Pre-existing traits associated with Covid-19 illness severity

Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear. To determine the demographic and clinical characteristics associated with increased severity of Covid-19 infection. Retrospective observational study. We curat...

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Published inPloS one Vol. 15; no. 7; p. e0236240
Main Authors Ebinger, Joseph E, Achamallah, Natalie, Ji, Hongwei, Claggett, Brian L, Sun, Nancy, Botting, Patrick, Nguyen, Trevor-Trung, Luong, Eric, Kim, Elizabeth H, Park, Eunice, Liu, Yunxian, Rosenberry, Ryan, Matusov, Yuri, Zhao, Steven, Pedraza, Isabel, Zaman, Tanzira, Thompson, Michael, Raedschelders, Koen, Berg, Anders H, Grein, Jonathan D, Noble, Paul W, Chugh, Sumeet S, Bairey Merz, C Noel, Marbán, Eduardo, Van Eyk, Jennifer E, Solomon, Scott D, Albert, Christine M, Chen, Peter, Cheng, Susan
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 23.07.2020
Public Library of Science (PLoS)
Subjects
Adolescent
Adult
African Americans
Age Factors
Aged
Aged, 80 and over
Betacoronavirus
Biology and Life Sciences
Cardiology
Child
Comorbidity
Coronavirus Infections - epidemiology
Coronaviruses
COVID-19
Critical care
Critical Care - statistics & numerical data
Diabetes
Diabetes Mellitus
Electronic health records
Electronic medical records
Female
Health care
Health risks
Heart
Hospitalization - statistics & numerical data
Hospitals
Humans
Illnesses
Infections
Information systems
Intubation
Los Angeles - epidemiology
Male
Medicine
Medicine and Health Sciences
Middle Aged
Morbidity
Obesity
Pandemics
Patients
People and places
Pneumonia, Viral - epidemiology
Regression analysis
Retrospective Studies
Risk Factors
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
State court decisions
Streisand, Barbra
Viral diseases
Young Adult
Los Angeles
Los Angeles California
California
United States > US
Massachusetts
China
Online AccessGet full text

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Abstract Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear. To determine the demographic and clinical characteristics associated with increased severity of Covid-19 infection. Retrospective observational study. 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. A large, multihospital healthcare system in Southern California. All patients with confirmed Covid-19 infection (N = 442). 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. In our healthcare system, greater Covid-19 illness severity is seen in patients who are older, male, African American, obese, with diabetes, and with greater overall comorbidity burden. Certain comorbidities paradoxically augment risk to a greater extent in younger patients. In hospitalized patients, male sex is the main determinant of needing more intensive care. Further investigation is needed to understand the mechanisms underlying these findings.
AbstractList ImportanceCertain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear.ObjectiveTo determine the demographic and clinical characteristics associated with increased severity of Covid-19 infection.DesignRetrospective observational study. 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.SettingA large, multihospital healthcare system in Southern California.ParticipantsAll patients with confirmed Covid-19 infection (N = 442).ResultsOf 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.Conclusions and relevanceIn our healthcare system, greater Covid-19 illness severity is seen in patients who are older, male, African American, obese, with diabetes, and with greater overall comorbidity burden. Certain comorbidities paradoxically augment risk to a greater extent in younger patients. In hospitalized patients, male sex is the main determinant of needing more intensive care. Further investigation is needed to understand the mechanisms underlying these findings.
Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear. To determine the demographic and clinical characteristics associated with increased severity of Covid-19 infection. Retrospective observational study. 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. A large, multihospital healthcare system in Southern California. All patients with confirmed Covid-19 infection (N = 442). 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. In our healthcare system, greater Covid-19 illness severity is seen in patients who are older, male, African American, obese, with diabetes, and with greater overall comorbidity burden. Certain comorbidities paradoxically augment risk to a greater extent in younger patients. In hospitalized patients, male sex is the main determinant of needing more intensive care. Further investigation is needed to understand the mechanisms underlying these findings.
Importance Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear. Objective To determine the demographic and clinical characteristics associated with increased severity of Covid-19 infection. Design Retrospective observational study. 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. Setting A large, multihospital healthcare system in Southern California. Participants All patients with confirmed Covid-19 infection (N = 442). 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. Conclusions and relevance In our healthcare system, greater Covid-19 illness severity is seen in patients who are older, male, African American, obese, with diabetes, and with greater overall comorbidity burden. Certain comorbidities paradoxically augment risk to a greater extent in younger patients. In hospitalized patients, male sex is the main determinant of needing more intensive care. Further investigation is needed to understand the mechanisms underlying these findings.
Importance Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear. Objective To determine the demographic and clinical characteristics associated with increased severity of Covid-19 infection. Design Retrospective observational study. 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. Setting A large, multihospital healthcare system in Southern California. Participants All patients with confirmed Covid-19 infection (N = 442). 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. Conclusions and relevance In our healthcare system, greater Covid-19 illness severity is seen in patients who are older, male, African American, obese, with diabetes, and with greater overall comorbidity burden. Certain comorbidities paradoxically augment risk to a greater extent in younger patients. In hospitalized patients, male sex is the main determinant of needing more intensive care. Further investigation is needed to understand the mechanisms underlying these findings.
Author Matusov, Yuri
Marbán, Eduardo
Van Eyk, Jennifer E
Luong, Eric
Rosenberry, Ryan
Ji, Hongwei
Cheng, Susan
Zhao, Steven
Pedraza, Isabel
Chugh, Sumeet S
Bairey Merz, C Noel
Ebinger, Joseph E
Solomon, Scott D
Nguyen, Trevor-Trung
Achamallah, Natalie
Thompson, Michael
Liu, Yunxian
Zaman, Tanzira
Albert, Christine M
Claggett, Brian L
Kim, Elizabeth H
Noble, Paul W
Sun, Nancy
Berg, Anders H
Raedschelders, Koen
Park, Eunice
Grein, Jonathan D
Chen, Peter
Botting, Patrick
AuthorAffiliation 5 Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
9 Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
8 Advanced Clinical Biosystems Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
12 Barbra Streisand Women’s Heart Center, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
1 Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
4 Division of Pulmonary and Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
6 Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
11 Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
3 Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
Nation
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/32702044$$D View this record in MEDLINE/PubMed
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Snippet Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear. To determine the...
Importance Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear....
IMPORTANCECertain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear....
ImportanceCertain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain...
Importance Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear....
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Title Pre-existing traits associated with Covid-19 illness severity
URI https://www.ncbi.nlm.nih.gov/pubmed/32702044
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https://doaj.org/article/c44b8c2c08e643f8ad65685b8ab6098c
http://dx.doi.org/10.1371/journal.pone.0236240
Volume 15
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