SESSION TITLE: COVID-19 Infections: Issues During and After Hospitalization
SESSION TYPE: Original Investigations
PRESENTED ON: 10/17/2022 01:30 pm - 02:30 pm
PURPOSE: We present a retrospective study at one of the largest public, safety-net hospitals in the United States to highlight the importance of codifying the impact of COVID-19 disparities in marginalized populations. We used the following metrics to draw conclusions: patient demographics, vaccination status, comorbid conditions, length of stay (LOS), readmission rates, and clinical outcome.
METHODS: For this retrospective study, we used Slicer Dicer software (Epic Verona, WI), an Epic self-service reporting tool, to query clinical data and identified a cohort of 9,040 patients ≥ 18 years old diagnosed with COVID-10 at Grady Memorial Hospital in Atlanta from 1/1/21 to 12/31/21. Statistical significance was defined as p<0.05.
RESULTS: Of the 9,040 patients, 54.7% were female (4,942) and 45.3% were male (4,096). The cohort median age was 51 (range 18 – 100) and 80.5% were African American (7,278/9,040). Double-dose vaccination rate was only 24.5% (2,215/9,040). 38.3% of patients diagnosed with COVID-19 were admitted (3,467/9,040) and among these patients 3.0% were re-admitted (107/3,467). The most prevalent comorbidities were essential hypertension (45.2%), diabetes (21.7%), and asthma (13.2%). Patients with these comorbidities were more likely to be discharged as opposed to being admitted. Patients with the following comorbidities were more likely to be admitted: Pulmonary hypertension (70% admission rate), COPD (64.9%), heart failure (61.0%), cancer (60.8%), atrial fibrillation (57.1%). Median LOS from admission was 4 days and there was no statistical difference among different comorbidities. We found higher mortality in COVID-19 patients with cancer (12.9%), atrial fibrillation (12.6%), heart failure (11.1%), pulmonary hypertension (10.1%) and COPD (9.1%) compared to patients with diabetes (7.5%), hypertension (6.7%), HIV (4.8%), DVT/PE (4.6%), or asthma (2.7%). When examining overall mortality based on self- reported race, we found that African American patients had a statistically significant higher mortality compared to Caucasian patients (p-value= 0.00454).
CONCLUSIONS: Current retrospective study, which included COVID-19 patients with different comorbidities showed that COVID-19 patients with pulmonary hypertension have worse clinical outcomes compared to other comorbid conditions.
CLINICAL IMPLICATIONS: Our findings suggest the importance of investigating COVID-19 disparities in marginalized populations to better understand the impact in these communities. All individuals should be encouraged to get vaccinated against COVID-19, especially those found to be at high risk of severe illness such as pulmonary hypertension. In this retrospective study, we found higher hospital admission rate and worse outcomes in patients with cancer, atrial fibrillation, heart failure, and pulmonary hypertension, as well as higher mortality among the African American patient population.
DISCLOSURES: No relevant relationships by nicolas bakinde
No relevant relationships by Suvrat Chandra
No relevant relationships by Michelle Lee
no disclosure on file for Mario Ponce;