Table 3. Most Frequent Underlying Medical Conditionsa and Their Association With the Risk of ICU Admission, IMV, and Death Among Adults Hospitalized With COVID-19, Stratified By Age Group, in Premier Healthcare Database Special COVID-19 Release (PHD-SR), March 2020–March 2021.
| Underlying Medical Condition (CCSR Category)b | No. (%) | Risk Ratio (95% CI)c |
||
|---|---|---|---|---|
| Death | IMV | ICU Admission | ||
| Aged 18–39 (n = 59,697) | ||||
| Obesity | 22,055 (36.9) | 2.20 (1.96–2.47) | 1.76 (1.63–1.89) | 1.30 (1.26–1.35) |
| Diabetes | 10,648 (17.9) | — | — | — |
| With complication | 7,737 (13.0) | 1.84 (1.62–2.08) | 1.70 (1.59–1.83) | 1.58 (1.51–1.65) |
| Without complication | 2,911 (4.9) | 1.11 (0.89–1.37) | 0.99 (0.87–1.13) | 1.13 (1.07–1.18) |
| Essential hypertension | 9,964 (16.7) | 1.26 (1.10–1.44) | 1.25 (1.17–1.35) | 1.11 (1.07–1.15) |
| Anxiety and fear-related disorders | 9,031 (15.1) | 1.26 (1.07–1.48) | 1.58 (1.45–1.71) | 1.28 (1.24–1.33) |
| Asthma | 8,524 (14.3) | 0.95 (0.81–1.10) | 0.99 (0.91–1.08) | 1.09 (1.05–1.13) |
| Tobacco-related disorders | 7,240 (12.1) | 0.81 (0.68–0.98) | 0.97 (0.89–1.05) | 1.07 (1.03–1.11) |
| Depressive disorders | 5,980 (10.0) | 0.96 (0.79–1.17) | 0.89 (0.80–0.98) | 0.99 (0.94–1.03) |
| Aged 40–64 (n = 195,897) | ||||
| Essential hypertension | 98,498 (50.3) | 0.92 (0.89–0.95) | 0.96 (0.94–0.99) | 0.99 (0.98–1.00) |
| Diabetes | 87,009 (44.4) | — | — | — |
| With complication | 62,980 (32.1) | 1.43 (1.38–1.48) | 1.51 (1.46–1.55) | 1.18 (1.16–1.21) |
| Without complication | 24,029 (12.3) | 0.93 (0.88–0.99) | 0.92 (0.88–0.96) | 0.97 (0.95–0.99) |
| Obesity | 82,782 (42.3) | 1.54 (1.47–1.61) | 1.58 (1.52–1.63) | 1.16 (1.13–1.19) |
| Disorders of lipid metabolism | 79,899 (40.8) | 0.91 (0.88–0.95) | 0.95 (0.92–0.98) | 0.98 (0.97–1.00) |
| Esophageal disorders | 42,121 (21.5) | 0.93 (0.89–0.96) | 0.92 (0.90–0.95) | 0.97 (0.95–0.99) |
| Anxiety and fear-related disorders | 36,978 (18.9) | 1.35 (1.29–1.41) | 1.46 (1.41–1.51) | 1.14 (1.12–1.16) |
| Chronic kidney disease | 31,911 (16.3) | 1.30 (1.23–1.37) | 1.09 (1.05–1.13) | 1.04 (1.02–1.06) |
| Sleep–wake disorders | 31,499 (16.1) | 0.85 (0.81–0.89) | 0.97 (0.93–1.00) | 0.99 (0.97–1.01) |
| Coronary atherosclerosis and other heart disease | 29,609 (15.1) | 1.14 (1.10–1.19) | 1.09 (1.06–1.13) | 1.09 (1.07–1.11) |
| Depressive disorders | 28,929 (14.8) | 0.83 (0.80–0.87) | 0.86 (0.83–0.89) | 0.95 (0.93–0.97) |
| Asthma | 25,618 (13.1) | 0.90 (0.86–0.94) | 0.93 (0.90–0.96) | 0.99 (0.97–1.01) |
| Thyroid disorders | 24,118 (12.3) | 1.03 (0.99–1.08) | 1.05 (1.01–1.09) | 1.03 (1.01–1.05) |
| Other specified status | 23,773 (12.1) | 1.07 (1.01–1.13) | 1.01 (0.96–1.06) | 1.01 (0.99–1.03) |
| Tobacco-related disorders | 22,893 (11.7) | 0.85 (0.81–0.89) | 0.90 (0.87–0.94) | 0.99 (0.98–1.01) |
| Chronic obstructive pulmonary disease and bronchiectasis | 21,690 (11.1) | 1.32 (1.26–1.38) | 1.26 (1.22–1.31) | 1.09 (1.07–1.11) |
| Aplastic anemia | 19,726 (10.1) | 1.32 (1.24–1.40) | 1.30 (1.24–1.36) | 1.11 (1.09–1.13) |
| Aged ≥65 (n = 285,073) | ||||
| Disorders of lipid metabolism | 182,267 (63.9) | 0.93 (0.91–0.95) | 0.95 (0.93–0.97) | 0.99 (0.98–1.00) |
| Essential hypertension | 164,129 (57.6) | 0.89 (0.87–0.90) | 0.86 (0.85–0.88) | 0.94 (0.93–0.96) |
| Diabetes | 133,883 (46.9) | — | — | — |
| With complication | 101,010 (35.4) | 1.21 (1.19–1.23) | 1.36 (1.33–1.40) | 1.11 (1.10–1.13) |
| Without complication | 32,873 (11.5) | 0.93 (0.90–0.96) | 0.89 (0.86–0.93) | 0.97 (0.95–0.99) |
| Coronary atherosclerosis and other heart disease | 103,987 (36.5) | 1.12 (1.11–1.14) | 1.11 (1.08–1.13) | 1.08 (1.07–1.09) |
| Chronic kidney disease | 97,802 (34.3) | 1.16 (1.13–1.19) | 1.04 (1.02–1.07) | 1.02 (1.01–1.04) |
| Esophageal disorders | 86,699 (30.4) | 0.96 (0.94–0.97) | 0.95 (0.93–0.98) | 0.98 (0.96–0.99) |
| Obesity | 73,316 (25.7) | 1.23 (1.20–1.25) | 1.42 (1.38–1.47) | 1.13 (1.11–1.15) |
| Neurocognitive disorders | 71,741 (25.2) | 1.11 (1.09–1.14) | 0.84 (0.81–0.86) | 1.00 (0.98–1.01) |
| Chronic obstructive pulmonary disease and bronchiectasis | 69,781 (24.5) | 1.14 (1.12–1.16) | 1.16 (1.13–1.18) | 1.09 (1.07–1.10) |
| Implant device or graft-related encounter | 64,343 (22.6) | 0.98 (0.96–0.99) | 0.92 (0.90–0.94) | 0.98 (0.97–0.99) |
| Thyroid disorders | 63,889 (22.4) | 1.03 (1.01–1.05) | 1.03 (1.00–1.05) | 1.02 (1.01–1.03) |
| Osteoarthritis | 58,125 (20.4) | 0.93 (0.91–0.95) | 0.91 (0.89–0.94) | 0.97 (0.95–0.99) |
| Anxiety and fear-related disorders | 52,837 (18.5) | 1.26 (1.23–1.29) | 1.27 (1.24–1.30) | 1.11 (1.10–1.13) |
| Depressive disorders | 50,241 (17.6) | 0.90 (0.88–0.92) | 0.87 (0.84–0.89) | 0.95 (0.94–0.97) |
| Other specified status | 45,419 (15.9) | 1.04 (1.01–1.06) | 0.97 (0.94–1.00) | 1.00 (0.98–1.02) |
| Hyperplasia of prostate | 44,618 (15.7) | 0.91 (0.89–0.93) | 0.90 (0.88–0.92) | 0.97 (0.96–0.98) |
| Sleep–wake disorders | 43,027 (15.1) | 0.98 (0.95–1.00) | 1.03 (1.00–1.06) | 1.00 (0.98–1.01) |
| Aplastic anemia | 41,091 (14.4) | 1.07 (1.05–1.10) | 1.09 (1.06–1.13) | 1.07 (1.05–1.09) |
| Malnutrition | 32,036 (11.2) | 1.39 (1.35–1.43) | 1.68 (1.61–1.76) | 1.22 (1.19–1.25) |
| Nervous system pain and pain syndromes | 31,129 (10.9) | 0.94 (0.91–0.96) | 0.89 (0.86–0.91) | 0.95 (0.94–0.97) |
Abbreviations: ICU, intensive care unit; IMV, invasive mechanical ventilation; CCSR, Clinical Classifications Software Refined.
Underlying medical conditions were defined by 1) using Chronic Condition Indicator to identify chronic International Classification of Diseases, Tenth Revision, Clinical Modification codes; 2) aggregating the codes into a smaller number of meaningful categories by using the CCSR; 3) a clinical review of CCSR categories that classified the CCSR codes as “likely underlying,” “indeterminate,” and “likely acute”; 4) including only “likely underlying” CCSR categories and excluding “indeterminate” and “likely acute” CCSR categories.
The reference category for each condition is the absence of that condition; the reference category for diabetes with complication and diabetes without complication is the absence of diabetes.
Each column includes the results of a generalized linear model (with Poisson distribution and log link function), stratified by age group (18–39, 40–64, ≥65) that includes frequent (present in ≥10.0% of patients) underlying medical conditions, age, sex, race/ethnicity, payer type, hospital urbanicity, US Census region of hospital, admission month, and admission month squared. Patients who died without using ICU care or IMV were excluded from the sample when estimating the model with the outcome of ICU care or IMV, respectively.