Risk Factors for Hospitalization Among Patients with COVID-19 at a Community Ambulatory Clinic in Massachusetts During the Initial Pandemic Surge

Abstract

Among patients with COVID-19 evaluated in outpatient settings, factors associated with hospitalization remain poorly understood. Multivariable regressions were used to assess sociodemographic and clinical factors associated with increased odds of hospitalization among patients with confirmed COVID-19 between March 18, 2020 through April 25, 2020 at a community-based outpatient clinic in Massachusetts. Older age, BMI ≥ 25, self-reported dizziness/lightheadedness, temperature ≥ 99.5°F, tachycardia, and oxygen saturation < 95% were associated with increased odds of hospitalization after adjustment for age, sex, and BMI. There was also an association between speaking Spanish as primary language and increased odds of hospitalization (compared to English, adjusted OR = 2.99 [95% CI 1.39, 6.39]). Speaking Portuguese as primary language was not associated with increased odds of hospitalization (compared to English, adjusted OR = 1.83 [0.78, 4.28]). In addition to several clinical risk factors established among inpatients, our study found that primarily speaking Spanish, but not Portuguese, was a marker of hospitalization risk among a diverse outpatient cohort of patients with COVID-19.

COVID-19 in Patients with a Primary Refugee-Associated Language in a Kentucky Emergency Department During 2020

“…These findings clarify the results of studies performed in Minnesota, California, and Massachusetts [ 5 , 6 , 12 ]. The California and Minnesota studies used death certificate data and found higher mortality from COVID-19 in all foreign-born groups but particularly Hispanic men.…”

Social Determinants and COVID-19 in a Community Health Center Cohort

“…Our findings extend the literature on the impact of social and structural determinants on SARS-CoV-2 infection [ 26 , 27 ], hospitalization [ 28 ], and mortality [ 29 , 30 ]. Racial and ethnic disparities in SARS-CoV-2 risk are well documented in COVID-19, suggesting that Black and Hispanic individuals are at greater risk for infection and poor outcomes [ 27 , 29 , 31 ].…”

Patient characteristics and prediction of CoViD-19 in-hospital mortality: a retrospective cohort study in Crete, Greece before and after the onset of a targeted vaccination strategy in 2021

“…19 Certain ethnicities, such as African American and Hispanic American have also emerged as risk factors for death and severe disease in the US, presumably in connection with social determinants of health. 2,20,21 Migrants in high income countries are also at higher risk of exposure and infection, but outcome data are lacking. 22 Despite the extensive literature on risk factors, it stands to reason that clinical symptoms (such as dyspnoea and altered mentation) and oxygen saturation measurements have remained as the main indicators of deterioration and criteria for hospital admission in national guidelines.…”