Characteristics and Risk Factors for Hospitalization and Mortality among Persons with COVID-19 in Atlanta Metropolitan Area

Abstract

Background: We present data on risk factors for severe outcomes among patients with coronavirus disease 2019 (COVID-19) in the southeast United States (U.S.). Objective: To determine risk factors associated with hospitalization, intensive care unit (ICU) admission, and mortality among patients with confirmed COVID-19. Design: A retrospective cohort study. Setting: Fulton County in Atlanta Metropolitan Area, Georgia, U.S. Patients: Community-based individuals of all ages that tested positive for SARS-CoV-2. Measurements: Demographic characteristics, comorbid conditions, hospitalization, ICU admission, death (all-cause mortality), and severe COVID-19 disease, defined as a composite measure of hospitalization and death. Results: Between March 2 and May 31, 2020, we included 4322 individuals with various COVID-19 outcomes. In a multivariable logistic regression random-effects model, patients in age groups ≥45 years compared to those <25 years were associated with severe COVID-19. Males compared to females (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI]: 1.1-1.6), non-Hispanic blacks (aOR 1.9, 95%CI: 1.5-2.4) and Hispanics (aOR 1.7, 95%CI: 1.2-2.5) compared to non-Hispanic whites were associated with increased odds of severe COVID-19. Those with chronic renal disease (aOR 3.6, 95%CI: 2.2-5.8), neurologic disease (aOR 2.8, 95%CI: 1.8-4.3), diabetes (aOR 2.0, 95%CI: 1.5-2.7), chronic lung disease (aOR 1.7, 95%CI: 1.2-2.3), and ″other chronic diseases″ (aOR 1.8, 95%CI: 1.3-2.6) compared to those without these conditions were associated with increased odds of having severe COVID-19. Conclusions: Multiple risk factors for hospitalization, ICU admission, and death were observed in this cohort from an urban setting in the southeast U.S. Improved screening and early, intensive treatment for persons with identified risk factors is urgently needed to reduce COVID-19 related morbidity and mortality.

Neurological comorbidities and COVID-19-related case fatality: A cohort study

“…However, the precise estimate of the role of neurological diseases, and the comparison between neurological vs. non-neurological patients, are mainly limited by the fact that patients with neurological diseases are frequently older and more affected by other comorbidities. A retrospective analysis of 2820 patients reported increased adjusted odds of having severe COVID-19 and fatal outcome in patients with neurological disease [16]. Two observational studies reported a 4.6-fold [17] and a 2.9-fold [18] higher COVID-19-related mortality in neurological patients, evaluated by a multivariate approach, while other studies reported, in univariate analyses only, a significant association between mortality and neurological diseases [23] or cerebrovascular and neurodegenerative disorders [11,12].…”

“…In addition, some studies investigating specific neurological diseases, reported that dementia [4,6,10], stroke [4,[11][12][13], and Parkinson's disease (PD) [14,15] may be associated with higher mortality. Other studies, applying a generic definition of "neurological disorders", reported higher mortality in patients affected by neurological diseases [4,[16][17][18], while a recent systematic review and meta-analysis on the impact of comorbidities on COVID-19 severity, hospitalization, and mortality did not include any neurological disease in the analysis due to the lack of data available [19]. Against this background, no previous studies have comprehensively analyzed the impact of different types of neurological diseases on the outcome of COVID-19 using a cohort design with matched patients.…”

Population‐based assessment of risks for severe COVID‐19 disease outcomes

“…Previous studies reported that older age 1 , 2 and comorbidities including asthma, chronic obstructive pulmonary disease (COPD), diabetes, and heart and renal disease are associated with severe COVID‐19. 3 , 4 , 5 , 6 , 7 However, association between some neurological condition such as Parkinson's disease, demyelinating disorders, and epilepsy have not been examined extensively. Furthermore, non‐White racial and ethnic persons are reportedly disproportionally affected by COVID‐19.…”

How About the Psychological Pandemic? Perceptions of COVID-19 and Work–Life of Private Sector Employees—A Qualitative Study

“…Jacobson et al ( 2020 ) examined and found that there have been intense searches in Google to find about stress, insomnia, negativity, and even suicidal thoughts. In their qualitative research, Williams et al ( 2020 ) mentioned that participants reported their helplessness in adjusting longer-term and experienced issues of non-adherence in seeing or hearing others at the beginning of the social distancing measures. The present study also demonstrates the psychological state of the participants after suffering financial losses, facing perpetual work-life challenges, and trying to comprehend the fundamental meaning of existence after the pandemic outbreak.…”