Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Sep 15, 2020)
Date Submitted: May 19, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Patient characteristics and pre-existing chronic diseases with COVID-19 related outcomes: a real-world experience
ABSTRACT
Background:
Significant variations in experience of the COVID-19 pandemic have been observed in the United States. However, there is currently no published study which comprehensively examines the relationship between patient characteristics and COVID-19 related health outcomes.
Objective:
In this study, using aggregated real-world data extracted from TriNetx electronic medical record data from 34 hospitals around United States, we intended to fill the gap.
Methods:
A total of 12,555 patients aged 18-80 years old who contracted COVID-19 were identified from January 20th to April 20th, 2020.
Results:
First, in the univariate analysis, we found that patients who were older (age 51-80), Black, male, and had pre-existing chronic diseases (e.g. obesity, diabetes, hypertension, and chronic kidney diseases (CKD)) had increased risk ratio (RR) of exhibiting severe outcomes, including increased C-reactive protein (CRP), decreased oxygen saturation, hospitalization, use of ventilator, and ultimately death. Next, we applied propensity score matching to match the patients based on their characteristics. We found that patients who were older, Black, male, and diagnosed with CKD had 3.69, 1.77, 1.75, and 1,61-fold increased RR of death. On the other hand, while obesity, diabetes, and hypertension had no direct relationship with death, they were associated with other severe outcomes. In further analysis by including CRP as a matching variable, death disparity by age group, race, gender, and CKD was reduced, particularly for race and CKD where a significant disparity was no longer observed.
Conclusions:
In summary, our data show significant disparities in COVID-19 related outcomes by patient characteristics and further suggest that acute inflammation plays an important role in the disparity in COVID-19 death.
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