Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID‐19 patients in Michigan, United States

Imam, Zaid; Odish, Fadi; Gill, Inayat; O'Connor, Daniel; Armstrong, Justin; Vanood, Aimen; Ibironke, Oluwatoyin; Hanna, Angy; Ranski, Alexandra; Halalau, Alexandra

INTRODUCTION: Higher comorbidity and older age have been reported as correlates of poor outcomes in COVID‐19 patients worldwide, however US data is scarce. We evaluated mortality predictors of COVID‐19 in a large cohort of hospitalized patients in the US. DESIGN: Retrospective, multicenter cohort of inpatients diagnosed with COVID‐19 by RT‐PCR from March 1‐April 1,2020 was performed, and outcome data evaluated from March 1‐April 17, 2020. Measures included demographics, comorbidities, clinical presentation, laboratory values, and imaging on admission. Primary outcome was mortality. Secondary outcomes included length of stay, time to death, and development of acute kidney injury in the first 48‐hours. RESULTS: 1305 patients were hospitalized during the evaluation period. Mean age was 61.0±16.3, 53.8% were male and 66.1% African‐American. Mean BMI was 33.2±8.8 kg/m2. Median Charlson Comorbidity Index (CCI) was 2 (1‐4), 72.6% of patients had at least one comorbidity, with hypertension (56.2%) and diabetes mellitus (30.1%) being the most prevalent. ACE‐I/ARB use and NSAIDs use were widely prevalent (43.3% and 35.7% respectively). Mortality occurred in 200 (15.3%) of patients with median time of 10 (6‐14) days. Age >60 (aOR:1.93,95% CI:1.26‐2.94), and CCI>3 (aOR:2.71,95% CI:1.85‐3.97) were independently associated with mortality by multivariate analyses. NSAIDs and ACE‐I/ARB use had no significant effects on renal failure in the first 48 hours. CONCLUSION: Advanced age and an increasing number of comorbidities are independent predictors of in‐hospital mortality for COVID‐19 patients. NSAIDs and ACE‐I/ARB use prior to admission is not associated with renal failure or increased mortality.