Correlates of In-Hospital COVID-19 Deaths: A Competing Risks Survival Time Analysis of Retrospective Mortality Data

Goel, Ashish; Raizada, Alpana; Agrawal, Ananya; Bansal, Kamakshi; Uniyal, Saurabh; Prasad, Pratima; Yadav, Alok Kumar; Tyagi, Asha; Rautela, R S

doi:10.1017/dmp.2021.85

Cited by 5 publications

(4 citation statements)

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“…Ignoring their competing relationship can lead to biased estimates of effects of risk factors for either event [ 97 ]. A recent study [ 98 ] investigated COVID-19 hospitalization outcomes in a similar manner, reporting a subdistribution hazard ratio for patient age, adjusting for sex. This result, in a smaller, localized international cohort, is consistent with our findings on age.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive evaluation of COVID-19 patient short- and long-term outcomes: Disparities in healthcare utilization and post-hospitalization outcomes

et al. 2021

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Background Understanding risk factors for short- and long-term COVID-19 outcomes have implications for current guidelines and practice. We study whether early identified risk factors for COVID-19 persist one year later and through varying disease progression trajectories. Methods This was a retrospective study of 6,731 COVID-19 patients presenting to Michigan Medicine between March 10, 2020 and March 10, 2021. We describe disease progression trajectories from diagnosis to potential hospital admission, discharge, readmission, or death. Outcomes pertained to all patients: rate of medical encounters, hospitalization-free survival, and overall survival, and hospitalized patients: discharge versus in-hospital death and readmission. Risk factors included patient age, sex, race, body mass index, and 29 comorbidity conditions. Results Younger, non-Black patients utilized healthcare resources at higher rates, while older, male, and Black patients had higher rates of hospitalization and mortality. Diabetes with complications, coagulopathy, fluid and electrolyte disorders, and blood loss anemia were risk factors for these outcomes. Diabetes with complications, coagulopathy, fluid and electrolyte disorders, and blood loss were associated with lower discharge and higher inpatient mortality rates. Conclusions This study found differences in healthcare utilization and adverse COVID-19 outcomes, as well as differing risk factors for short- and long-term outcomes throughout disease progression. These findings may inform providers in emergency departments or critical care settings of treatment priorities, empower healthcare stakeholders with effective disease management strategies, and aid health policy makers in optimizing allocations of medical resources.

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Section: Discussionmentioning

confidence: 99%

Comprehensive evaluation of COVID-19 patient short- and long-term outcomes: Disparities in healthcare utilization and post-hospitalization outcomes

et al. 2021

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“…[57] Ignoring their competing relationship can lead to biased estimates of effects of risk factors for either event. [97] A recent study [98] investigated COVID-19 hospitalization outcomes in a similar manner, reporting a subdistribution hazard ratio for patient age, adjusting for sex. This result, in a smaller, localized international cohort, is consistent with our findings on age.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Evaluation of COVID-19 Patient Short- and Long-term Outcomes: Disparities in Healthcare Utilization and Post-Hospitalization Outcomes

Salerno

Sun

Morris

et al. 2021

Preprint

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Background: Understanding risk factors for short- and long-term COVID-19 outcomes have implications for current guidelines and practice. We study whether early identified risk factors for COVID-19 persist one year later and through varying disease progression trajectories. Methods: This was a retrospective study of 6,731 COVID-19 patients presenting to Michigan Medicine between March 10, 2020 and March 10, 2021. We describe disease progression trajectories from diagnosis to potential hospital admission, discharge, readmission, or death. Outcomes pertained to all patients: rate of medical encounters, hospitalization-free survival, and overall survival, and hospitalized patients: discharge versus in-hospital death and readmission. Risk factors included patient age, sex, race, body mass index, and 29 comorbidity conditions. Results: Younger, non-Black patients utilized healthcare resources at higher rates, while older, male, and Black patients had higher rates of hospitalization and mortality. Diabetes with complications, coagulopathy, fluid and electrolyte disorders, and blood loss anemia were risk factors for these outcomes. Diabetes with complications, coagulopathy, fluid and electrolyte disorders, and blood loss were associated with lower discharge and higher inpatient mortality rates. Conclusions: This study found differences in healthcare utilization and adverse COVID-19 outcomes, as well as differing risk factors for short- and long-term outcomes throughout disease progression. These findings may inform providers in emergency departments or critical care settings of treatment priorities, empower healthcare stakeholders with effective disease management strategies, and aid health policy makers in optimizing allocations of medical resources.

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“…Diabetic COVID-19 patients have had a poorer outcome in several hospital-based observational studies. 9 – 11 Although the short-term mortality of patients with COVID-19 infection and hyperglycemia with and without preexisting diabetes has been well documented, data around longer-term outcomes is now emerging. It remains unclear whether patients have increased susceptibility to developing diabetes or related complications after recovery from the infection.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Persistence of COVID-Induced Hyperglycemia: A Cohort Study

Goel,

Raizada,

Aggarwal

et al. 2024

The American Journal of Tropical Medicine and Hygiene

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Although the short-term mortality of patients with COVID-19 infection and hyperglycemia has been well documented, there is little available data regarding longer-term prognosis. The presence of diabetes has not only influenced disease severity but has also impacted its transmission dynamics. In this study, we followed a historical cohort of patients without previous history of diabetes who presented with moderate to severe COVID-19 and were found to have hyperglycemia (random blood glucose > 140 mg/dL) at the time of admission. We evaluated the need for antidiabetic therapy in these patients at the end of 6 months and the risk factors associated with persistent hyperglycemia determined by monthly values of self-monitored blood glucose. Of the seventy participants who were followed telephonically, 54 (77%) continued to receive antidiabetic therapy or have persistent hyperglycemia (> 140 mg/dL) at the end of 6 months. Persistent hyperglycemia at the end of follow-up, was found to be associated with a higher blood glucose at presentation.

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Correlates of In-Hospital COVID-19 Deaths: A Competing Risks Survival Time Analysis of Retrospective Mortality Data

Cited by 5 publications

References 65 publications

Comprehensive evaluation of COVID-19 patient short- and long-term outcomes: Disparities in healthcare utilization and post-hospitalization outcomes

Comprehensive evaluation of COVID-19 patient short- and long-term outcomes: Disparities in healthcare utilization and post-hospitalization outcomes

Comprehensive Evaluation of COVID-19 Patient Short- and Long-term Outcomes: Disparities in Healthcare Utilization and Post-Hospitalization Outcomes

Long-Term Persistence of COVID-Induced Hyperglycemia: A Cohort Study

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