Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 6;73(11):e4113-e4123.
doi: 10.1093/cid/ciaa1787.

Impact of Sex and Metabolic Comorbidities on Coronavirus Disease 2019 (COVID-19) Mortality Risk Across Age Groups: 66 646 Inpatients Across 613 U.S. Hospitals

Katherine E Goodman  1 , Laurence S Magder  1 , Jonathan D Baghdadi  1 , Lisa Pineles  1 , Andrea R Levine  2 , Eli N Perencevich  3 , Anthony D Harris  1
Affiliations

Impact of Sex and Metabolic Comorbidities on Coronavirus Disease 2019 (COVID-19) Mortality Risk Across Age Groups: 66 646 Inpatients Across 613 U.S. Hospitals

Katherine E Goodman et al. Clin Infect Dis. .

Abstract

Background: The relationship between common patient characteristics, such as sex and metabolic comorbidities, and mortality from coronavirus disease 2019 (COVID-19) remains incompletely understood. Emerging evidence suggests that metabolic risk factors may also vary by age. This study aimed to determine the association between common patient characteristics and mortality across age-groups among COVID-19 inpatients.

Methods: We performed a retrospective cohort study of patients discharged from hospitals in the Premier Healthcare Database between April-June 2020. Inpatients were identified using COVID-19 ICD-10-CM diagnosis codes. A priori-defined exposures were sex and present-on-admission hypertension, diabetes, obesity, and interactions between age and these comorbidities. Controlling for additional confounders, we evaluated relationships between these variables and in-hospital mortality in a log-binomial model.

Results: Among 66 646 (6.5%) admissions with a COVID-19 diagnosis, across 613 U.S. hospitals, 12 388 (18.6%) died in-hospital. In multivariable analysis, male sex was independently associated with 30% higher mortality risk (aRR, 1.30, 95% CI: 1.26-1.34). Diabetes without chronic complications was not a risk factor at any age (aRR 1.01, 95% CI: 0.96-1.06), and hypertension without chronic complications was a risk factor only in 20-39 year-olds (aRR, 1.68, 95% CI: 1.17-2.40). Diabetes with chronic complications, hypertension with chronic complications, and obesity were risk factors in most age-groups, with highest relative risks among 20-39 year-olds (respective aRRs 1.79, 2.33, 1.92; P-values ≤ .002).

Conclusions: Hospitalized men with COVID-19 are at increased risk of death across all ages. Hypertension, diabetes with chronic complications, and obesity demonstrated age-dependent effects, with the highest relative risks among adults aged 20-39.

Keywords: COVID-19; claims data; hypertension; metabolic comorbidities; sex.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
In-hospital mortality by decade of life among inpatients with coronavirus disease 2019 (COVID-19) diagnoses (n = 66 646).
Figure 2.
Figure 2.
In-hospital mortality by decade of life and month of admission among inpatients with coronavirus disease 2019 (COVID-19) diagnoses (n = 66 646).
See this image and copyright information in PMC

References

    1. Gupta S, Hayek SS, Wang W, et al. Factors associated with death in critically ill patients with coronavirus disease 2019 in the US. JAMA Intern Med 2020; 180:1436–46. - PMC - PubMed
    1. Banerjee A, Pasea L, Harris S, et al. Estimating excess 1-year mortality associated with the COVID-19 pandemic according to underlying conditions and age: a population-based cohort study. Lancet 2020; 395:1715–25. - PMC - PubMed
    1. Grasselli G, Zangrillo A, Zanella A, et al. ; COVID-19 Lombardy ICU Network . Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020; 323:1574–81. - PMC - PubMed
    1. Miller LE, Bhattacharyya R, Miller AL. Diabetes mellitus increases the risk of hospital mortality in patients with Covid-19: Systematic review with meta-analysis. Medicine (Baltimore) 2020; 99:e22439. - PMC - PubMed
    1. Jie L, Daniel QH, Biyao Z, et al. Epidemiology of COVID‐19: A systematic review and meta‐analysis of clinical characteristics, risk factors, and outcomes. J Med Virol Available at: https://onlinelibrary.wiley.com/doi/10.1002/jmv.26424. Accessed 3 November 2020. - DOI - PMC - PubMed

Publication types