Correlates of Coronavirus Disease 2019 Inpatient Mortality at a Southern California Community Hospital With a Predominantly Hispanic/Latino Adult Population

Nicole M Gatto; Debbie Freund; Pamela Ogata; Lisa Diaz; Ace Ibarrola; Mamta Desai; Thor Aspelund; Daniel Gluckstein

doi:10.1093/ofid/ofad011

Correlates of Coronavirus Disease 2019 Inpatient Mortality at a Southern California Community Hospital With a Predominantly Hispanic/Latino Adult Population

Open Forum Infect Dis. 2023 Jan 10;10(1):ofad011. doi: 10.1093/ofid/ofad011. eCollection 2023 Jan.

Authors

Nicole M Gatto^{1

2

3

4}, Debbie Freund^{5

6

7}, Pamela Ogata⁵, Lisa Diaz³, Ace Ibarrola³, Mamta Desai³, Thor Aspelund⁴, Daniel Gluckstein³

Affiliations

¹ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
² School of Public Health, Loma Linda University, Loma Linda, California, USA.
³ Pomona Valley Hospital and Medical Center, Pomona, California, USA.
⁴ Center for Public Health Sciences, University of Iceland, Reykjavik, Iceland.
⁵ School of Community and Global Health, Claremont Graduate University, Claremont, California, USA.
⁶ Department of Economic Sciences, Claremont Graduate University, Claremont, California, USA.
⁷ Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA.

Abstract

Background: Studies of inpatient coronavirus disease 2019 (COVID-19) mortality risk factors have mainly used data from academic medical centers or large multihospital databases and have not examined populations with large proportions of Hispanic/Latino patients. In a retrospective cohort study of 4881 consecutive adult COVID-19 hospitalizations at a single community hospital in Los Angeles County with a majority Hispanic/Latino population, we evaluated factors associated with mortality.

Methods: Data on demographic characteristics, comorbidities, laboratory and clinical results, and COVID-19 therapeutics were abstracted from the electronic medical record. Cox proportional hazards regression modeled statistically significant, independently associated predictors of hospital mortality.

Results: Age ≥65 years (hazard ratio [HR] = 2.66; 95% confidence interval [CI] = 1.90-3.72), male sex (HR = 1.31; 95% CI = 1.07-1.60), renal disease (HR = 1.52; 95% CI = 1.18-1.95), cardiovascular disease (HR = 1.45; 95% CI = 1.18-1.78), neurological disease (HR = 1.84; 95% CI = 1.41-2.39), D-dimer ≥500 ng/mL (HR = 2.07; 95% CI = 1.43-3.0), and pulse oxygen level <88% (HR = 1.39; 95% CI = 1.13-1.71) were independently associated with increased mortality. Patient household with (1) multiple COVID-19 cases and (2) Asian, Black, or Hispanic compared with White non-Hispanic race/ethnicity were associated with reduced mortality. In hypoxic COVID-19 inpatients, remdesivir, tocilizumab, and convalescent plasma were associated with reduced mortality, and corticosteroid use was associated with increased mortality.

Conclusions: We corroborate several previously identified mortality risk factors and find evidence that the combination of factors associated with mortality differ between populations.

Keywords: COVID-19; Hispanic; Latino; community hospital; mortality.