COVID-19 death risk and comorbidities
In 31,461 US adults with COVID-19, older age, male sex, Black race, and several comorbidities including heart disease predicted higher mortality.
Source
Comorbidities associated with mortality in 31,461 adults with COVID-19 in the United States: A federated electronic medical record analysis
Study at a glance
- Design
- Cohort — Federated US EMR analysis (Jan–May 2020) across 24 organisations
- N
- N=31461 · Adults with COVID-19 codes or positive tests
- Population
- US adults with COVID-19 in a multi-organisation federated EMR network
- Outcome
- Mortality associations with Charlson comorbidities and demographics
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COVID-19 death risk and comorbidities
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
31,461 adults were included in analyses.
Therefore, 31,461 patients were included in analyses.
Median age was 50 years and 54.5% were female.
The median (IQR) age was 50 (35–63) years and 54.5% ( n = 17,155) were female.
What they did
Investigators analysed federated EMR data from 24 US organisations (Jan–May 2020) to relate Charlson comorbidities and demographics to mortality among adults with COVID-19 codes or positive tests.
What they found
Mortality associated with increasing age, male sex, Black vs white race, prior MI, heart failure, dementia, chronic lung, liver, and renal disease, and metastatic solid tumour; common comorbidities included COPD and diabetes.
The limits
What it doesn't show
Causal effects of treating comorbidities, hospital vs community severity nuance, and complete ethnicity data (nearly a quarter unknown) remain limited.
Key terms
- Charlson comorbidity index
- Weighted list of chronic conditions used to summarise comorbidity burden.
- Federated EMR network
- Multi-site electronic records analysed without centralising identifiable charts.
- Myocardial infarction
- Heart attack from coronary artery blockage, a key cardiac history factor.
- Congestive heart failure
- Heart’s inability to pump adequately, linked here to COVID mortality.
- Odds of mortality
- Relative likelihood of dying comparing exposed vs unexposed groups.
- COVID-19
- Disease caused by SARS-CoV-2 infection.
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Analytic sample size was about:
Common questions
How large was the analytic sample?
31,461 adults after excluding missing age/sex and patients under 18.
Which cardiac histories mattered?
Prior myocardial infarction and congestive heart failure were associated with mortality.
What were the most common comorbidities?
Chronic pulmonary disease (17.5%) and diabetes (15.0%).
Was comorbidity universal?
No—about 59.5% had none of the listed Charlson comorbidities recorded.
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