We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Clinical Epidemiology and Risk Factors for Critical Outcomes Among Vaccinated and Unvaccinated Adults Hospitalized With COVID-19—VISION Network, 10 States, June 2021–March 2023.
- Authors
Griggs, Eric P; Mitchell, Patrick K; Lazariu, Victoria; Gaglani, Manjusha; McEvoy, Charlene; Klein, Nicola P; Valvi, Nimish R; Irving, Stephanie A; Kojima, Noah; Stenehjem, Edward; Crane, Bradley; Rao, Suchitra; Grannis, Shaun J; Embi, Peter J; Kharbanda, Anupam B; Ong, Toan C; Natarajan, Karthik; Dascomb, Kristin; Naleway, Allison L; Bassett, Elizabeth
- Abstract
Background The epidemiology of coronavirus disease 2019 (COVID-19) continues to develop with emerging variants, expanding population-level immunity, and advances in clinical care. We describe changes in the clinical epidemiology of COVID-19 hospitalizations and risk factors for critical outcomes over time. Methods We included adults aged ≥18 years from 10 states hospitalized with COVID-19 June 2021–March 2023. We evaluated changes in demographics, clinical characteristics, and critical outcomes (intensive care unit admission and/or death) and evaluated critical outcomes risk factors (risk ratios [RRs]), stratified by COVID-19 vaccination status. Results A total of 60 488 COVID-19–associated hospitalizations were included in the analysis. Among those hospitalized, median age increased from 60 to 75 years, proportion vaccinated increased from 18.2% to 70.1%, and critical outcomes declined from 24.8% to 19.4% (all P <.001) between the Delta (June–December, 2021) and post-BA.4/BA.5 (September 2022–March 2023) periods. Hospitalization events with critical outcomes had a higher proportion of ≥4 categories of medical condition categories assessed (32.8%) compared to all hospitalizations (23.0%). Critical outcome risk factors were similar for unvaccinated and vaccinated populations; presence of ≥4 medical condition categories was most strongly associated with risk of critical outcomes regardless of vaccine status (unvaccinated: adjusted RR, 2.27 [95% confidence interval {CI}, 2.14–2.41]; vaccinated: adjusted RR, 1.73 [95% CI, 1.56–1.92]) across periods. Conclusions The proportion of adults hospitalized with COVID-19 who experienced critical outcomes decreased with time, and median patient age increased with time. Multimorbidity was most strongly associated with critical outcomes.
- Subjects
UNITED States; MORTALITY risk factors; EVALUATION of medical care; INTENSIVE care units; RELATIVE medical risk; COVID-19; IMMUNIZATION; CONFIDENCE intervals; AGE distribution; PATIENTS; CATASTROPHIC illness; RISK assessment; HOSPITAL admission &; discharge; HOSPITAL mortality; HOSPITAL care; VACCINATION status; COMORBIDITY; DISEASE complications; EVALUATION
- Publication
Clinical Infectious Diseases, 2024, Vol 78, Issue 2, p338
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciad505