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Predictors of COVID-19 Mortality in Residents of Flint, Michigan: Effect of Age, Gender, Smoking, and Health Plan
Published online by Cambridge University Press: 29 July 2021
Abstract
Background: Current literature suggests that older age, hypertension, and diabetes mellitus confer a significant increased risk of mortality among patients with COVID-19. The purpose of this study is to further characterize the predictors of mortality in patients with COVID-19 in residents of Flint, Michigan, based on variables such as gender, age, smoking status, health insurance plan, and comorbidities. Methods: Hurley Medical Center, is a 443-bed public, nonprofit, teaching medical center located in Flint, Michigan. In total, 289 consecutive adult patients (aged ≥18 years) with confirmed SARS-CoV-2 infection by nasal polymerase chain reaction (PCR), admitted and discharged from our facility from March 2020 through June 2020, were retrospectively analyzed. Results: During the 4-month study period, the overall in-hospital case fatality rate (CFR) was 18% (51 of 289), with highest CFR in the age group aged 60–69 years (36%; P = .06). Nonsurvivors tended to be older with mean age of 67 years (95% CI, 61.6–71.8) versus survivors with mean age of 60 years (95% CI, 57.7–62.4). Highest mortality was seen in patients with Medicare or Medicaid as their sole health plan (39%, P = .59). Men comprised 51% (148 of 289) of the cohort with CFR of 21% versus 14% in females. Females tended to be younger with a higher body mass index (BMI) than their male counterparts (mean age of 58 years, mean BMI of 35 in women vs a mean age of 62 and BMI of 29 in men). A higher proportion of deceased were active smokers (51%; P = .02). CFR was highest in patients with hypertension (92%,; P = .15), followed by diabetes (44%; P = .85), chronic kidney disease (CKD) (31%; P = .10), obstructive sleep apnea (OSA) (28%; P = .25), asthma (22%; P = .64), and coronary artery disease (22%; P = .34). It was lowest in patients with end-stage renal disease (3%; P = .69). Conclusions: Our study suggests trends towards higher mortality with male sex, hypertension and diabetes, along with other comorbidities. Smoking seems to be a strong predictor of mortality in this cohort. Further studies are needed to ascertain the relationship between possible risk factors with COVID-19 mortality in residents of Flint, Michigan. Describing and understanding the potential risk factors is the key to improving outcomes in this population.
Funding: No
Disclosures: None
- Type
- COVID-19
- Information
- Antimicrobial Stewardship & Healthcare Epidemiology , Volume 1 , Issue S1: SHEA Spring 2021 Abstracts , July 2021 , pp. s57 - s58
- Creative Commons
- This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
- Copyright
- © The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America