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Trends in Clinical Severity of Hospitalized Patients With Coronavirus Disease 2019-Premier Hospital Dataset, April 2020-April 2021.
Whitfield, Geoffrey P; Harris, Aaron M; Kadri, Sameer S; Warner, Sara; Bamrah Morris, Sapna; Giovanni, Jennifer E; Rogers-Brown, Jessica S; Hinckley, Alison F; Kompaniyets, Lyudmyla; Sircar, Kanta D; Yusuf, Hussain R; Koumans, Emilia H; Schweitzer, Beth K.
  • Whitfield GP; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Harris AM; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Kadri SS; Critical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
  • Warner S; Critical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
  • Bamrah Morris S; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Giovanni JE; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Rogers-Brown JS; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Hinckley AF; Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.
  • Kompaniyets L; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Sircar KD; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Yusuf HR; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Koumans EH; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Schweitzer BK; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Open Forum Infect Dis ; 9(1): ofab599, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1608608
ABSTRACT

BACKGROUND:

Clinical severity of coronavirus disease 2019 (COVID-19) may vary over time; trends in clinical severity at admission during the pandemic among hospitalized patients in the United States have been incompletely described, so a historical record of severity over time is lacking.

METHODS:

We classified 466677 hospital admissions for COVID-19 from April 2020 to April 2021 into 4 mutually exclusive severity grades based on indicators present on admission (from most to least severe) Grade 4 included intensive care unit (ICU) admission and invasive mechanical ventilation (IMV); grade 3 included non-IMV ICU and/or noninvasive positive pressure ventilation; grade 2 included diagnosis of acute respiratory failure; and grade 1 included none of the above indicators. Trends were stratified by sex, age, race/ethnicity, and comorbid conditions. We also examined severity in states with high vs low Alpha (B.1.1.7) variant burden.

RESULTS:

Severity tended to be lower among women, younger adults, and those with fewer comorbidities compared to their counterparts. The proportion of admissions classified as grade 1 or 2 fluctuated over time, but these less-severe grades comprised a majority (75%-85%) of admissions every month. Grades 3 and 4 consistently made up a minority of admissions (15%-25%), and grade 4 showed consistent decreases in all subgroups, including states with high Alpha variant burden.

CONCLUSIONS:

Clinical severity among hospitalized patients with COVID-19 has varied over time but has not consistently or markedly worsened over time. The proportion of admissions classified as grade 4 decreased in all subgroups. There was no consistent evidence of worsening severity in states with higher vs lower Alpha prevalence.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Risk factors Topics: Variants Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Risk factors Topics: Variants Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid