Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 1 de 1
Add filters

Document Type
Year range
Topics in Antiviral Medicine ; 29(1):248-249, 2021.
Article in English | EMBASE | ID: covidwho-1250702


Background: Individuals hospitalized with COVID-19 exhibit a wide spectrum of disease. There is growing evidence that racial and ethnic minorities bear a disproportionate burden from COVID-19. Temporal changes in the pandemic epidemiology require careful study to identify determinants of poor outcomes. We assessed patient socio-demographics, comorbidities, baseline severity, treating hospital and pandemic month as independent risk factors for mortality and time to discharge. Methods: We analyzed 2500 individuals hospitalized with PCR-confirmed COVID-19 in 5 hospitals in the University of Pennsylvania Health System between March and September 2020, using electronic health records to assess outcomes through 8 weeks post-admission. Hospital discharge and mortality were analyzed as competing risks using a multivariable cause-specific hazards model. Results: Patients were 50.9% Black, 39.4% White and 9.7% other race;11% were Hispanic. Mortality decreased markedly over time, with cumulative incidence (95% CI) 30 days post-admission of 19.1% (17.2, 21.3) in March- April versus 6.3% (4.3, 8.9) in July-September;19% of deaths occurred after discharge. During this time, average age (SD) at admission declined from 62.7 (17.6) to 53.4 (20.6), ICU level care at admission increased from 16.5% to 18.6%, mechanical ventilation declined from 9.4% to 2.9%. Compared to Caucasian, Black race was associated with more severe disease at admission, a higher rate of co-morbidities and residence in low income zip code. In multivariable models, there were no detectable differences in mortality risk by race;while admitting hospital, increasing age, admission early in the pandemic, and severe disease and low blood pressure at admission were associated with increased mortality hazard (Figure 1). Mortality appeared similar between sexes, though males tended to have longer hospital stays (discharge hazard ratio 0.82 (95% CI: 0.75, 0.90)). Hispanic ethnicity was associated with fewer baseline co-morbidities and lower mortality hazard (0.57, 95% CI: 0.37, .087). Conclusion: We found that morbidity and mortality for hospitalized COVID-19 patients substantially decreased over time but post-discharge mortality remained non-trivial. Black race was associated with more risk factors for morbidity and with treatment at hospitals with lower mortality. In multivariable models, there were no detectable race differences in hospital outcomes. Future work is needed to better understand the identified betweenhospital differences in mortality.