Pre-Existing Traits Associated with Covid-19 Illness Severity
Joseph E. Ebinger, Natalie Achamallah, Hongwei Ji, Brian L. Claggett, Nancy Sun, Patrick Botting, Trevor-Trung Nguyen, Eric Luong, Elizabeth H. Kim, Eunice Park, Yunxian Liu, Ryan Rosenberry, Yuri Matusov, Steven Zhao, Isabel Pedraza, Tanzira Zaman, Michael Thompson, Koen Raedschelders, Anders H. Berg, Jonathan D. Grein, Paul W. Noble, Sumeet S. Chugh, C. Noel Bairey Merz, Eduardo Marbán, Jennifer E. Van Eyk, Scott D. Solomon, Christine M. Albert, Peter Chen, Susan Cheng
doi: https://doi.org/10.1101/2020.04.29.20084533
Abstract
Background. Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear. Methods. We studied N=442 patients who presented with laboratory confirmed Covid-19 illness to our U.S. metropolitan healthcare system. We curated data from the electronic health record, and used multivariable logistic regression to examine the association of pre-existing traits with a Covid-19 illness severity defined by level of required care: need for hospital admission, need for intensive care, and need for intubation. Results. Of all patients studied, 48% required hospitalization, 17% required intensive care, and 12% required intubation. In multivariable-adjusted analyses, patients requiring a higher levels of care were more likely to be older (OR 1.5 per 10 years, P<0.001), male (OR 2.0, P=0.001), African American (OR 2.1, P=0.011), obese (OR 2.0, P=0.021), with diabetes mellitus (OR 1.8, P=0.037), and with a higher comorbidity index (OR 1.8 per SD, P<0.001). Several clinical associations were more pronounced in younger compared to older patients (Pinteraction<0.05). Of all hospitalized patients, males required higher levels of care (OR 2.5, P=0.003) irrespective of age, race, or morbidity profile.
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