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396. Relationship Between Patient Characteristics and Critical Illness in Patients Admitted for CoVID-19

BACKGROUND: While several studies have explored hospitalization risk factors with the novel coronavirus (COVID-19) infection, the risk of poor outcomes during hospitalization has primarily relied upon laboratory or hospital-acquired data. Our goal was to identify clinical characteristics associated...

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Autores principales: Windham, Samuel L, Wilson, Melissa P, Fling, Connor, Sheneman, David W, Wand, Taylor, Babcock, Lyndsey, Delson, Samantha, Erlandson, Kristine M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777818/
http://dx.doi.org/10.1093/ofid/ofaa439.591
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author Windham, Samuel L
Wilson, Melissa P
Fling, Connor
Sheneman, David W
Wand, Taylor
Babcock, Lyndsey
Delson, Samantha
Erlandson, Kristine M
author_facet Windham, Samuel L
Wilson, Melissa P
Fling, Connor
Sheneman, David W
Wand, Taylor
Babcock, Lyndsey
Delson, Samantha
Erlandson, Kristine M
author_sort Windham, Samuel L
collection PubMed
description BACKGROUND: While several studies have explored hospitalization risk factors with the novel coronavirus (COVID-19) infection, the risk of poor outcomes during hospitalization has primarily relied upon laboratory or hospital-acquired data. Our goal was to identify clinical characteristics associated with intubation or death within 7 days of admission. METHODS: The first 436 patients admitted to the University of Colorado Hospital (Denver metropolitan area) with confirmed CoVID-19 were included. Demographics, comorbidities, and select medications were collected by chart abstraction. Missing height for calculating body mass index (BMI) was imputed using the median height for patients’ sex and race/ethnicity. Adjusted odds ratios (aOR) were estimated using multivariable logistic regression and a minimax concave penalty (MCP) regularized logistic regression explored prediction. RESULTS: Participants had a mean(SD) age 55(17), BMI 30.9(8.2), 55% were male and 80% were ethnic/racial minorities. Unadjusted comparisons by outcome are shown (Table 1). Male sex (aOR: 1.60, 95% CI (1.02, 2.54)), increasing age (aOR: 1.25(1.08, 1.47); per 10 years), higher BMI (aOR 1.03(1.00, 1.06) and poorly controlled diabetes (hemoglobin A1C ≥8) (aOR 2.33(1.27, 4.27) were significantly (p< 0.05) associated with greater odds of intubation or death. Minority status tended to be associated with higher odds (aOR:1.8(1.01,3.36); p=0.052). Surprisingly, need for hospital interpreter was associated with decreased odds (OR: 0.58(0.35, 0.95)) of intubation/death. Our final MCP model included indicators of A1C≥8, age >65, sex and minority status, but predicted intubation/death only slightly better than random chance (AUC= 0.61(0.56, 0.67)). Table 1. Patient Characteristics Stratified by Intubation and/or Death Within One Week of Admission (n=436) [Image: see text] CONCLUSION: In a hospitalized patient cohort with COVID-19, male sex, poorly controlled diabetes, increasing age and BMI were significantly associated with early intubation or death. These results complement larger cohort studies, and highlight risk differences across metropolitan areas with varying COVID-19 prevalence, demographics, and comorbid disease burden. Notably, our predictive model had limited success, which may suggest unmeasured factors also contribute to disease severity differences. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77778182021-01-07 396. Relationship Between Patient Characteristics and Critical Illness in Patients Admitted for CoVID-19 Windham, Samuel L Wilson, Melissa P Fling, Connor Sheneman, David W Wand, Taylor Babcock, Lyndsey Delson, Samantha Erlandson, Kristine M Open Forum Infect Dis Poster Abstracts BACKGROUND: While several studies have explored hospitalization risk factors with the novel coronavirus (COVID-19) infection, the risk of poor outcomes during hospitalization has primarily relied upon laboratory or hospital-acquired data. Our goal was to identify clinical characteristics associated with intubation or death within 7 days of admission. METHODS: The first 436 patients admitted to the University of Colorado Hospital (Denver metropolitan area) with confirmed CoVID-19 were included. Demographics, comorbidities, and select medications were collected by chart abstraction. Missing height for calculating body mass index (BMI) was imputed using the median height for patients’ sex and race/ethnicity. Adjusted odds ratios (aOR) were estimated using multivariable logistic regression and a minimax concave penalty (MCP) regularized logistic regression explored prediction. RESULTS: Participants had a mean(SD) age 55(17), BMI 30.9(8.2), 55% were male and 80% were ethnic/racial minorities. Unadjusted comparisons by outcome are shown (Table 1). Male sex (aOR: 1.60, 95% CI (1.02, 2.54)), increasing age (aOR: 1.25(1.08, 1.47); per 10 years), higher BMI (aOR 1.03(1.00, 1.06) and poorly controlled diabetes (hemoglobin A1C ≥8) (aOR 2.33(1.27, 4.27) were significantly (p< 0.05) associated with greater odds of intubation or death. Minority status tended to be associated with higher odds (aOR:1.8(1.01,3.36); p=0.052). Surprisingly, need for hospital interpreter was associated with decreased odds (OR: 0.58(0.35, 0.95)) of intubation/death. Our final MCP model included indicators of A1C≥8, age >65, sex and minority status, but predicted intubation/death only slightly better than random chance (AUC= 0.61(0.56, 0.67)). Table 1. Patient Characteristics Stratified by Intubation and/or Death Within One Week of Admission (n=436) [Image: see text] CONCLUSION: In a hospitalized patient cohort with COVID-19, male sex, poorly controlled diabetes, increasing age and BMI were significantly associated with early intubation or death. These results complement larger cohort studies, and highlight risk differences across metropolitan areas with varying COVID-19 prevalence, demographics, and comorbid disease burden. Notably, our predictive model had limited success, which may suggest unmeasured factors also contribute to disease severity differences. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7777818/ http://dx.doi.org/10.1093/ofid/ofaa439.591 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Windham, Samuel L
Wilson, Melissa P
Fling, Connor
Sheneman, David W
Wand, Taylor
Babcock, Lyndsey
Delson, Samantha
Erlandson, Kristine M
396. Relationship Between Patient Characteristics and Critical Illness in Patients Admitted for CoVID-19
title 396. Relationship Between Patient Characteristics and Critical Illness in Patients Admitted for CoVID-19
title_full 396. Relationship Between Patient Characteristics and Critical Illness in Patients Admitted for CoVID-19
title_fullStr 396. Relationship Between Patient Characteristics and Critical Illness in Patients Admitted for CoVID-19
title_full_unstemmed 396. Relationship Between Patient Characteristics and Critical Illness in Patients Admitted for CoVID-19
title_short 396. Relationship Between Patient Characteristics and Critical Illness in Patients Admitted for CoVID-19
title_sort 396. relationship between patient characteristics and critical illness in patients admitted for covid-19
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777818/
http://dx.doi.org/10.1093/ofid/ofaa439.591
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