Author:
Stepanova Maria,Lam Brian,Younossi Elena,Felix Sean,Ziayee Mariam,Price Jillian,Pham Huong,de Avila Leyla,Terra Kathy,Austin Patrick,Jeffers Thomas,Escheik Carey,Golabi Pegah,Cable Rebecca,Srishord Manirath,Venkatesan Chapy,Henry Linda,Gerber Lynn,Younossi Zobair M.
Abstract
Abstract
Background
COVID-19 outcomes among hospitalized patients may have changed due to new variants, therapies and vaccine availability. We assessed outcomes of adults hospitalized with COVID-19 from March 2020–February 2022.
Methods
Data were retrieved from electronic health medical records of adult COVID-19 patients hospitalized in a large community health system. Duration was split into March 2020–June 2021 (pre-Delta period), July–November 2021 (Delta period), and December 2021–February 2022 (Omicron period).
Results
Of included patients (n = 9582), 75% were admitted during pre-Delta, 9% during Delta, 16% during Omicron period. The COVID-positive inpatients were oldest during Omicron period but had lowest rates of COVID pneumonia and resource utilization (p < 0.0001); 46% were vaccinated during Delta and 61% during Omicron period (p < 0.0001). After adjustment for demographics and comorbidities, vaccination was associated with lower inpatient mortality (OR = 0.47 (0.34–0.65), p < 0.0001). The Omicron period was independently associated with lower risk of inpatient mortality (OR = 0.61 (0.45–0.82), p = 0.0010). Vaccination and Omicron period admission were also independently associated with lower healthcare resource utilization (p < 0.05). Magnitudes of associations varied between age groups with strongest protective effects seen in younger patients.
Conclusion
Outcomes of COVID-19 inpatients were evolving throughout the pandemic and were affected by changing demographics, virus variants, and vaccination.
Key point
In this observational study of almost 10,000 patients hospitalized from March 2020–February 2022 with COVID-19, age and having multiple comorbidities remained consistent risk factors for mortality regardless of the variant. Vaccination was high in our hospitalized patients. Vaccination conveyed less severe illness and was associated with lower inpatient mortality.
Funder
Inova Health System, Medicine Service Line; Beatty Research Fund
Publisher
Springer Science and Business Media LLC
Reference22 articles.
1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727–33.
2. Sohrabi C, Alsafi Z, O’Neill N, et al. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;76:71–6.
3. Iuliano AD, Brunkard JM, Boehmer TK, et al. Trends in disease severity and health care utilization during the early Omicron variant period compared with previous SARS-CoV-2 high transmission periods—United States, December 2020–January 2022. MMWR Morb Mortal Wkly Rep. 2022;71:146–52.
4. Lam B, Stepanova M, Venkatasan C, Garcia I, Reyes M, Mannan A, et al. Outcomes of hospitalized patients in COVID-19 during the course of the pandemic in a fully integrated health system. PLoS ONE. 2022;17(2):e0263417.
5. CDC collects data on risk for SARS-CoV-2 infection, hospitalization, and death by race/ethnicity from COVID-NET, a population-based surveillance system collecting data through a network of 250 acute-care hospitals across 14 states. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html. Accessed 27 Feb 2022.
Cited by
37 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献