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Published on: November 10, 2023
Risk Factors for Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization: COVID-19-Associated Hospitalization
Jean Y Ko1,2, Melissa L Danielson1, Machell Town3
1COVID-NET Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Insights
Older adults and those with multiple underlying health conditions, such as severe obesity or chronic kidney disease, face higher hospitalization risks for coronavirus disease 2019 (COVID-19). These findings highlight key groups for targeted prevention and treatment strategies.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Understanding risk factors for coronavirus disease 2019 (COVID-19) hospitalization is crucial for effective prevention and clinical management.
- The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) collects data on hospitalized individuals across the United States.
Purpose of the Study:
- To identify factors independently associated with COVID-19-associated hospitalizations among community-dwelling adults in the U.S.
- To inform targeted public health interventions and clinical care strategies.
Main Methods:
- Analysis of data from 5,416 adults hospitalized with laboratory-confirmed COVID-19 between March 1 and June 23, 2020.
- Utilized Generalized Poisson regression models to calculate adjusted rate ratios (aRRs) for hospitalization based on demographic factors and underlying medical conditions.
Main Results:
- Individuals with three or more underlying conditions (aRR: 5.0) faced the highest hospitalization risk.
- Severe obesity (aRR: 4.4), chronic kidney disease (aRR: 4.0), and diabetes (aRR: 3.2) were significantly associated with increased COVID-19 hospitalization rates.
- Higher hospitalization rates were also observed in adults aged 45-64 and ≥65 years, males, and non-Hispanic Black and other race/ethnic groups.
Conclusions:
- Specific demographic groups and individuals with certain pre-existing conditions exhibit elevated risk for severe COVID-19 outcomes.
- Findings underscore the need for targeted preventive measures and therapeutic interventions for high-risk populations.
Background:
Data on risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization are needed to guide prevention efforts and clinical care. We sought to identify factors independently associated with COVID-19-associated hospitalizations.
Methods:
Community-dwelling adults (aged ≥18 years) in the United States hospitalized with laboratory-confirmed COVID-19 during 1 March-23 June 2020 were identified from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), a multistate surveillance system. To calculate hospitalization rates by age, sex, and race/ethnicity strata, COVID-NET data served as the numerator and Behavioral Risk Factor Surveillance System estimates served as the population denominator for characteristics of interest. Underlying medical conditions examined included hypertension, coronary artery disease, history of stroke, diabetes, obesity, severe obesity, chronic kidney disease, asthma, and chronic obstructive pulmonary disease. Generalized Poisson regression models were used to calculate adjusted rate ratios (aRRs) for hospitalization.
Results:
Among 5416 adults, hospitalization rates (all reported as aRR [95% confidence interval]) were higher among those with ≥3 underlying conditions (vs without) (5.0 [3.9-6.3]), severe obesity (4.4 [3.4-5.7]), chronic kidney disease (4.0 [3.0-5.2]), diabetes (3.2 [2.5-4.1]), obesity (2.9 [2.3-3.5]), hypertension (2.8 [2.3-3.4]), and asthma (1.4 [1.1-1.7]), after adjusting for age, sex, and race/ethnicity. Adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults aged ≥65 or 45-64 years (vs 18-44 years), males (vs females), and non-Hispanic black and other race/ethnicities (vs non-Hispanic whites).
Conclusions:
Our findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions.
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