tetano
Editor, Senior Moderator
Clin Infect Dis
. 2023 Aug 26;ciad505.
doi: 10.1093/cid/ciad505. Online ahead of print. Clinical epidemiology and risk factors for critical outcomes among vaccinated and unvaccinated adults hospitalized with COVID-19-VISION Network, 10 States, June 2021-March 2023
Eric P Griggs[SUP] 1 [/SUP], Patrick K Mitchell[SUP] 2 [/SUP], Victoria Lazariu[SUP] 2 [/SUP], Manjusha Gaglani[SUP] 3 4 [/SUP], Charlene McEvoy[SUP] 5 [/SUP], Nicola P Klein[SUP] 6 [/SUP], Nimish R Valvi[SUP] 7 [/SUP], Stephanie A Irving[SUP] 8 [/SUP], Noah Kojima[SUP] 9 [/SUP], Edward Stenehjem[SUP] 10 [/SUP], Bradley Crane[SUP] 8 [/SUP], Suchitra Rao[SUP] 11 [/SUP], Shaun J Grannis[SUP] 7 12 [/SUP], Peter J Embi[SUP] 13 [/SUP], Anupam B Kharbanda[SUP] 14 [/SUP], Toan C Ong[SUP] 11 [/SUP], Karthik Natarajan[SUP] 15 16 [/SUP], Kristin Dascomb[SUP] 10 [/SUP], Allison L Naleway[SUP] 8 [/SUP], Elizabeth Bassett[SUP] 2 [/SUP], Malini B DeSilva[SUP] 5 [/SUP], Monica Dickerson[SUP] 9 [/SUP], Deepika Konatham[SUP] 17 [/SUP], Bruce Fireman[SUP] 6 [/SUP], Katie S Allen[SUP] 7 18 [/SUP], Michelle A Barron[SUP] 11 [/SUP], Maura Beaton[SUP] 15 [/SUP], Julie Arndorfer[SUP] 10 [/SUP], Gabriela Vazquez-Benitez[SUP] 5 [/SUP], Shikha Garg[SUP] 9 [/SUP], Kempapura Murthy[SUP] 17 [/SUP], Kristin Goddard[SUP] 6 [/SUP], Brian E Dixon[SUP] 7 18 [/SUP], Jungmi Han[SUP] 15 [/SUP], Nancy Grisel[SUP] 10 [/SUP], Chandni Raiyani[SUP] 17 [/SUP], Ned Lewis[SUP] 6 [/SUP], William F Fadel[SUP] 7 18 [/SUP], Melissa S Stockwell[SUP] 16 19 20 [/SUP], Mufaddal Mamawala[SUP] 17 [/SUP], John Hansen[SUP] 6 [/SUP], Ousseny Zerbo[SUP] 6 [/SUP], Palak Patel[SUP] 9 [/SUP], Ruth Link-Gelles[SUP] 1 [/SUP], Katherine Adams[SUP] 9 [/SUP], Mark W Tenforde[SUP] 9 [/SUP]
Affiliations
Background: The epidemiology of COVID-19 continues to develop with emerging variants, expanding population-level immunity, and advances in clinical care. We describe changes in the clinical epidemiology of hospitalized COVID-19 and risk factors for critical outcomes over time.
Methods: We included adults aged ≥18 years from 10 states hospitalized with COVID-19 June 2021-March 2023 when multiple SARS-CoV-2 variants or sub-lineages predominated. We evaluated changes in baseline demographic and clinical characteristics and critical outcomes (intensive care unit admission and/or death) and used regression models to evaluate critical outcomes risk factors (risk ratios) stratified by COVID-19 vaccination status.
Results: 60,488 COVID-19-associated hospitalizations were included in the analysis. Among those hospitalized, from Delta period (June-December 2021) to the Omicron post-BA.4/BA.5 period (September 2022-March 2023), median age increased from 60 to 75 years, proportion vaccinated increased from 18.2% to 70.1%, while critical outcomes declined from 24.8% to 19.4% (all p < 0.001). Compared to all hospitalization events, those with critical outcomes had a higher proportion of four or more categories of medical conditions categories assessed (32.8% critical versus 23.0% all hospitalized). Critical outcome risk factors were similar for unvaccinated and vaccinated populations; presence of ≥4 medical condition categories was most strongly associated with risk of critical outcomes regardless of vaccine status (unvaccinated aRR 2.27 [95% CI: 2.14-2.41]; vaccinated aRR 1.73 [95% CI: 1.56-1.92]) across periods.
Conclusion: The proportion of adults hospitalized with COVID-19 who experienced critical outcomes decreased with time and median patient age increased with time. Multimorbidity was mostly strongly associated with critical outcomes.
Keywords: COVID-19; Clinical Epidemiology; Critical Disease; Death; Hospitalization.
. 2023 Aug 26;ciad505.
doi: 10.1093/cid/ciad505. Online ahead of print. Clinical epidemiology and risk factors for critical outcomes among vaccinated and unvaccinated adults hospitalized with COVID-19-VISION Network, 10 States, June 2021-March 2023
Eric P Griggs[SUP] 1 [/SUP], Patrick K Mitchell[SUP] 2 [/SUP], Victoria Lazariu[SUP] 2 [/SUP], Manjusha Gaglani[SUP] 3 4 [/SUP], Charlene McEvoy[SUP] 5 [/SUP], Nicola P Klein[SUP] 6 [/SUP], Nimish R Valvi[SUP] 7 [/SUP], Stephanie A Irving[SUP] 8 [/SUP], Noah Kojima[SUP] 9 [/SUP], Edward Stenehjem[SUP] 10 [/SUP], Bradley Crane[SUP] 8 [/SUP], Suchitra Rao[SUP] 11 [/SUP], Shaun J Grannis[SUP] 7 12 [/SUP], Peter J Embi[SUP] 13 [/SUP], Anupam B Kharbanda[SUP] 14 [/SUP], Toan C Ong[SUP] 11 [/SUP], Karthik Natarajan[SUP] 15 16 [/SUP], Kristin Dascomb[SUP] 10 [/SUP], Allison L Naleway[SUP] 8 [/SUP], Elizabeth Bassett[SUP] 2 [/SUP], Malini B DeSilva[SUP] 5 [/SUP], Monica Dickerson[SUP] 9 [/SUP], Deepika Konatham[SUP] 17 [/SUP], Bruce Fireman[SUP] 6 [/SUP], Katie S Allen[SUP] 7 18 [/SUP], Michelle A Barron[SUP] 11 [/SUP], Maura Beaton[SUP] 15 [/SUP], Julie Arndorfer[SUP] 10 [/SUP], Gabriela Vazquez-Benitez[SUP] 5 [/SUP], Shikha Garg[SUP] 9 [/SUP], Kempapura Murthy[SUP] 17 [/SUP], Kristin Goddard[SUP] 6 [/SUP], Brian E Dixon[SUP] 7 18 [/SUP], Jungmi Han[SUP] 15 [/SUP], Nancy Grisel[SUP] 10 [/SUP], Chandni Raiyani[SUP] 17 [/SUP], Ned Lewis[SUP] 6 [/SUP], William F Fadel[SUP] 7 18 [/SUP], Melissa S Stockwell[SUP] 16 19 20 [/SUP], Mufaddal Mamawala[SUP] 17 [/SUP], John Hansen[SUP] 6 [/SUP], Ousseny Zerbo[SUP] 6 [/SUP], Palak Patel[SUP] 9 [/SUP], Ruth Link-Gelles[SUP] 1 [/SUP], Katherine Adams[SUP] 9 [/SUP], Mark W Tenforde[SUP] 9 [/SUP]
Affiliations
- PMID: 37633258
- DOI: 10.1093/cid/ciad505
Background: The epidemiology of COVID-19 continues to develop with emerging variants, expanding population-level immunity, and advances in clinical care. We describe changes in the clinical epidemiology of hospitalized COVID-19 and risk factors for critical outcomes over time.
Methods: We included adults aged ≥18 years from 10 states hospitalized with COVID-19 June 2021-March 2023 when multiple SARS-CoV-2 variants or sub-lineages predominated. We evaluated changes in baseline demographic and clinical characteristics and critical outcomes (intensive care unit admission and/or death) and used regression models to evaluate critical outcomes risk factors (risk ratios) stratified by COVID-19 vaccination status.
Results: 60,488 COVID-19-associated hospitalizations were included in the analysis. Among those hospitalized, from Delta period (June-December 2021) to the Omicron post-BA.4/BA.5 period (September 2022-March 2023), median age increased from 60 to 75 years, proportion vaccinated increased from 18.2% to 70.1%, while critical outcomes declined from 24.8% to 19.4% (all p < 0.001). Compared to all hospitalization events, those with critical outcomes had a higher proportion of four or more categories of medical conditions categories assessed (32.8% critical versus 23.0% all hospitalized). Critical outcome risk factors were similar for unvaccinated and vaccinated populations; presence of ≥4 medical condition categories was most strongly associated with risk of critical outcomes regardless of vaccine status (unvaccinated aRR 2.27 [95% CI: 2.14-2.41]; vaccinated aRR 1.73 [95% CI: 1.56-1.92]) across periods.
Conclusion: The proportion of adults hospitalized with COVID-19 who experienced critical outcomes decreased with time and median patient age increased with time. Multimorbidity was mostly strongly associated with critical outcomes.
Keywords: COVID-19; Clinical Epidemiology; Critical Disease; Death; Hospitalization.