Impact of Sex and Metabolic Comorbidities on COVID-19 Mortality Risk Across Age Groups: 66,646 Inpatients Across 613 U.S. Hospitals

Katherine E Goodman; Laurence S Magder; Jonathan D Baghdadi; Lisa Pineles; Andrea R Levine; Eli N Perencevich; Anthony D Harris

doi:10.1093/cid/ciaa1787

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Impact of Sex and Metabolic Comorbidities on COVID-19 Mortality Risk Across Age Groups: 66,646 Inpatients Across 613 U.S. Hospitals

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Impact of Sex and Metabolic Comorbidities on COVID-19 Mortality Risk Across Age Groups: 66,646 Inpatients Across 613 U.S. Hospitals

Katherine E Goodman, Laurence S Magder, Jonathan D Baghdadi, Lisa Pineles, Andrea R Levine, Eli N Perencevich and Anthony D Harris

Clinical infectious diseases, Vol.73(11), pp.e4113-e4123

12/18/2020

DOI: 10.1093/cid/ciaa1787

PMID: 33337474

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Abstract

Background The relationship between common patient characteristics, such as sex and metabolic comorbidities, and mortality from coronavirus disease 2019 (COVID-19) remains incompletely understood. Emerging evidence suggests that metabolic risk factors may also vary by age. This study aimed to determine the association between common patient characteristics and mortality across age-groups among COVID-19 inpatients. Methods We performed a retrospective cohort study of patients discharged from hospitals in the Premier Healthcare Database between April–June 2020. Inpatients were identified using COVID-19 ICD-10-CM diagnosis codes. A priori-defined exposures were sex and present-on-admission hypertension, diabetes, obesity, and interactions between age and these comorbidities. Controlling for additional confounders, we evaluated relationships between these variables and in-hospital mortality in a log-binomial model. Results Among 66 646 (6.5%) admissions with a COVID-19 diagnosis, across 613 U.S. hospitals, 12 388 (18.6%) died in-hospital. In multivariable analysis, male sex was independently associated with 30% higher mortality risk (aRR, 1.30, 95% CI: 1.26–1.34). Diabetes without chronic complications was not a risk factor at any age (aRR 1.01, 95% CI: 0.96–1.06), and hypertension without chronic complications was a risk factor only in 20–39 year-olds (aRR, 1.68, 95% CI: 1.17–2.40). Diabetes with chronic complications, hypertension with chronic complications, and obesity were risk factors in most age-groups, with highest relative risks among 20–39 year-olds (respective aRRs 1.79, 2.33, 1.92; P-values ≤ .002). Conclusions Hospitalized men with COVID-19 are at increased risk of death across all ages. Hypertension, diabetes with chronic complications, and obesity demonstrated age-dependent effects, with the highest relative risks among adults aged 20–39.

Hypertension

COVID-19

MED00290

Major

Claims Data

Metabolic Comorbidities

Sex

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Title: Subtitle: Impact of Sex and Metabolic Comorbidities on COVID-19 Mortality Risk Across Age Groups: 66,646 Inpatients Across 613 U.S. Hospitals
Creators: Katherine E Goodman - The University of Maryland School of Medicine
Laurence S Magder - The University of Maryland School of Medicine
Jonathan D Baghdadi - The University of Maryland School of Medicine
Lisa Pineles - The University of Maryland School of Medicine
Andrea R Levine - The University of Maryland School of Medicine
Eli N Perencevich - The University of Iowa Carver College of Medicine
Anthony D Harris - The University of Maryland School of Medicine
Resource Type: Journal article
Publication Details: Clinical infectious diseases, Vol.73(11), pp.e4113-e4123
DOI: 10.1093/cid/ciaa1787
PMID: 33337474
NLM abbreviation: Clin Infect Dis
ISSN: 1058-4838
eISSN: 1537-6591
Publisher: Oxford University Press; US
Grant note: DOI: 10.13039/100017046, name: University of Maryland School of Medicine
Language: English
Date published: 12/18/2020
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9984077378302771

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