N)
William Schaffner (W)
Andrea George (A)

Informations de copyright

Published by Oxford University Press for the Infectious Diseases Society of America 2020.

Auteurs

Jean Y Ko (JY)

COVID-NET Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
US Public Health Service, Rockville, Maryland, USA.

Melissa L Danielson (ML)

COVID-NET Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Machell Town (M)

Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Gordana Derado (G)

COVID-NET Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Kurt J Greenlund (KJ)

Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Pam Daily Kirley (PD)

California Emerging Infections Program, Oakland, California, USA.

Nisha B Alden (NB)

Colorado Department of Public Health and Environment, Denver, Colorado, USA.

Kimberly Yousey-Hindes (K)

Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA.

Evan J Anderson (EJ)

Department of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
Emerging Infections Program, Georgia Department of Health, Atlanta, Georgia, USA.
Veterans Affairs Medical Center, Atlanta, Georgia, USA.

Patricia A Ryan (PA)

Maryland Department of Health, Baltimore, Maryland, USA.

Sue Kim (S)

Michigan Department of Health and Human Services, Lansing, Michigan, USA.

Ruth Lynfield (R)

Minnesota Department of Health, St Paul, Minnesota, USA.

Salina M Torres (SM)

New Mexico Department of Health, Santa Fe, New Mexico, USA.

Grant R Barney (GR)

New York State Department of Health, Albany, New York, USA.

Nancy M Bennett (NM)

University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.

Melissa Sutton (M)

Oregon Health Authority, Portland, Oregon, USA.

H Keipp Talbot (HK)

Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

Mary Hill (M)

Salt Lake County Health Department, Salt Lake City, Utah, USA.

Aron J Hall (AJ)

COVID-NET Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Alicia M Fry (AM)

COVID-NET Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
US Public Health Service, Rockville, Maryland, USA.

Shikha Garg (S)

COVID-NET Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
US Public Health Service, Rockville, Maryland, USA.

Lindsay Kim (L)

COVID-NET Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
US Public Health Service, Rockville, Maryland, USA.

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