Details

Autor(en) / Beteiligte

• Ebinger, Joseph E
• Achamallah, Natalie
• Ji, Hongwei
• Claggett, Brian L
• Sun, Nancy
• Botting, Patrick
• Nguyen, Trevor-Trung
• Luong, Eric
• Kim, Elizabeth H
• Park, Eunice
• Liu, Yunxian
• Rosenberry, Ryan
• Matusov, Yuri
• Zhao, Steven
• Pedraza, Isabel
• Zaman, Tanzira
• Thompson, Michael
• Raedschelders, Koen
• Berg, Anders H
• Grein, Jonathan D
• Noble, Paul W
• Chugh, Sumeet S
• Bairey Merz, C Noel
• Marbán, Eduardo
• Van Eyk, Jennifer E
• Solomon, Scott D
• Albert, Christine M
• Chen, Peter
• Cheng, Susan
• Kou, Yu Ru

Titel

Pre-existing traits associated with Covid-19 illness severity

Ist Teil von

• PloS one, 2020-07, Vol.15 (7), p.e0236240-e0236240

Ort / Verlag

United States: Public Library of Science

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear. To determine the demographic and clinical characteristics associated with increased severity of Covid-19 infection. Retrospective observational study. We curated data from the electronic health record, and used multivariable logistic regression to examine the association of pre-existing traits with a Covid-19 illness severity defined by level of required care: need for hospital admission, need for intensive care, and need for intubation. A large, multihospital healthcare system in Southern California. All patients with confirmed Covid-19 infection (N = 442). Of all patients studied, 48% required hospitalization, 17% required intensive care, and 12% required intubation. In multivariable-adjusted analyses, patients requiring a higher levels of care were more likely to be older (OR 1.5 per 10 years, P<0.001), male (OR 2.0, P = 0.001), African American (OR 2.1, P = 0.011), obese (OR 2.0, P = 0.021), with diabetes mellitus (OR 1.8, P = 0.037), and with a higher comorbidity index (OR 1.8 per SD, P<0.001). Several clinical associations were more pronounced in younger compared to older patients (Pinteraction<0.05). Of all hospitalized patients, males required higher levels of care (OR 2.5, P = 0.003) irrespective of age, race, or morbidity profile. In our healthcare system, greater Covid-19 illness severity is seen in patients who are older, male, African American, obese, with diabetes, and with greater overall comorbidity burden. Certain comorbidities paradoxically augment risk to a greater extent in younger patients. In hospitalized patients, male sex is the main determinant of needing more intensive care. Further investigation is needed to understand the mechanisms underlying these findings.