PLoS ONE (Jan 2020)

Pre-existing traits associated with Covid-19 illness severity.

  • Joseph E Ebinger,
  • Natalie Achamallah,
  • Hongwei Ji,
  • Brian L Claggett,
  • Nancy Sun,
  • Patrick Botting,
  • Trevor-Trung Nguyen,
  • Eric Luong,
  • Elizabeth H Kim,
  • Eunice Park,
  • Yunxian Liu,
  • Ryan Rosenberry,
  • Yuri Matusov,
  • Steven Zhao,
  • Isabel Pedraza,
  • Tanzira Zaman,
  • Michael Thompson,
  • Koen Raedschelders,
  • Anders H Berg,
  • Jonathan D Grein,
  • Paul W Noble,
  • Sumeet S Chugh,
  • C Noel Bairey Merz,
  • Eduardo Marbán,
  • Jennifer E Van Eyk,
  • Scott D Solomon,
  • Christine M Albert,
  • Peter Chen,
  • Susan Cheng

Journal volume & issue
Vol. 15, no. 7
p. e0236240


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ImportanceCertain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear.ObjectiveTo determine the demographic and clinical characteristics associated with increased severity of Covid-19 infection.DesignRetrospective observational study. We curated data from the electronic health record, and used multivariable logistic regression to examine the association of pre-existing traits with a Covid-19 illness severity defined by level of required care: need for hospital admission, need for intensive care, and need for intubation.SettingA large, multihospital healthcare system in Southern California.ParticipantsAll patients with confirmed Covid-19 infection (N = 442).ResultsOf all patients studied, 48% required hospitalization, 17% required intensive care, and 12% required intubation. In multivariable-adjusted analyses, patients requiring a higher levels of care were more likely to be older (OR 1.5 per 10 years, PConclusions and relevanceIn our healthcare system, greater Covid-19 illness severity is seen in patients who are older, male, African American, obese, with diabetes, and with greater overall comorbidity burden. Certain comorbidities paradoxically augment risk to a greater extent in younger patients. In hospitalized patients, male sex is the main determinant of needing more intensive care. Further investigation is needed to understand the mechanisms underlying these findings.