期刊
OPEN FORUM INFECTIOUS DISEASES
卷 8, 期 12, 页码 -出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/ofid/ofab556
关键词
COVID-19; risk; predictive symptoms; burden; outcomes
资金
- Defense Health Program
- National Institute of Allergy and Infectious Disease [HU00011920111]
- National Institute of Allergy and Infectious Diseases at the National Institutes of Health [Y1-AI-5072]
In the first month after COVID-19 infection, older age, being of Asian, Black, or Hispanic race/ethnicity, and obesity are associated with an increased risk of SARS-CoV-2 hospitalization. Some acute cases of SARS-CoV-2 infection require long-term oxygen therapy, and the infection has a significant impact on short-term functional status. A considerable number of MHS beneficiaries had not returned to normal activities by 1 month post-infection.
Background. We evaluated clinical outcomes, functional burden, and complications 1 month after coronavirus disease 2019 (COVID-19) infection in a prospective US Military Health System (MHS) cohort of active duty, retiree, and dependent populations using serial patient-reported outcome surveys and electronic medical record (EMR) review. Methods. MHS beneficiaries presenting at 9 sites across the United States with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test, a COVID-19-like illness, or a high-risk SARS-CoV-2 exposure were eligible for enrollment. Medical history and clinical outcomes were collected through structured interviews and International Classification of Diseases-based EMR review. Risk factors associated with hospitalization were determined by multivariate logistic regression. Results. A total of 1202 participants were enrolled. There were 1070 laboratory-confirmed SARS-CoV-2 cases and 132 SARSCoV-2-negative participants. In the first month post-symptom onset among the SARS-CoV-2-positive cases, there were 212 hospitalizations, 80% requiring oxygen, 20 1CU admissions, and 10 deaths. Risk factors for COVID-19-associated hospitalization included race (increased for Asian, Black, and Hispanic compared with non-Hispanic White), age (age 45-64 and 65+ compared with <45), and obesity (BMI >= 30 compared with BMI <30). Over 2% of survey respondents reported the need for supplemental oxygen, and 31% had not returned to normal daily activities at 1 month post-symptom onset. Conclusions. Older age, reporting Asian, Black, or Hispanic race/ethnicity, and obesity are associated with SARS-CoV-2 hospitalization. A proportion of acute SARS-CoV-2 infections require long-term oxygen therapy; the impact of SARS-CoV-2 infection on short-term functional status was substantial. A significant number of MHS beneficiaries had not yet returned to normal activities by 1 month.
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