ABSTRACT
Purpose: Prior studies have identified risk factors which prognosticate severity of SARSCoV2 illness among hospitalized patients. Since the majority of patients first present to ambulatory care sites, there is a need to identify early predictors of disease progression in this population. Methods: This retrospective cohort study investigated the impact of underlying comorbid conditions on SARSCoV2 infection severity in the ambulatory setting. All patients who presented to a single federally qualified health center (FQHC) between March to May 2020 with a positive SARSCoV2 test were reviewed for inclusion. Patient demographics, symptomology, prior medical history, and outcomes were collected. Results: 301 patients were included, with nearly equal numbers of patients with (n=151) and without (n=150) underlying comorbidities. Overall, 269 patients (89%) had a mild outcome and 32 patients (11%) had a severe outcome. Advanced age (OR: 9.4 [95% CI: 3.4 to 27.4], p < 0.001) and male gender (OR: 3.2 [95% CI: 1.2 to 9.8], p = 0.02) were significant predictors of severe outcomes. Additionally, every obesity category (1: BMI = 30.0 to 34.9; 2: BMI = 35 to 39.9; 3: BMI = 40.0 plus) was associated with more severe outcomes compared to non-obese (OR: 3.5, p = 0.05; OR: 5.2, p = 0.03; OR: 13.9, p = 0.01). Compared to an HbA1C < 6, an HbA1C of 7.1 to 8.0 showed a clinically significant association. Conclusion: SARSCoV2 severity can be prognosticated in the ambulatory population by the presence and severity of preexisting comorbidities. Early identification and risk stratification of these comorbidities will allow clinicians to develop plans for closer monitoring to prevent severe illness.