About: Covid-19 Testing, Hospital Admission, and Intensive Care Among 2,026,227 United States Veterans Aged 54

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About: Covid-19 Testing, Hospital Admission, and Intensive Care Among 2,026,227 United States Veterans Aged 54–75 Years Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Covid-19 Testing, Hospital Admission, and Intensive Care Among 2,026,227 United States Veterans Aged 54–75 Years
Creator	Crothers, Kristina Jarvis, Christopher Akgün, Kathleen Freiberg, Matthew Justice, Amy Rentsch, Christopher Schultze, Anna Hauser, Ronald Holodniy, Mark Kidwai-Khan, Farah King, Joseph Park, Lesley Skanderson, Melissa Taddei, Tamar Tate, Janet Re, Vincent
Source	MedRxiv; Medline; PMC
abstract	IMPORTANCE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes coronavirus disease 2019 (Covid-19), an evolving pandemic. Limited data are available characterizing SARS-Cov-2 infection in the United States. OBJECTIVE: To determine associations between demographic and clinical factors and testing positive for coronavirus 2019 (Covid-19+), and among Covid-19+ subsequent hospitalization and intensive care. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study including all patients tested for Covid-19 between February 8 and March 30, 2020, inclusive. We extracted electronic health record data from the national Veterans Affairs Healthcare System, the largest integrated healthcare system in the United States, on 2,026,227 patients born between 1945 and 1965 and active in care. EXPOSURES: Demographic data, comorbidities, medication history, substance use, vital signs, and laboratory measures. Laboratory tests were analyzed first individually and then grouped into a validated summary measure of physiologic injury (VACS Index). MAIN OUTCOMES AND MEASURES: We evaluated which factors were associated with Covid-19+ among all who tested. Among Covid-19+ we identified factors associated with hospitalization or intensive care. We identified independent associations using multivariable and conditional multivariable logistic regression with multiple imputation of missing values. RESULTS: Among Veterans aged 54–75 years, 585/3,789 (15.4%) tested Covid-19+. In adjusted analysis (C-statistic=0.806) black race was associated with Covid-19+ (OR 4.68, 95% Cl 3.795.78) and the association remained in analyses conditional on site (OR 2.56, 95% Cl 1.89–3.46). In adjusted models, laboratory abnormalities (especially fibrosis-4 score [FIB-4] >3.25 OR 8.73, 95% Cl 4.11–18.56), and VACS Index (per 5-point increase OR 1.62, 95% Cl 1.43–1.84) were strongly associated with hospitalization. Associations were similar for intensive care. Although significant in unadjusted analyses, associations with comorbid conditions and medications were substantially reduced and, in most cases, no longer significant after adjustment. CONCLUSIONS AND RELEVANCE: Black race was strongly associated with Covid-19+, but not with hospitalization or intensive care. Among Covid-19+, risk of hospitalization and intensive care may be better characterized by laboratory measures and vital signs than by comorbid conditions or prior medication exposure.
has issue date	2020-04-14(xsd:dateTime)
bibo:doi	10.1101/2020.04.09.20059964
bibo:pmid	32511595
has license	cc-by-nc-nd
schema:url	https://doi.org/10.1101/2020.04.09.20059964
resource representing a document's title	Covid-19 Testing, Hospital Admission, and Intensive Care Among 2,026,227 United States Veterans Aged 54–75 Years
has PubMed Central identifier	PMC7276022
has PubMed identifier	32511595
schema:publication	medRxiv
resource representing a document's body	covid:PMC7276022#body_text
is schema:about of	named entity 'Hospital' named entity 'HOSPITAL ADMISSION' named entity 'COVID-19' named entity '75 Years' named entity 'inflammation' named entity 'eGFR' named entity 'vital signs' named entity 'albumin' named entity 'positive test' named entity 'chronic kidney disease' named entity 'diabetes' named entity 'comorbid conditions' named entity 'vital signs' named entity 'pharmacy' named entity 'angiotensin II receptor blockers' named entity 'infection' named entity 'NSAIDS' named entity 'COPD' named entity 'body mass index' named entity 'Covid-19' named entity 'respiratory failure' named entity 'coronavirus disease 2019' named entity 'intensive care' named entity 'Covid' named entity 'confidence intervals' named entity 'Covid' named entity 'Birth Cohort' named entity 'white blood cell count' named entity 'Severe acute respiratory syndrome coronavirus 2' named entity 'hepatic' named entity 'COPD' named entity 'White blood cell count' named entity 'pharmacoepidemiological' named entity 'Covid' named entity 'ICU' named entity 'infection' named entity 'statistical significance' named entity 'intensive care' named entity 'comorbid diagnoses' named entity 'SARS-CoV-2' named entity 'liver disease' named entity 'immunosuppressive drugs' named entity 'systolic blood pressure' named entity 'diabetes' named entity 'hypertension' named entity 'Institutional Review Boards' named entity 'fever' named entity 'intensive care unit' named entity 'nonsteroidal anti-inflammatory drugs' named entity 'Connecticut' named entity 'epidemic' named entity 'ARBs' named entity 'electronic health record' named entity 'alcohol use disorder' named entity 'tachycardia' named entity 'Yale University' named entity 'Covid' named entity 'intensive care' named entity 'vital signs' named entity 'cytokine storm' named entity 'intensive care' named entity 'intensive care' named entity 'BMI' named entity 'Covid-19' named entity 'Covid' named entity 'emergency use authorization' named entity 'Covid'

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