COVID-19 patients had a more than five times higher risk for in-hospital death

https://www.cdc.gov/mmwr/volumes/69/wr/mm6942e3.htm

Weekly / October 23, 2020 / 69(42);1528–1534

On October 20, 2020, this report was posted online as an MMWR Early Release.

Jordan Cates, PhD1,2; Cynthia Lucero-Obusan, MD3; Rebecca M. Dahl, MPH1; Patricia Schirmer, MD3; Shikha Garg, MD1,4; Gina Oda, MS3; Aron J. Hall, DVM1; Gayle Langley, MD1; Fiona P. Havers, MD1; Mark Holodniy, MD3,5; Cristina V. Cardemil, MD1,4 (View author affiliations)

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Hospitalized patients with COVID-19 in the Veterans Health Administration had a more than five times higher risk for in-hospital death and increased risk for 17 respiratory and nonrespiratory complications than did hospitalized patients with influenza. The risks for sepsis and respiratory, neurologic, and renal complications of COVID-19 were higher among non-Hispanic Black or African American and Hispanic patients than among non-Hispanic White patients.

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Patients with COVID-19 had almost 19 times the risk for acute respiratory distress syndrome (ARDS) than did patients with influenza, (adjusted risk ratio , and more than twice the risk for myocarditis , deep vein thrombosis , pulmonary embolism , intracranial hemorrhage , acute hepatitis/liver failure , bacteremia , and pressure ulcers.

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Compared with patients with influenza, patients with COVID-19 had two times the risk for pneumonia; 1.7 times the risk for respiratory failure; 19 times the risk for ARDS; 3.5 times the risk for pneumothorax; and statistically significantly increased risks for cardiogenic shock, myocarditis, deep vein thrombosis, pulmonary embolism, disseminated intravascular coagulation, cerebral ischemia or infarction, intracranial hemorrhage, acute kidney failure, dialysis initiation, acute hepatitis or liver failure, sepsis, bacteremia, and pressure ulcers (Figure). Patients with COVID-19 had a lower risk for five complications (asthma exacerbation, COPD exacerbation, acute myocardial infarction (MI) or unstable angina, acute congestive heart failure (CHF), and hypertensive crisis), although acute MI or unstable angina, acute CHF, and hypertensive crisis were not statistically significant when restricting to patients diagnosed during the same seasonal months.

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