Characteristics of Patients Hospitalized With COVID-19

Younger patients hospitalized with COVID-19 frequently feature obesity as an underlying condition.

Older adults and those with one or more underlying conditions make up the highest number of coronavirus disease 2019 (COVID-19) hospitalizations, according to the US Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report.

The CDC investigators retrospectively examined medical histories and epidemiological data from 1482 patients hospitalized with COVID-19 through March in order to categorize hospitalizations among patients. The investigators used COVID-NET to identify their patients.

The study authors wrote that 75% of their patients were aged greater than 50 years and about half were male. About 12% of the patients had data on their underlying conditions, and the most common conditions were hypertension, obesity, chronic lung disease, diabetes, and cardiovascular disease.

For patients aged 18-49 years, obesity was the most prevalent underlying condition, followed by chronic lung disease (mostly asthma, the study authors explained), and diabetes.

For older patients, obesity was also prevalent, followed by hypertension and diabetes. The oldest patients saw hypertension, followed by cardiovascular disease and diabetes, as their most common underlying condition.

“These findings suggest that older adults have elevated rates of COVID-19-associated hospitalization and the majority of persons hospitalized with COVID-19 have underlying medical conditions,” the study authors wrote.

“These findings underscore the importance of preventive measures (eg, social distancing, respiratory hygiene, and wearing face coverings in public settings where social distancing measures are difficult to maintain) to protect older adults and persons with underlying medical conditions, as well as the general public.”

Through the month of March, the COVID-19-associated hospitalization rate was 4.6 per 100,000 persons. However hospitalization rates increased by age: 0.3 in persons aged 0-4 years; 0.1 in patients aged between 5 and 17 years; 2.5 in those aged 18-49 years; 7.4 in those aged 50-64 years; and 13.8 in those older than 65 years.

Hospitalizations occurred more in men, the study authors found (5.1 vs. 4.1 per 100,000, respectively). The investigators also had data on race and ethnicity for 580 patients and determined that 45% were white, 33% were black, 8% were Hispanic, and 5% were Asian. Less than 1 percent of the patients were American Indian/Alaskan Native, they added, while about 8% were of other or unknown race.

The median interval from symptom onset to hospital admission was 7 days, the study authors found, after examining the available data from 167 patients. The most common symptoms at admission were cough (86% of patients), fever or chills (85% of patients), and shortness of breath (80% of patients). The investigators also noted gastrointestinal symptoms were common: about a quarter of patients had diarrhea and another quarter of patients presented with nausea or vomiting, they said.

“Early data from COVID-NET suggest that COVID-19—associated hospitalizations in the United States are highest among older adults, and nearly 90% of persons hospitalized have one or more underlying medical conditions,” the study authors concluded.

“Ongoing monitoring of hospitalization rates, clinical characteristics, and outcomes of hospitalized patients will be important to better understand the evolving epidemiology of COVID-19 in the United States and the clinical spectrum of disease, and to help guide planning and prioritization of health care system resources.”