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Griggs, Eric P; Mitchell, Patrick K; Lazariu, Victoria; Gaglani, Manjusha; McEvoy, Charlene; Klein, Nicola P; Valvi, Nimish R; Irving, Stephanie A; Kojima, Noah; Stenehjem, Edward; Crane, Bradley; Rao, Suchitra; Grannis, Shaun J; Embi, Peter J; Kharbanda, Anupam B; Ong, Toan C; Natarajan, Karthik; Dascomb, Kristin; Naleway, Allison L; Bassett, Elizabeth; DeSilva, Malini B; Dickerson, Monica; Konatham, Deepika; Fireman, Bruce; [...]

Clinical Epidemiology and Risk Factors for Critical Outcomes Among Vaccinated and Unvaccinated Adults Hospitalized With COVID-19—VISION Network, 10 States, June 2021–March 2023

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  • Media type: E-Article
  • Title: Clinical Epidemiology and Risk Factors for Critical Outcomes Among Vaccinated and Unvaccinated Adults Hospitalized With COVID-19—VISION Network, 10 States, June 2021–March 2023
  • Contributor: Griggs, Eric P; Mitchell, Patrick K; Lazariu, Victoria; Gaglani, Manjusha; McEvoy, Charlene; Klein, Nicola P; Valvi, Nimish R; Irving, Stephanie A; Kojima, Noah; Stenehjem, Edward; Crane, Bradley; Rao, Suchitra; Grannis, Shaun J; Embi, Peter J; Kharbanda, Anupam B; Ong, Toan C; Natarajan, Karthik; Dascomb, Kristin; Naleway, Allison L; Bassett, Elizabeth; DeSilva, Malini B; Dickerson, Monica; Konatham, Deepika; Fireman, Bruce; [...]
  • imprint: Oxford University Press (OUP), 2024
  • Published in: Clinical Infectious Diseases
  • Language: English
  • DOI: 10.1093/cid/ciad505
  • ISSN: 1058-4838; 1537-6591
  • Keywords: Infectious Diseases ; Microbiology (medical)
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>The epidemiology of coronavirus disease 2019 (COVID-19) continues to develop with emerging variants, expanding population-level immunity, and advances in clinical care. We describe changes in the clinical epidemiology of COVID-19 hospitalizations and risk factors for critical outcomes over time.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We included adults aged ≥18 years from 10 states hospitalized with COVID-19 June 2021–March 2023. We evaluated changes in demographics, clinical characteristics, and critical outcomes (intensive care unit admission and/or death) and evaluated critical outcomes risk factors (risk ratios [RRs]), stratified by COVID-19 vaccination status.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 60 488 COVID-19–associated hospitalizations were included in the analysis. Among those hospitalized, median age increased from 60 to 75 years, proportion vaccinated increased from 18.2% to 70.1%, and critical outcomes declined from 24.8% to 19.4% (all P &amp;lt; .001) between the Delta (June–December, 2021) and post-BA.4/BA.5 (September 2022–March 2023) periods. Hospitalization events with critical outcomes had a higher proportion of ≥4 categories of medical condition categories assessed (32.8%) compared to all hospitalizations (23.0%). Critical outcome risk factors were similar for unvaccinated and vaccinated populations; presence of ≥4 medical condition categories was most strongly associated with risk of critical outcomes regardless of vaccine status (unvaccinated: adjusted RR, 2.27 [95% confidence interval {CI}, 2.14–2.41]; vaccinated: adjusted RR, 1.73 [95% CI, 1.56–1.92]) across periods.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The proportion of adults hospitalized with COVID-19 who experienced critical outcomes decreased with time, and median patient age increased with time. Multimorbidity was most strongly associated with critical outcomes.</jats:p> </jats:sec>