Characteristics Associated with Hospitalization Among Patients with COVID-19 — Metropolitan Atlanta, Georgia, March–April 2020

Abstract

COVID-19-associated deaths have been reported in the United States.* Reports of U.S. patients hospitalized with SARS-CoV-2 infection (the virus that causes COVID-19) describe high proportions of older, male, and black persons (2-4). Similarly, when comparing hospitalized patients with catchment area populations or nonhospitalized COVID-19 patients, high proportions have underlying conditions, including diabetes mellitus, hypertension, obesity, cardiovascular disease, chronic kidney disease, or chronic respiratory disease (3,4). For this report, data were abstracted from the medical records of 220 hospitalized and 311 nonhospitalized patients aged ≥18 years with laboratory-confirmed COVID-19 from six acute care hospitals and associated outpatient clinics in metropolitan Atlanta, Georgia. Multivariable analyses were performed to identify patient characteristics associated with hospitalization. The following characteristics were independently associated with hospitalization: age ≥65 years (adjusted odds ratio [aOR] = 3.4), black race (aOR = 3.2), having diabetes mellitus (aOR = 3.1), lack of insurance (aOR = 2.8), male sex (aOR = 2.4), smoking (aOR = 2.3), and obesity (aOR = 1.9). Infection with SARS-CoV-2 can lead to severe outcomes, including death, and measures to protect persons from infection, such as staying at home, social distancing (5), and awareness and management of underlying conditions should be emphasized for those at highest risk for hospitalization with COVID-19. Measures that prevent the spread of infection to others, such as wearing cloth face coverings (6), should be used whenever possible to protect groups at high risk. Potential barriers to the ability to adhere to these measures need to be addressed. Patients were selected from six acute care hospitals and associated outpatient clinics affiliated with a single academic health care system in metropolitan Atlanta. Hospitalized patients were selected sequentially from hospital-provided lists of * https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html.

Handwashing and disinfection precautions taken by U.S. adults to prevent coronavirus disease 2019, Spring 2020

“…(men and people in poor health) [11,12] are of particular concern. Practice gaps for those with low incomes are also concerning, given that underlying health conditions are more prevalent in this group [18].…”

“…Hispanics reported higher disinfecting rates. Current data indicate that COVID-19 causes a disproportionate burden of severe illness and death among older people and among racial and ethnic minority groups [11][12][13].…”

Detection-based prioritisation: Framework of multi-laboratory characteristics for asymptomatic COVID-19 carriers based on integrated Entropy–TOPSIS methods

“…These patients are called asymptomatic carriers who could infect other people and become chronic virus carriers [ 4 , 7 ]. Prioritising infected patients and differentiating their critical health conditions while considering asymptomatic carriers are highly beneficial to laboratories and stakeholders and would support hospitalisation concerns in recognising health conditions [ 8 ], timely managing patients care [ 9 ], optimising clinical prediction rules [ 10 , 11 ], and enhancing decision-making for patients prior to discharge [ 4 , 12 , 13 ]. Additionally, early recognition and stratification according to priority levels upon admission to the emergency department (ED) are important for the quality and safety of emergency medicine [ 14 , 15 ].…”

Outcomes associated with SARS-CoV-2 viral clades in COVID-19

“…Overall, worldwide mortality is approximately 6% of clinically confirmed cases, while hospitalization rates in the US average approximately 15% of such cases (https://coronavirus.jhu.edu/map.html) (although given the high prevalence of asymptomatic or unreported infections, these values likely overestimate mortality and hospitalization rate substantially 3 ). While age and comorbid conditions have been identified as risk factors for hospitalization and death [4][5][6] , outcomes appear variable even among large populations. For example, at present, comparing outcomes from two large states in the US (New York and California), the former has a nearly 8% mortality rate among confirmed cases compared with a 3.4% rate in the latter (https://coronavirus.jhu.edu/map.html).…”