Predictors of COVID-19 Mortality in Residents of Flint, Michigan: Effect of Age, Gender, Smoking, and Health Plan

• Published in: Antimicrobial stewardship & healthcare epidemiology : ASHE Vol. 1; no. S1; pp. s57 - s58
• Main Authors: Younas, Mariam, Osterholzer, Danielle, McDonald, Philip, Rios-Bedoya, Carlos, Bachuwa, Ghassan, Demian, Sherry, Deliwala, Smit, Kunaprayoon, Lalida, Lakshman, Harini, Beere, Thulasi, Omaduvie, Uyoyo
• Format: Journal Article
• Language: English
• Published: Cambridge Cambridge University Press 01.07.2021
• Subjects: Age; Body mass index; Cardiovascular disease; Coronaviruses; COVID-19; Diabetes; Disease prevention; Hypertension; Mortality; Poster Presentation; Severe acute respiratory syndrome coronavirus 2; Sleep apnea; United States > US; Michigan
• ISSN: 2732-494X; 2732-494X
• DOI: 10.1017/ash.2021.111

Background: Current literature suggests that older age, hypertension, and diabetes mellitus confer a significant increased risk of mortality among patients with COVID-19. The purpose of this study is to further characterize the predictors of mortality in patients with COVID-19 in residents of Flint, Michigan, based on variables such as gender, age, smoking status, health insurance plan, and comorbidities. Methods: Hurley Medical Center, is a 443-bed public, nonprofit, teaching medical center located in Flint, Michigan. In total, 289 consecutive adult patients (aged ≥18 years) with confirmed SARS-CoV-2 infection by nasal polymerase chain reaction (PCR), admitted and discharged from our facility from March 2020 through June 2020, were retrospectively analyzed. Results: During the 4-month study period, the overall in-hospital case fatality rate (CFR) was 18% (51 of 289), with highest CFR in the age group aged 60–69 years (36%; P = . 06). Nonsurvivors tended to be older with mean age of 67 years (95% CI, 61.6–71.8) versus survivors with mean age of 60 years (95% CI, 57.7–62.4). Highest mortality was seen in patients with Medicare or Medicaid as their sole health plan (39%, P = .59). Men comprised 51% (148 of 289) of the cohort with CFR of 21% versus 14% in females. Females tended to be younger with a higher body mass index (BMI) than their male counterparts (mean age of 58 years, mean BMI of 35 in women vs a mean age of 62 and BMI of 29 in men). A higher proportion of deceased were active smokers (51%; P = .02). CFR was highest in patients with hypertension (92%,; P = .15), followed by diabetes (44%; P = .85), chronic kidney disease (CKD) (31%; P = .10), obstructive sleep apnea (OSA) (28%; P = .25), asthma (22%; P = .64), and coronary artery disease (22%; P = .34). It was lowest in patients with end-stage renal disease (3%; P = .69). Conclusions: Our study suggests trends towards higher mortality with male sex, hypertension and diabetes, along with other comorbidities. Smoking seems to be a strong predictor of mortality in this cohort. Further studies are needed to ascertain the relationship between possible risk factors with COVID-19 mortality in residents of Flint, Michigan. Describing and understanding the potential risk factors is the key to improving outcomes in this population. Funding: No Disclosures: None