TY - JOUR
T1 - COVID-19 waves in an urban setting 2020–2022
T2 - an electronic medical record analysis
AU - Chen, Yi shuan Elaine
AU - Gawel, Susan H.
AU - Desai, Pankaja
AU - Rojas, Juan
AU - Barbian, Hannah J.
AU - Tippireddy, Nagarjuna
AU - Gopinath, Rajkamal
AU - Schneider, Sharon
AU - Orzechowski, Anthony
AU - Cloherty, Gavin
AU - Landay, Alan
N1 - Publisher Copyright:
Copyright © 2024 Chen, Gawel, Desai, Rojas, Barbian, Tippireddy, Gopinath, Schneider, Orzechowski, Cloherty and Landay.
PY - 2024
Y1 - 2024
N2 - Background: Global and national surveillance efforts have tracked COVID-19 incidence and clinical outcomes, but few studies have compared comorbid conditions and clinical outcomes across each wave of the pandemic. We analyzed data from the COVID-19 registry of a large urban healthcare system to determine the associations between presenting comorbidities and clinical outcomes during the pandemic. Methods: We analyzed registry data for all inpatients and outpatients with COVID-19 from March 2020 through September 2022 (N = 44,499). Clinical outcomes were death, hospitalization, and intensive care unit (ICU) admission. Demographic and clinical outcomes data were analyzed overall and for each wave. Unadjusted and multivariable logistic regressions were performed to explore the associations between age, sex, race, ethnicity, comorbidities, and mortality. Results: Waves 2 and 3 (Alpha and Delta variants) were associated with greater hospitalizations, ICU admissions, and mortality than other variants. Chronic pulmonary disease was the most common comorbid condition across all age groups and waves. Mortality rates were higher in older patients but decreased across all age groups in later waves. In every wave, mortality was associated with renal disease, congestive heart failure, cerebrovascular disease, diabetes, and chronic pulmonary disease. Multivariable analysis found that liver disease and renal disease were significantly associated with mortality, hospitalization, and ICU admission, and diabetes was significantly associated with hospitalization and ICU admission. Conclusion: The COVID-19 registry is a valuable resource to identify risk factors for clinical outcomes. Our findings may inform risk stratification and care planning for patients with COVID-19 based on age and comorbid conditions.
AB - Background: Global and national surveillance efforts have tracked COVID-19 incidence and clinical outcomes, but few studies have compared comorbid conditions and clinical outcomes across each wave of the pandemic. We analyzed data from the COVID-19 registry of a large urban healthcare system to determine the associations between presenting comorbidities and clinical outcomes during the pandemic. Methods: We analyzed registry data for all inpatients and outpatients with COVID-19 from March 2020 through September 2022 (N = 44,499). Clinical outcomes were death, hospitalization, and intensive care unit (ICU) admission. Demographic and clinical outcomes data were analyzed overall and for each wave. Unadjusted and multivariable logistic regressions were performed to explore the associations between age, sex, race, ethnicity, comorbidities, and mortality. Results: Waves 2 and 3 (Alpha and Delta variants) were associated with greater hospitalizations, ICU admissions, and mortality than other variants. Chronic pulmonary disease was the most common comorbid condition across all age groups and waves. Mortality rates were higher in older patients but decreased across all age groups in later waves. In every wave, mortality was associated with renal disease, congestive heart failure, cerebrovascular disease, diabetes, and chronic pulmonary disease. Multivariable analysis found that liver disease and renal disease were significantly associated with mortality, hospitalization, and ICU admission, and diabetes was significantly associated with hospitalization and ICU admission. Conclusion: The COVID-19 registry is a valuable resource to identify risk factors for clinical outcomes. Our findings may inform risk stratification and care planning for patients with COVID-19 based on age and comorbid conditions.
KW - COVID-19
KW - electronic health records
KW - mortality
KW - SARS-CoV-2
KW - surveillance
UR - http://www.scopus.com/inward/record.url?scp=85184726432&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85184726432&partnerID=8YFLogxK
U2 - 10.3389/fpubh.2024.1323481
DO - 10.3389/fpubh.2024.1323481
M3 - Article
C2 - 38347927
AN - SCOPUS:85184726432
SN - 2296-2565
VL - 12
JO - Frontiers in Public Health
JF - Frontiers in Public Health
M1 - 1323481
ER -