Demographics, comorbidities and outcomes in hospitalized Covid-19 patients in rural southwest Georgia

• Published in: Annals of medicine (Helsinki) Vol. 52; no. 7; pp. 354 - 360
• Main Authors: Shah, Priyank, Owens, Jack, Franklin, James, Mehta, Akshat, Heymann, William, Sewell, William, Hill, Jennifer, Barfield, Krista, Doshi, Rajkumar
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 02.10.2020
• Subjects: Adolescent; Adult; African Americans - statistics & numerical data; Age Factors; Aged; baseline characteristics; Child; Child, Preschool; Comorbidity; Coronavirus Infections - epidemiology; Coronavirus Infections - mortality; COVID-19; demographics; Female; Georgia - epidemiology; Hospital Mortality; Hospitalization - statistics & numerical data; Humans; Hypertension - epidemiology; Immunocompromised Host; Infant; Male; Middle Aged; Original; outcomes; Pandemics; Pneumonia, Viral - epidemiology; Pneumonia, Viral - mortality; Retrospective Studies; Risk Factors; Rural Population - statistics & numerical data; rural US; Sex Factors; Young Adult; Georgia; Covid-19; rural US; outcomes; baseline characteristics; demographics
• ISSN: 0785-3890; 1365-2060; 1365-2060
• DOI: 10.1080/07853890.2020.1791356

There is limited data on outcomes in patients with coronavirus disease 2019 (Covid-19) in rural United States (US). This study aimed to describe the demographics, and outcomes of hospitalized Covid-19 patients in rural Southwest Georgia. Using electronic medical records, we analyzed data from all hospitalized Covid-19 patients who either died or survived to discharge between 2 March 2020 and 6 May 2020. Of the 522 patients, 92 died in hospital (17.6%). Median age was 63 years, 58% were females, and 87% African-Americans. Hypertension (79.7%), obesity (66.5%) and diabetes mellitus (42.3%) were the most common comorbidities. Males had higher overall mortality compared to females (23 v 13.8%). Immunosuppression [odds ratio (OR) 3.6; (confidence interval (CI): 1.52-8.47, p=.003)], hypertension (OR 3.36; CI:1.3-8.6, p=.01), age ≥65 years (OR 3.1; CI:1.7-5.6, p<.001) and morbid obesity (OR 2.29; CI:1.11-4.69, p=.02), were independent predictors of in-hospital mortality. Female gender was an independent predictor of decreased in-hospital mortality. Mortality in intubated patients was 67%. Mortality was 8.9% in <50 years, compared to 20% in ≥50 years. Immunosuppression, hypertension, age ≥ 65 years and morbid obesity were independent predictors of mortality, whereas female gender was protective for mortality in hospitalized Covid-19 patients in rural Southwest Georgia. KEY MESSAGES Patients hospitalized with Covid-19 in rural US have higher comorbidity burden. Immunosuppression, hypertension, age ≥ 65 years and morbid obesity are independent predictors of increased mortality. Female gender is an independent predictor of reduced mortality.