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Characteristics and Risk Factors for Mortality by Coronavirus Disease 2019 Pandemic Waves in Fulton County, Georgia: A Cohort Study March 2020-February 2021.
Chishinga, Nathaniel; Smith, Sasha; Gandhi, Neel R; Onwubiko, Udodirim N; Telford, Carson; Prieto, Juliana; Chamberlain, Allison T; Khan, Shamimul; Williams, Steve; Khan, Fazle; Sarita Shah, N.
  • Chishinga N; Office of Epidemiology, Fulton County Board of Health, Atlanta, Georgia, USA.
  • Smith S; Fulton County Government, Atlanta, Georgia, USA.
  • Gandhi NR; Office of Epidemiology, Fulton County Board of Health, Atlanta, Georgia, USA.
  • Onwubiko UN; Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
  • Telford C; Emory School of Medicine, Emory University, Atlanta, Georgia, USA.
  • Prieto J; Office of Epidemiology, Fulton County Board of Health, Atlanta, Georgia, USA.
  • Chamberlain AT; Office of Epidemiology, Fulton County Board of Health, Atlanta, Georgia, USA.
  • Khan S; Office of Epidemiology, Fulton County Board of Health, Atlanta, Georgia, USA.
  • Williams S; Office of Epidemiology, Fulton County Board of Health, Atlanta, Georgia, USA.
  • Khan F; Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
  • Sarita Shah N; Office of Epidemiology, Fulton County Board of Health, Atlanta, Georgia, USA.
Open Forum Infect Dis ; 9(4): ofac101, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1774409
ABSTRACT

Background:

We examined differences in mortality among coronavirus disease 2019 (COVID-19) cases in the first, second, and third waves of the COVID-19 pandemic.

Methods:

A retrospective cohort study of COVID-19 cases in Fulton County, Georgia, USA, reported to a public health surveillance from March 2020 through February 2021. We estimated case-fatality rates (CFR) by wave and used Cox proportional hazards random-effects models in each wave, with random effects at individual and long-term-care-facility level, to determine risk factors associated with rates of mortality.

Results:

Of 75 289 confirmed cases, 4490 (6%) were diagnosed in wave 1 (CFR 31 deaths/100 000 person days [pd]), 24 293 (32%) in wave 2 (CFR 7 deaths/100 000 pd), and 46 506 (62%) in wave 3 (CFR 9 deaths/100 000 pd). Compared with females, males were more likely to die in each wave wave 1 (adjusted hazard ratio [aHR], 1.5; 95% confidence interval [CI], 1.2-1.8), wave 2 (aHR 1.5, 95% CI, 1.2-1.8), and wave 3 (aHR 1.7, 95% CI, 1.5-2.0). Compared with non-Hispanic whites, non-Hispanic blacks were more likely to die in each wave wave 1 (aHR, 1.4; 95% CI, 1.1-1.8), wave 2 (aHR, 1.5; 95% CI, 1.2-1.9), and wave 3 (aHR, 1.7; 95% CI, 1.4-2.0). Cases with any disability, chronic renal disease, and cardiovascular disease were more likely to die in each wave compared with those without these comorbidities.

Conclusions:

Our study found gender and racial/ethnic disparities in COVID-19 mortality and certain comorbidities associated with COVID-19 mortality. These factors have persisted throughout the COVID-19 pandemic waves, despite improvements in diagnosis and treatment.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid 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: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid