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

• Type of Material: Article
• Authors: Jean Y. Ko, Centers for Disease Control and Prevention; Melissa L. Danielson, Centers for Disease Control and Prevention; Machell Town, Centers for Disease Control and Prevention; Gordana Derado, Emory University; Kurt J. Greenlund, Centers for Disease Control and Prevention; Pam Daily Kirley, California Emerging Infections Program; Nisha B. Alden, Colorado Department of Public Health and Environment; Kimberly Yousey-Hindes, Yale University; Evan Anderson, Emory University; Patricia A. Ryan, Maryland Department of Health; Sue Kim, Michigan Department of Health and Human Services; Ruth Lynfield, Minnesota Department of Health; Salina M. Torres, New Mexico Department of Health; Grant R. Barney, New York State Department of Health; Nancy M. Bennett, University of Rochester; Melissa Sutton, Oregon Health Authority; H. Keipp Talbot, Vanderbilt University; Mary Hill, Salt Lake City Health Care System; Aron J. Hall, Centers for Disease Control and Prevention; Alicia M. Fry, Centers for Disease Control and Prevention; Shikha Garg, Centers for Disease Control and Prevention; Lindsay Kim, Centers for Disease Control and Prevention
• Language: English
• Date: 2021-06-01
• Publisher: OXFORD UNIV PRESS INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Published by Oxford University Press for the Infectious Diseases Society of America 2020.
• License: Creative Commons Universal : Public Domain Dedication
• Final Published Version (URL): http://dx.doi.org/10.1093/cid/ciaa1419
• Title of Journal or Parent Work: CLINICAL INFECTIOUS DISEASES
• Volume: 72
• Issue: 11
• Start Page: E695
• End Page: E703
• Keywords: ADULTS; Immunology; hospitalization; PREVALENCE; risk factors; Science & Technology; Infectious Diseases; epidemiology; Life Sciences & Biomedicine; OUTCOMES; STATES; surveillance; Microbiology; COVID-19
• Research Categories: Health Sciences, Public Health; Health Sciences, Immunology; Biology, Virology

Abstract

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.