Risk of Clinical Severity by Age and Race/Ethnicity Among Adults Hospitalized for COVID-19—United States, March–September 2020. (28th December 2020)

• Record Type: Journal Article
• Authors: Pennington, Audrey F; Kompaniyets, Lyudmyla; Summers, April D; Danielson, Melissa L; Goodman, Alyson B; Chevinsky, Jennifer R; Preston, Leigh Ellyn; Schieber, Lyna Z; Namulanda, Gonza; Courtney, Joseph; Strosnider, Heather M; Boehmer, Tegan K; Mac Kenzie, William R; Baggs, James; Gundlapalli, Adi V
• Is Part Of: Open forum infectious diseases. Volume 8:Number 2(2021)
• Publication Date: 2020-12-28
• Subjects: 2019 novel coronavirus disease -- health care disparities -- adult -- mortality -- race/ethnicity; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofaa638
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Older adults and people from certain racial and ethnic groups are disproportionately represented in coronavirus disease 2019 (COVID-19) hospitalizations and deaths. Methods: Using data from the Premier Healthcare Database on 181 813 hospitalized adults diagnosed with COVID-19 during March–September 2020, we applied multivariable log-binomial regression to assess the associations between age and race/ethnicity and COVID-19 clinical severity (intensive care unit [ICU] admission, invasive mechanical ventilation [IMV], and death) and to determine whether the impact of age on clinical severity differs by race/ethnicity. Results: Overall, 84 497 (47%) patients were admitted to the ICU, 29 078 (16%) received IMV, and 27 864 (15%) died in the hospital. Increased age was strongly associated with clinical severity when controlling for underlying medical conditions and other covariates; the strength of this association differed by race/ethnicity. Compared with non-Hispanic White patients, risk of death was lower among non-Hispanic Black patients (adjusted risk ratio, 0.96; 95% CI, 0.92–0.99) and higher among Hispanic/Latino patients (risk ratio [RR], 1.15; 95% CI, 1.09–1.20), non-Hispanic Asian patients (RR, 1.16; 95% CI, 1.09–1.23), and patients of other racial and ethnic groups (RR, 1.13; 95% CI, 1.06–1.21). Risk of ICU admission and risk of IMV were elevated among some racial and ethnic groups. Conclusions: These results indicate that age is a driver of poor outcomes among hospitalized persons with COVID-19. Additionally, clinical severity may be elevated among patients of some racial and ethnic minority groups. Public health strategies to reduce severe acute respiratory syndrome coronavirus 2 infection rates among older adults and racial and ethnic minorities are essential to reduce poor outcomes.