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Characteristics and Clinical Outcomes of Adult Patients Hospitalized with COVID-19 – Georgia, March 2020

Our take —

In this study from mostly metropolitan Atlanta, Black patients represented a higher-than-expected proportion of COVID-19 hospitalizations, but were not more likely to die or receive invasive mechanical ventilation than a combined group of non-Black patients. These patterns should continue to be monitored, and rigorous multivariable analyses (including socio-economic factors, for example) are warranted. As expected, younger patients and those without high-risk conditions were less likely to be admitted to the ICU, receive invasive mechanical ventilation, or die.

Study design

Retrospective cohort

Study population and setting

This convenience sample includes 305 adults with laboratory-confirmed COVID-19 who were selected sequentially from 698 adult patients hospitalized at one of eight Georgia hospitals between March 1 and March 30, 2020.

Summary of Main Findings

The median age of patients was 60 years, 50.5% were female, 83.2% were Black, and 73.8% had a condition that put them at high-risk for COVID-19. Overall, 39% of patients were admitted to an ICU, and, of those, 30.2% received invasive mechanical ventilation (IMV). Most patients (76.4%) were discharged alive, 7.9% were still hospitalized at the time of analysis, and 17.1% of patients died. In unadjusted analyses, Black patients (versus non-Black patients) were not more likely to receive IMV or to die; these results were supported by an adjusted time-to-event model with a composite outcome of death or IMV.

Study Strengths

This report details clinical data on a decently sized, multi-site cohort of hospitalized patients in Georgia. Time-to-event analysis was used with censoring to account for patients still hospitalized and not receiving IMV.

Limitations

The selection process of the convenience sample isn’t well defined. Patients were not followed after discharge. Medical record data may differ by hospital. The multivariable model was based on a stepwise selection approach, which can lead to residual confounding. The main outcome was a composite of death or IMV. The authors do not provide a breakdown of non-Black racial/ethnic groups.

Value added

This study highlights clinical and epidemiologic characteristics of COVID-19 patients from a somewhat large cohort of hospitalized patients in metropolitan Atlanta and southern Georgia.