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Predictors of life-threatening complications in relatively lower-risk patients hospitalized with COVID-19

Older individuals with chronic health conditions are at highest risk of adverse clinical outcomes from COVID-19, but there is widespread belief that risk to younger, relatively lower-risk individuals is negligible. We assessed the rate and predictors of life-threatening complications among relativel...

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Autores principales: Gonzalez, Christopher J., Hogan, Cameron J., Rajan, Mangala, Wells, Martin T., Safford, Monika M., Pinheiro, Laura C., Ghosh, Arnab K., Choi, Justin J., Burchenal, Clare A., Shah, Pooja D., Shapiro, Martin F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8846540/
https://www.ncbi.nlm.nih.gov/pubmed/35167610
http://dx.doi.org/10.1371/journal.pone.0263995
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author Gonzalez, Christopher J.
Hogan, Cameron J.
Rajan, Mangala
Wells, Martin T.
Safford, Monika M.
Pinheiro, Laura C.
Ghosh, Arnab K.
Choi, Justin J.
Burchenal, Clare A.
Shah, Pooja D.
Shapiro, Martin F.
author_facet Gonzalez, Christopher J.
Hogan, Cameron J.
Rajan, Mangala
Wells, Martin T.
Safford, Monika M.
Pinheiro, Laura C.
Ghosh, Arnab K.
Choi, Justin J.
Burchenal, Clare A.
Shah, Pooja D.
Shapiro, Martin F.
author_sort Gonzalez, Christopher J.
collection PubMed
description Older individuals with chronic health conditions are at highest risk of adverse clinical outcomes from COVID-19, but there is widespread belief that risk to younger, relatively lower-risk individuals is negligible. We assessed the rate and predictors of life-threatening complications among relatively lower-risk adults hospitalized with COVID-19. Of 3766 adults hospitalized with COVID-19 to three hospitals in New York City from March to May 2020, 963 were relatively lower-risk based on absence of preexisting health conditions. Multivariable logistic regression models examined in-hospital development of life-threatening complications (major medical events, intubation, or death). Covariates included age, sex, race/ethnicity, hypertension, weight, insurance type, and area-level sociodemographic factors (poverty, crowdedness, and limited English proficiency). In individuals ≥55 years old (n = 522), 33.3% experienced a life-threatening complication, 17.4% were intubated, and 22.6% died. Among those <55 years (n = 441), 15.0% experienced a life-threatening complication, 11.1% were intubated, and 5.9% died. In multivariable analyses among those ≥55 years, age (OR 1.03 [95%CI 1.01–1.06]), male sex (OR 1.72 [95%CI 1.14–2.64]), being publicly insured (versus commercial insurance: Medicare, OR 2.02 [95%CI 1.22–3.38], Medicaid, OR 1.87 [95%CI 1.10–3.20]) and living in areas with relatively high limited English proficiency (highest versus lowest quartile: OR 3.50 [95%CI 1.74–7.13]) predicted life-threatening complications. In those <55 years, no sociodemographic factors significantly predicted life-threatening complications. A substantial proportion of relatively lower-risk patients hospitalized with COVID-19 experienced life-threatening complications and more than 1 in 20 died. Public messaging needs to effectively convey that relatively lower-risk individuals are still at risk of serious complications.
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spelling pubmed-88465402022-02-16 Predictors of life-threatening complications in relatively lower-risk patients hospitalized with COVID-19 Gonzalez, Christopher J. Hogan, Cameron J. Rajan, Mangala Wells, Martin T. Safford, Monika M. Pinheiro, Laura C. Ghosh, Arnab K. Choi, Justin J. Burchenal, Clare A. Shah, Pooja D. Shapiro, Martin F. PLoS One Research Article Older individuals with chronic health conditions are at highest risk of adverse clinical outcomes from COVID-19, but there is widespread belief that risk to younger, relatively lower-risk individuals is negligible. We assessed the rate and predictors of life-threatening complications among relatively lower-risk adults hospitalized with COVID-19. Of 3766 adults hospitalized with COVID-19 to three hospitals in New York City from March to May 2020, 963 were relatively lower-risk based on absence of preexisting health conditions. Multivariable logistic regression models examined in-hospital development of life-threatening complications (major medical events, intubation, or death). Covariates included age, sex, race/ethnicity, hypertension, weight, insurance type, and area-level sociodemographic factors (poverty, crowdedness, and limited English proficiency). In individuals ≥55 years old (n = 522), 33.3% experienced a life-threatening complication, 17.4% were intubated, and 22.6% died. Among those <55 years (n = 441), 15.0% experienced a life-threatening complication, 11.1% were intubated, and 5.9% died. In multivariable analyses among those ≥55 years, age (OR 1.03 [95%CI 1.01–1.06]), male sex (OR 1.72 [95%CI 1.14–2.64]), being publicly insured (versus commercial insurance: Medicare, OR 2.02 [95%CI 1.22–3.38], Medicaid, OR 1.87 [95%CI 1.10–3.20]) and living in areas with relatively high limited English proficiency (highest versus lowest quartile: OR 3.50 [95%CI 1.74–7.13]) predicted life-threatening complications. In those <55 years, no sociodemographic factors significantly predicted life-threatening complications. A substantial proportion of relatively lower-risk patients hospitalized with COVID-19 experienced life-threatening complications and more than 1 in 20 died. Public messaging needs to effectively convey that relatively lower-risk individuals are still at risk of serious complications. Public Library of Science 2022-02-15 /pmc/articles/PMC8846540/ /pubmed/35167610 http://dx.doi.org/10.1371/journal.pone.0263995 Text en © 2022 Gonzalez et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Gonzalez, Christopher J.
Hogan, Cameron J.
Rajan, Mangala
Wells, Martin T.
Safford, Monika M.
Pinheiro, Laura C.
Ghosh, Arnab K.
Choi, Justin J.
Burchenal, Clare A.
Shah, Pooja D.
Shapiro, Martin F.
Predictors of life-threatening complications in relatively lower-risk patients hospitalized with COVID-19
title Predictors of life-threatening complications in relatively lower-risk patients hospitalized with COVID-19
title_full Predictors of life-threatening complications in relatively lower-risk patients hospitalized with COVID-19
title_fullStr Predictors of life-threatening complications in relatively lower-risk patients hospitalized with COVID-19
title_full_unstemmed Predictors of life-threatening complications in relatively lower-risk patients hospitalized with COVID-19
title_short Predictors of life-threatening complications in relatively lower-risk patients hospitalized with COVID-19
title_sort predictors of life-threatening complications in relatively lower-risk patients hospitalized with covid-19
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8846540/
https://www.ncbi.nlm.nih.gov/pubmed/35167610
http://dx.doi.org/10.1371/journal.pone.0263995
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