Higher hospitalization and mortality rates among SARS-CoV-2-infected persons in rural America.

Humans United States / epidemiology SARS-CoV-2 COVID-19 / epidemiology Rural Population Retrospective Studies Hospitalization
COVID-19 SARS-CoV-2 hospitalization mortality urban-rural health

Journal

The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
ISSN: 1748-0361
Titre abrégé: J Rural Health
Pays: England
ID NLM: 8508122

Informations de publication

Date de publication:
01 2023
Historique:
pubmed: 28 6 2022
medline: 23 12 2022
entrez: 27 6 2022
Statut: ppublish

Résumé

Rural communities are among the most underserved and resource-scarce populations in the United States. However, there are limited data on COVID-19 outcomes in rural America. This study aims to compare hospitalization rates and inpatient mortality among SARS-CoV-2-infected persons stratified by residential rurality. This retrospective cohort study from the National COVID Cohort Collaborative (N3C) assesses 1,033,229 patients from 44 US hospital systems diagnosed with SARS-CoV-2 infection between January 2020 and June 2021. Primary outcomes were hospitalization and all-cause inpatient mortality. Secondary outcomes were utilization of supplemental oxygen, invasive mechanical ventilation, vasopressor support, extracorporeal membrane oxygenation, and incidence of major adverse cardiovascular events or hospital readmission. The analytic approach estimates 90-day survival in hospitalized patients and associations between rurality, hospitalization, and inpatient adverse events while controlling for major risk factors using Kaplan-Meier survival estimates and mixed-effects logistic regression. Of 1,033,229 diagnosed COVID-19 patients included, 186,882 required hospitalization. After adjusting for demographic differences and comorbidities, urban-adjacent and nonurban-adjacent rural dwellers with COVID-19 were more likely to be hospitalized (adjusted odds ratio [aOR] 1.18, 95% confidence interval [CI], 1.16-1.21 and aOR 1.29, CI 1.24-1.1.34) and to die or be transferred to hospice (aOR 1.36, CI 1.29-1.43 and 1.37, CI 1.26-1.50), respectively. All secondary outcomes were more likely among rural patients. Hospitalization, inpatient mortality, and other adverse outcomes are higher among rural persons with COVID-19, even after adjusting for demographic differences and comorbidities. Further research is needed to understand the factors that drive health disparities in rural populations.

Identifiants

DOI: 10.1111/jrh.12689 PMID: 35758856 PMC: PMC9349606
pubmed: 35758856
doi: 10.1111/jrh.12689
pmc: PMC9349606
mid: NIHMS1816611
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

39-54

Subventions

Organisme : NIGMS NIH HHS
ID : U54 GM104938
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM115458
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001453
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM104940
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001422
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001860
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM104942
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM104941
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002373
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001439
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001873
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM115677
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR003142
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM115516
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002001
Pays : United States
Organisme : NCATS NIH HHS
ID : U24 TR002306
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001436
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002240
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002556
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM115428
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002345
Pays : United States

Informations de copyright

© 2022 The Authors. The Journal of Rural Health published by Wiley Periodicals LLC on behalf of National Rural Health Association.

Références

JAMA Netw Open. 2020 Oct 1;3(10):e2022111
pubmed: 33090226
J Am Board Fam Med. 2021 Feb;34(Suppl):S247-S249
pubmed: 33622847
J Rural Health. 2021 Mar;37(2):272-277
pubmed: 33619806
J Am Coll Surg. 2006 Nov;203(5):599-604
pubmed: 17084319
J Rural Health. 2021 Mar;37(2):287-295
pubmed: 33619836
Am J Public Health. 2004 Oct;94(10):1723-9
pubmed: 15451741
J Am Med Inform Assoc. 2020 Dec 9;27(12):1999-2010
pubmed: 33166397
Int J Environ Res Public Health. 2019 May 16;16(10):
pubmed: 31100851
Health Aff (Millwood). 2019 Dec;38(12):1976-1984
pubmed: 31794301
Proc Natl Acad Sci U S A. 2021 Jan 5;118(1):
pubmed: 33328335
JAMIA Open. 2018 Oct;1(2):147-152
pubmed: 30474072
JAMA Netw Open. 2021 Jul 1;4(7):e2116901
pubmed: 34255046
JAMA Netw Open. 2021 Jul 01;4(7):e2117060
pubmed: 34259847
MMWR Morb Mortal Wkly Rep. 2021 Apr 09;70(14):523-527
pubmed: 33830982
MMWR Morb Mortal Wkly Rep. 2020 Nov 20;69(46):1753
pubmed: 33211682
Health Equity. 2021 Jun 08;5(1):394-397
pubmed: 34235363
MMWR Morb Mortal Wkly Rep. 2019 Jun 14;68(23):513-518
pubmed: 31194722
Am J Public Health. 2004 Oct;94(10):1762-7
pubmed: 15451747
Am J Public Health. 2008 Aug;98(8):1470-2
pubmed: 18556611
J Urban Health. 2014 Apr;91(2):272-92
pubmed: 24366854
J Am Med Inform Assoc. 2021 Mar 1;28(3):427-443
pubmed: 32805036
Am J Epidemiol. 2011 Mar 15;173(6):676-82
pubmed: 21330339
PLoS Med. 2015 Oct 06;12(10):e1001885
pubmed: 26440803
J Health Econ Outcomes Res. 2021 May 11;8(1):51-62
pubmed: 34017883
Am J Prev Med. 2014 Feb;46(2):e19-29
pubmed: 24439358
JCO Clin Cancer Inform. 2018 Dec;2:1-10
pubmed: 30652541
Int J Environ Res Public Health. 2020 Oct 01;17(19):
pubmed: 33019735
J Rural Health. 2021 Jan;37(1):124-132
pubmed: 33155723
Lancet Infect Dis. 2020 May;20(5):533-534
pubmed: 32087114
JAMA. 2021 Jun 8;325(22):2312-2314
pubmed: 34100876
BMJ Health Care Inform. 2020 Mar;27(1):
pubmed: 32229499
J Rural Health. 2020 Mar;36(2):274-280
pubmed: 30913340
JAMA Netw Open. 2021 May 3;4(5):e218799
pubmed: 33938935
MMWR Morb Mortal Wkly Rep. 2021 Apr 09;70(14):519-522
pubmed: 33830988
J Community Health. 2010 Aug;35(4):365-74
pubmed: 20386968
J Rural Health. 2021 Mar;37(2):278-286
pubmed: 33619746
PLoS One. 2021 Jul 23;16(7):e0255063
pubmed: 34297747
Health Aff (Millwood). 2019 Dec;38(12):1993-2002
pubmed: 31794307
J Rural Health. 2017 Apr;33(2):167-179
pubmed: 27557442
Int J Environ Res Public Health. 2021 Aug 04;18(16):
pubmed: 34444007

Auteurs

Alfred Jerrod Anzalone (AJ)

University of Nebraska Medical Center, Omaha, Nebraska, USA.
Great Plains IDeA-CTR, Omaha, Nebraska, USA.
ORCID: 0000-0002-3212-7845

Ronald Horswell (R)

Pennington Biomedical Research Centre, Baton Rouge, Louisiana, USA.
LA CaTS Center, Baton Rouge, Louisiana, USA.

Brian M Hendricks (BM)

West Virginia University, Morgantown, West Virginia, USA.
West Virginia Clinical and Translational Sciences Institute, Morgantown, West Virginia, USA.

San Chu (S)

Pennington Biomedical Research Centre, Baton Rouge, Louisiana, USA.
LA CaTS Center, Baton Rouge, Louisiana, USA.

William B Hillegass (WB)

University of Mississippi Medical Center, Jackson, Mississippi, USA.
Mississippi Center for Clinical and Translational Research, Jackson, Mississippi, USA.

William H Beasley (WH)

University of Oklahoma, Norman, Oklahoma, USA.
Oklahoma Clinical and Translational Science Institute, Oklahoma City, Oklahoma, USA.

Jeremy R Harper (JR)

Owl Health Works LLC, Indianapolis, Indiana, USA.

Wesley Kimble (W)

West Virginia University, Morgantown, West Virginia, USA.
West Virginia Clinical and Translational Sciences Institute, Morgantown, West Virginia, USA.
ORCID: 0000-0003-3325-3808

Clifford J Rosen (CJ)

Maine Medical Center Research Institute, Scarborough, Maine, USA.
Northern New England Clinical & Translational Research Network, Burlington, Vermont, USA.

Lucio Miele (L)

LA CaTS Center, Baton Rouge, Louisiana, USA.
Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.

James C McClay (JC)

University of Nebraska Medical Center, Omaha, Nebraska, USA.
Great Plains IDeA-CTR, Omaha, Nebraska, USA.

Susan L Santangelo (SL)

Maine Medical Center Research Institute, Scarborough, Maine, USA.
Northern New England Clinical & Translational Research Network, Burlington, Vermont, USA.
Tufts University School of Medicine, Boston, Massachusetts, USA.

Sally L Hodder (SL)

West Virginia University, Morgantown, West Virginia, USA.
West Virginia Clinical and Translational Sciences Institute, Morgantown, West Virginia, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

Recherchemedicale.com › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Higher hospitalization and mortality rates...
Recherchemedicale.com › Régions géographiques › Amériques › Amérique du Nord › États-Unis › Higher hospitalization and mortality rates...
Recherchemedicale.com › Virus › Virus à ARN › Virus à ARN à brin positif › Nidovirales › Coronaviridae › Coronavirus › Betacoronavirus › Virus du SRAS › SARS-CoV-2 › Higher hospitalization and mortality rates...
Recherchemedicale.com › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Higher hospitalization and mortality rates...
Recherchemedicale.com › Caractéristiques de la population › Population › Population rurale › Higher hospitalization and mortality rates...
Recherchemedicale.com › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Higher hospitalization and mortality rates...
Recherchemedicale.com › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Higher hospitalization and mortality rates...