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10.15585/mmwr.mm6942e3

http://scihub22266oqcxt.onion/10.15585/mmwr.mm6942e3
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33090987!7583498!33090987
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suck abstract from ncbi


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pmid33090987      MMWR+Morb+Mortal+Wkly+Rep 2020 ; 69 (42): 1528-1534
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  • Risk for In-Hospital Complications Associated with COVID-19 and Influenza - Veterans Health Administration, United States, October 1, 2018-May 31, 2020 #MMPMID33090987
  • Cates J; Lucero-Obusan C; Dahl RM; Schirmer P; Garg S; Oda G; Hall AJ; Langley G; Havers FP; Holodniy M; Cardemil CV
  • MMWR Morb Mortal Wkly Rep 2020[Oct]; 69 (42): 1528-1534 PMID33090987show ga
  • Coronavirus disease 2019 (COVID-19) is primarily a respiratory illness, although increasing evidence indicates that infection with SARS-CoV-2, the virus that causes COVID-19, can affect multiple organ systems (1). Data that examine all in-hospital complications of COVID-19 and that compare these complications with those associated with other viral respiratory pathogens, such as influenza, are lacking. To assess complications of COVID-19 and influenza, electronic health records (EHRs) from 3,948 hospitalized patients with COVID-19 (March 1-May 31, 2020) and 5,453 hospitalized patients with influenza (October 1, 2018-February 1, 2020) from the national Veterans Health Administration (VHA), the largest integrated health care system in the United States,* were analyzed. Using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes, complications in patients with laboratory-confirmed COVID-19 were compared with those in patients with influenza. Risk ratios were calculated and adjusted for age, sex, race/ethnicity, and underlying medical conditions; proportions of complications were stratified among patients with COVID-19 by race/ethnicity. Patients with COVID-19 had almost 19 times the risk for acute respiratory distress syndrome (ARDS) than did patients with influenza, (adjusted risk ratio [aRR] = 18.60; 95% confidence interval [CI] = 12.40-28.00), and more than twice the risk for myocarditis (2.56; 1.17-5.59), deep vein thrombosis (2.81; 2.04-3.87), pulmonary embolism (2.10; 1.53-2.89), intracranial hemorrhage (2.85; 1.35-6.03), acute hepatitis/liver failure (3.13; 1.92-5.10), bacteremia (2.46; 1.91-3.18), and pressure ulcers (2.65; 2.14-3.27). The risks for exacerbations of asthma (0.27; 0.16-0.44) and chronic obstructive pulmonary disease (COPD) (0.37; 0.32-0.42) were lower among patients with COVID-19 than among those with influenza. The percentage of COVID-19 patients who died while hospitalized (21.0%) was more than five times that of influenza patients (3.8%), and the duration of hospitalization was almost three times longer for COVID-19 patients. Among patients with COVID-19, the risk for respiratory, neurologic, and renal complications, and sepsis was higher among non-Hispanic Black or African American (Black) patients, patients of other races, and Hispanic or Latino (Hispanic) patients compared with those in non-Hispanic White (White) patients, even after adjusting for age and underlying medical conditions. These findings highlight the higher risk for most complications associated with COVID-19 compared with influenza and might aid clinicians and researchers in recognizing, monitoring, and managing the spectrum of COVID-19 manifestations. The higher risk for certain complications among racial and ethnic minority patients provides further evidence that certain racial and ethnic minority groups are disproportionally affected by COVID-19 and that this disparity is not solely accounted for by age and underlying medical conditions.
  • |*Hospitalization[MESH]
  • |Aged[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/*complications/epidemiology/ethnology/*therapy[MESH]
  • |Female[MESH]
  • |Health Status Disparities[MESH]
  • |Hospital Mortality/trends[MESH]
  • |Humans[MESH]
  • |Influenza, Human/*complications/epidemiology/*therapy[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*complications/epidemiology/ethnology/*therapy[MESH]
  • |Respiratory Tract Diseases/epidemiology/virology[MESH]
  • |Risk Assessment[MESH]
  • |United States Department of Veterans Affairs[MESH]


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