key: cord-0750555-t1v5ozao
authors: Imam, Zaid; Odish, Fadi; Armstrong, Justin; Elassar, Heba; Dokter, Jonathan; Langnas, Emily; Halalau, Alexandra
title: Independent Correlates of Hospitalization in 2040 Patients with COVID-19 at a Large Hospital System in Michigan, United States
date: 2020-06-09
journal: J Gen Intern Med
DOI: 10.1007/s11606-020-05937-5
sha: ab3602648a50f2d382acefc43f2c8b9788c9e166
doc_id: 750555
cord_uid: t1v5ozao

nan

Prognostic information about the novel coronavirus disease (COVID-19) pandemic is important for patient care. While China reported prediction models on length of stay and mortality 1 and US data is emerging, predictors for hospitalization have not been well defined yet. 2, 3 Our study aims to identify correlates for hospitalization in a large cohort of COVID-19 patients in Michigan.

We performed a retrospective review of patients diagnosed with SARS-CoV2 infection by a positive RT-PCR on nasopharyngeal swab from the largest healthcare system in Southeast Michigan (8 hospitals), through April 1, 2020. We abstracted demographics, comorbidities, medications, and calculated disease burden with the Charlson Comorbidity Index (CCI). 4 Logistic regression evaluated associations and multivariate analyses, including variables with p value <0.20 on univariate analysis (SPSS). 

We found that older age (>60 years), obesity, CCl > 2, ACE-I/ ARB use, and male sex as independent correlates for hospitalization in COVID-19 patients, after controlling for objective clinical findings of illness severity of tachycardia, tachypnea, and hypoxia. Older age and higher comorbidity burden have also been reported as risk factors for mortality in hospitalized COVID-19 patients. 2, 5, 6 This information can provide insight to help guide triage decisions of COVID-19 patients in the emergency center and help appropriate allocation of healthcare resources in the time of a pandemic. The main limitations of our study include its retrospective nature, limited follow-up time, and potential inaccuracies in the medical records. Additionally, the high admission rate in our cohort suggests high patient acuity hence limiting the utility of the identified correlates in other settings such as outpatient offices.

Older age, medical comorbidities, obesity, ACE-I/ARB use, and male sex are independent correlates of hospitalization in COVID-19 patients presenting to the emergency department. 

Prediction models for diagnosis and prognosis of covid-19 infection: systematic review and critical appraisal

Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

Characteristics of Hospitalized Adults With COVID-19 in an Integrated Health Care System in California

A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Preliminary estimates of the prevalence of selected underlying health conditions among patients with coronavirus disease 2019 -United States