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Natural History of Coronavirus Disease 2019: Risk Factors for Hospitalizations and Deaths Among >26 Million US Medicare Beneficiaries.
Izurieta, Hector S; Graham, David J; Jiao, Yixin; Hu, Mao; Lu, Yun; Wu, Yue; Chillarige, Yoganand; Wernecke, Michael; Menis, Mikhail; Pratt, Douglas; Kelman, Jeffrey; Forshee, Richard.
  • Izurieta HS; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
  • Graham DJ; Center for Drugs Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
  • Jiao Y; Acumen, LLC, Burlingame, California, USA.
  • Hu M; Acumen, LLC, Burlingame, California, USA.
  • Lu Y; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
  • Wu Y; Acumen, LLC, Burlingame, California, USA.
  • Chillarige Y; Acumen, LLC, Burlingame, California, USA.
  • Wernecke M; Acumen, LLC, Burlingame, California, USA.
  • Menis M; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
  • Pratt D; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
  • Kelman J; Centers for Medicare $ Medicaid Services, Washington, DC, USA.
  • Forshee R; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
J Infect Dis ; 223(6): 945-956, 2021 03 29.
Article in English | MEDLINE | ID: covidwho-1155781
Semantic information from SemMedBD (by NLM)
1. Kidney Failur PROCESS_OF C0030705
Subject
Kidney Failur
Predicate
PROCESS_OF
Object
C0030705
2. Cessation of life PROCESS_OF primary group
Subject
Cessation of life
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PROCESS_OF
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primary group
3. Cessation of life PROCESS_OF Old age
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Old age
4. Kidney Failure, Chronic PROCESS_OF Patients
Subject
Kidney Failure, Chronic
Predicate
PROCESS_OF
Object
Patients
5. Cessation of life PROCESS_OF primary group
Subject
Cessation of life
Predicate
PROCESS_OF
Object
primary group
6. Cessation of life PROCESS_OF Old age
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Old age
ABSTRACT

BACKGROUND:

The current study was performed to evaluate risk factors for severe coronavirus disease 2019 (COVID-19) outcomes among Medicare beneficiaries during the pandemic's early phase.

METHODS:

In a retrospective cohort study covering Medicare fee-for-service beneficiaries, we separated out elderly residents in nursing homes (NHs) and those with end-stage renal disease (ESRD) from the primary study population of individuals age ≥65 years. Outcomes included COVID-19 hospital encounters and COVID-19-associated deaths. We estimated adjusted odds ratios (ORs) using logistic regression.

RESULTS:

We analyzed 25 333 329 elderly non-NH beneficiaries without ESRD, 653 966 elderly NH residents, and 292 302 patients with ESRD. COVID-related death rates (per 10 000) were much higher among elderly NH residents (275.7) and patients with ESRD (60.8) than in the primary study population (5.0). Regression-adjusted clinical predictors of death among the primary population included immunocompromised status (OR, 1.43), frailty index conditions such as cognitive impairment (3.16), and other comorbid conditions, including congestive heart failure (1.30). Demographic-related risk factors included male sex (OR, 1.77), older age (3.09 for 80- vs 65-year-olds), Medicaid dual-eligibility status (2.17), and racial/ethnic minority. Compared with whites, ORs were higher for blacks (2.47), Hispanics (3.11), and Native Americans (5.82). Results for COVID-19 hospital encounters were consistent.

CONCLUSIONS:

Frailty, comorbid conditions, and race/ethnicity were strong risk factors for COVID-19 hospitalization and death among the US elderly.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Medicare / COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male Country/Region as subject: North America Language: English Journal: J Infect Dis Year: 2021 Document Type: Article Affiliation country: Infdis

Full text: Available Collection: International databases Database: MEDLINE Main subject: Medicare / COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male Country/Region as subject: North America Language: English Journal: J Infect Dis Year: 2021 Document Type: Article Affiliation country: Infdis