International Journal of General Medicine (Feb 2022)

Predictors of Mortality for Patients with COVID-19 in the Rural Appalachian Region

  • Bhopalwala H,
  • Dewaswala N,
  • Kolagatla S,
  • Wisnieski L,
  • Piercy J,
  • Bhopalwala A,
  • Moka N

Journal volume & issue
Vol. Volume 15
pp. 2207 – 2214

Abstract

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Huzefa Bhopalwala,1 Nakeya Dewaswala,2 Sandhya Kolagatla,1 Lauren Wisnieski,3 Jonathan Piercy,1 Adnan Bhopalwala,1 Nagabhishek Moka1 1Department of Internal Medicine, Appalachian Regional Healthcare, Whitesburg, KY, USA; 2Department of Cardiovascular Disease, University of Kentucky, Lexington, KY, USA; 3Department of Public Health and Research, Lincoln Memorial University, Harrogate, TN, USACorrespondence: Nakeya Dewaswala, Department of Cardiovascular Disease, University of Kentucky, 900 South Limestone Street, Charles T. Wethington Building Rm. 326, Lexington, KY, 40536-0200, USA, Tel +1 4252136401, Email [email protected]: The prevalence and outcome of coronavirus disease 2019 (COVID-19) in rural areas is unknown.Methods: This is a multi-center retrospective cohort study of hospitalized patients diagnosed with COVID-19 from April 5, 2020 to December 31, 2020. The data were extracted from 13 facilities in the Appalachian Regional Healthcare system that share the same electronic health record using ICD-10-CM codes.Results: The number of patients diagnosed with COVID-19 per facility ranged from 5 to 535 with a median of 106 patients. Total mortality was 11.4% and ranged from 0% to 22.6% by facility (median: 9.0%). Non-survivors had a greater prevalence of congestive heart failure (CHF), hypertension, type 2 diabetes mellitus, stroke, transient ischemic attack (TIA), and pulmonary embolism. Patients who died were also more likely to have had chronic obstructive pulmonary disease (COPD), acute respiratory failure (ARF), liver cirrhosis, chronic kidney disease (CKD), dementia, cancer, anemia, and opiate dependence.Conclusion: The aging population, multiple co-morbidities, and health-related behaviors make rural patients vulnerable to COVID-19. A better understanding of the disease in rural areas is crucial, given its heightened vulnerability to adverse outcomes.Keywords: coronavirus, COVID-19, SARS-CoV-2, cohort, mortality, survival

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