Clinical Trends Among US Adults Hospitalized With COVID-19, March to December 2020 A Cross-Sectional Study

被引：43

作者：

Garg, Shikha ^{[1
,2
]}

Patel, Kadam ^{[3
]}

Pham, Huong ^{[1
]}

Whitaker, Michael ^{[1
]}

O'Halloran, Alissa ^{[1
]}

Milucky, Jennifer ^{[1
]}

Anglin, Onika ^{[3
]}

Kirley, Pam D. ^{[4
]}

Reingold, Arthur ^{[4
]}

Kawasaki, Breanna ^{[5
]}

Herlihy, Rachel ^{[5
]}

Yousey-Hindes, Kimberly ^{[6
]}

Maslar, Amber ^{[6
]}

Anderson, Evan J. ^{[7
]}

Openo, Kyle P. ^{[8
]}

Weigel, Andrew

Teno, Kenzie

Ryan, Patricia A. ^{[9
]}

Monroe, Maya L. ^{[9
]}

Reeg, Libby ^{[10
]}

Kim, Sue ^{[10
]}

Como-Sabetti, Kathryn

Bye, Erica

Davis, Sarah Shrum ^{[11
]}

Eisenberg, Nancy ^{[11
]}

Muse, Alison ^{[12
]}

Barney, Grant ^{[12
]}

Bennett, Nancy M. ^{[13
]}

Felsen, Christina B. ^{[13
]}

Billing, Laurie ^{[14
]}

Shiltz, Jess ^{[14
]}

Sutton, Melissa ^{[15
]}

Abdullah, Nasreen ^{[15
]}

Talbot, H. Keipp ^{[16
]}

Schaffner, William ^{[16
]}

Hill, Mary ^{[17
]}

Chatelain, Ryan ^{[17
]}

Wortham, Jonathan ^{[1
,2
]}

Taylor, Christopher ^{[1
]}

Hall, Aron ^{[1
]}

Fry, Alicia M. ^{[1
,2
]}

Kim, Lindsay ^{[1
,2
]}

Havers, Fiona P. ^{[1
,2
]}

机构：

[1] Ctr Dis Control & Prevent, 1600 Clifton Rd NE,MS H24-7, Atlanta, GA 30329 USA

[2] US PHS, Rockville, MD USA

[3] Ctr Dis Control & Prevent & Gen Dynam Informa, Atlanta, GA USA

[4] Calif Emerging Infect Program, Oakland, CA USA

[5] Colorado Dept Publ Hlth & Environm, Denver, CO USA

[6] Yale Sch Publ Hlth, Connecticut Emerging Infect Program, New Haven, CT USA

[7] Emory Univ, Sch Med & Georgia Emerging Infect Program, Georgia Dept Hlth, Atlanta, GA USA

[8] Georgia Dept Hlth, Georgia Emerging Infect Program, Atlanta, GA USA

[9] Iowa Dept Publ Hlth, Des Moines, IA USA

[10] Michigan Dept Hlth & Human Serv, Lansing, MI USA

[11] New Mexico Dept Hlth, Santa Fe, NM USA

[12] New York State Dept Hlth, Albany, NY USA

[13] Univ Rochester, Sch Med & Dent, Rochester, NY USA

[14] Ohio Dept Hlth, Columbus, OH USA

[15] Oregon Hlth Author, Portland, OR USA

[16] Vanderbilt Univ, Sch Med, Nashville, TN USA

[17] Salt Lake Cty Hlth Dept, Salt Lake City, UT USA

来源：

ANNALS OF INTERNAL MEDICINE | 2021年 / 174卷 / 10期

关键词：

NEW-YORK-CITY; UNITED-STATES; OUTCOMES; RATES;

D O I：

10.7326/M21-1991

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The COVID-19 pandemic has caused substantial morbidity and mortality. Objective: To describe monthly clinical trends among adults hospitalized with COVID-19. Design: Pooled cross-sectional study. Setting: 99 counties in 14 states participating in the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network (COVID-NET). Patients: U.S. adults (aged >= 18 years) hospitalized with laboratory-confirmed COVID-19 during 1 March to 31 December 2020. Measurements: Monthly hospitalizations, intensive care unit (ICU) admissions, and in-hospital death rates per 100 000 persons in the population; monthly trends in weighted percentages of interventions, including ICU admission, mechanical ventilation, and vasopressor use, among an age- and site-stratified random sample of hospitalized case patients. Results: Among 116 743 hospitalized adults with COVID-19, the median age was 62 years, 50.7% were male, and 40.8% were non-Hispanic White. Monthly rates of hospitalization (105.3 per 100 000 persons), ICU admission (20.2 per 100 000 persons), and death (11.7 per 100 000 persons) peaked during December 2020. Rates of all 3 outcomes were highest among adults aged 65 years or older, males, and Hispanic or non-Hispanic Black persons. Among 18 508 sampled hospitalized adults, use of remdesivir and systemic corticosteroids increased from 1.7% and 18.9%, respectively, in March to 53.8% and 74.2%, respectively, in December. Frequency of ICU admission, mechanical ventilation, and vasopressor use decreased from March (37.8%, 27.8%, and 22.7%, respectively) to December (20.5%, 12.3%, and 12.8%, respectively); use of noninvasive respiratory support increased from March to December. Limitation: COVID-NET covers approximately 10% of the U.S. population; findings may not be generalizable to the entire country. Conclusion: Rates of COVID-19-associated hospitalization, ICU admission, and death were highest in December 2020, corresponding with the third peak of the U.S. pandemic. The frequency of intensive interventions for management of hospitalized patients decreased over time. These data provide a longitudinal assessment of clinical trends among adults hospitalized with COVID-19 before widespread implementation of COVID-19 vaccines.

引用

页码：1409 / +

页数：13

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