Predictors of Hospitalization Among Older Adults with COVID-19 in Saudi Arabia: A Cross-Sectional Study of a Nationally Representative Sample

Abstract

Background The aim of this study was to identify the predictors of hospitalization in older (≥60 years) patients with coronavirus disease-19 (COVID-19) in Saudi Arabia. Methods Patients were randomly selected from a COVID-19 database maintained by the Ministry of Health, Saudi Arabia. All patients were aged ≥60 years, had reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19, and were registered in the database during March 2020 to July 2020. Medical and sociodemographic characteristics were retrieved from the database. Additional data were collected by telephone interviews conducted by trained health professionals. Descriptive statistics and multiple logistic regression analyses were used to analyze the relationship between patient characteristics and the risk of hospitalization. Results Of the 613 included patients (51.1% females), more than half (57.3%) were between 60 to 69 years of age, and 53% (324/613) had been hospitalized. The independent predictors of hospitalization included age ≥65 years (OR = 2.35, 95% CI: 1.66–3.33, P < 0.001), having more than one comorbidity (OR = 1.55, 95% CI: 1.09–2.20, P = 0.01), diabetes mellitus (OR = 1.52, 95% CI: 1.09–2.11, P = 0.01), hypertension (OR = 1.40, 95% CI: 1.007–1.97, P = 0.04), chronic kidney disease (OR = 3.87, 95% CI: 1.41–10.58, P = 0.008), and history of hospital admission within the preceding year (OR = 1.69, 95% CI: 1.11–2.55, P = 0.013). Risk of hospitalization was lower in males (OR = 0.65, 95% CI: 0.43–0.90, P = 0.01) and in patients co-living with health care workers (OR = 0.64, 95% CI: 0.43–0.96, P = 0.03). Conclusion Factors associated with higher risk of COVID-19-associated hospitalization should be used in prioritizing older adults’ admission. Future studies with more robust designs should be conducted to examine the risk of COVID-19-associated illness severity and mortality.

Risk factors for hospitalization among persons with COVID-19—Colorado

“…While cardiovascular disease, a category inclusive of multiple individual conditions, has been identified as a risk factor for hospitalization and severe COVID-19 [ 2 , 10 , 15 ], it was not statistically significant in our multivariable analysis. Previous reports have found individual cardiac conditions (e.g., congestive heart failure, coronary artery disease, atrial fibrillation/arrythmia, and hypertension) to be associated with hospitalization [ 7 , 26 , 27 , 33 , 41 – 43 , 55 ]. Within this disease category, we found that history of hypertension or arrhythmia was associated with increased risk of hospitalization in multivariable analysis.…”

“…We did not differentiate between type 1 and type 2 DM in our analysis, so we are unable to determine if the relationship between DM and COVID-19 hospitalization varies by type. Additionally, we had a lower number of patients with DM, which might have reduced our power to detect an association in multivariable analysis, as was reported in at least one other study [ 35 ] compared to studies where DM was reported to occur at a higher frequency and was found to be a risk factor for hospitalization [ 7 , 27 , 29 , 30 , 34 , 48 , 55 , 56 ]. Compared to other U.S. states, Colorado’s population is relatively healthy having the lowest proportion of adults with obesity and the fourth lowest percentage of residents with at least one of six underlying medical conditions found to be associated with an increased COVID-19 case fatality ratio in China [ 62 , 63 ].…”

COVID-19 among people with diabetes mellitus in Saudi Arabia: Current situation and new perspectives

“…It is noteworthy that the Ministry of Health (MOH) in Saudi Arabia confirmed that approximately 50 % of the COVID-related deaths among the critical cases present in an ICU were from among patients experiencing chronic diseases such as diabetes [ 40 ]. A recently published study stated that DM significantly more prevalent in hospitalized patients than in non-hospitalized patients, and patients with diabetes had a 52.1 % higher risk of hospitalization than patients without diabetes (OR = 1.52) [ 41 ].…”

Risk factors associated with hospitalization owing to COVID-19: a cross-sectional study in Palestine

“…The sample size was determined using G power software with an alpha of 0.05 (two-sided) and 90% power, the input parameter, and logistic regression. The sample size was calculated using different odds ratio values from a previous study 20 for different predictors (age, comorbidities, sex). The largest sample size was considered.…”