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SARS-CoV-2 proteins

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    Magnitude, change over time, demographic characteristics and geographic distribution of excess deaths MESHD among nursing home residents during the first wave of COVID-19 MESHD in France: a nationwide cohort study

    Authors: Florence Canoui-Poitrine; Antoine Rachas; Martine Thomas; Laure Carcaillon-Bentata; Romeo Fontaine; Gaetan Gavazzi; Marie Laurent; Jean-Marie Robine

    doi:10.1101/2021.01.09.20248472 Date: 2021-01-14 Source: medRxiv

    ImportanceNursing home ( NH MESHD) residents are particularly vulnerable to SARS-CoV-2 infections MESHD and coronavirus disease 2019 MESHD ( COVID-19 MESHD) lethality. However, excess deaths in this population have rarely been documented. ObjectivesThe primary objective was to assess the number of excess deaths MESHD among NH residents during the first wave of the COVID-19 pandemic MESHD in France. The secondary objectives were to determine the number of excess deaths MESHD as a proportion of the total excess deaths in the general population and determine whether a harvesting effect was present. DesignWe studied a cohort of 494,753 adults (as of March 1st, 2020) aged 60 and over in 6,515 NHs in mainland France. This cohort was exposed to the first wave of the COVID-19 pandemic MESHD (from March 1 HGNCst to May 31st, 2020) and was compared with the corresponding, reference cohorts from 2014 to 2019 (using data from the French National Health Data System). Main outcome and measuresThe main outcome was all-cause death MESHD. Weekly excess deaths and standardized mortality ratios (SMRs) were estimated. ResultThere were 13,505 excess deaths among NH residents. Mortality increased by 43% (SMR: 1.43). The mortality excess was higher among males than among females (SMR: 1.51 and 1.38, respectively) and decreased with age (SMRs in females: 1.61 in the 60-74 age group, 1.58 for 75-84, 1.41 for 85-94, and 1.31 for 95 or over; Males: SMRs: 1.59 for 60-74, 1.69 for 75-84, 1.47 for 85-94, and 1.41 for 95 or over). We did not observe a harvesting effect (up until August 30th, 2020). By extrapolating to all NH MESHD residents nationally (N=570,003), the latter accounted for 51% of the total excess deaths in the general population (N=15,114 out of 29,563). ConclusionNH residents accounted for about half of the total excess deaths in France during the first wave of the COVID-19 pandemic MESHD. The excess death rate was higher among males than females and among younger residents than among older residents. We did not observe a harvesting effect. A real-time mortality surveillance system and the identification of individual and environmental risk factors might help to design the future model of care for older dependent adults. Key pointsO_LIDuring the first wave of the COVID-19 pandemic MESHD in France, the mortality among nursing home residents increased by 43%. C_LIO_LINursing home residents accounted for 51% of the total excess deaths in France. C_LIO_LIThe excess mortality was higher among younger residents than among older residents. C_LIO_LIThe excess mortality was higher among males than among females. C_LIO_LIWe did not observe a harvesting effect during the study period (ending on August 30th, 2020, i.e., three months after the end of the first wave). C_LI

    Clinical Features and Outcomes of Critically Ill Patients with Coronavirus Disease 2019 MESHD ( COVID19 MESHD): A Multicenter Cohort Study

    Authors: Khalid Al Sulaiman; Ohoud A. Al Juhani; Khalid Eljaaly; Aisha A. Alharbi; Adel M. Al Shabasy; Alawi S. Alsaeedi; Mashael Al Mutairi; Hisham A. Badreldin; Shmeylan A. Al Harbi; Hussain A. Al Haji; Omar I. Al Zumai; Ramesh Vishwakarma; Abdulmalik Alkatheri

    doi:10.21203/rs.3.rs-129353/v1 Date: 2020-12-15 Source: ResearchSquare

    BackgroundA novel coronavirus, named Severe Acute Respiratory Syndrome Coronavirus 2 MESHD (SARS-CoV-2) causing coronavirus disease-19 MESHD ( COVID-19 MESHD) manifested by a broad spectrum of symptoms, ranging from asymptomatic manifestations to severe illness and death MESHD. The purpose of the study was to extensively describe the clinical features and outcomes in critically ill MESHD patients with COVID19 MESHD in Saudi Arabia. MethodA multi-center, non-interventional, observational study for all critically ill MESHD patients aged 18 years or older who are admitted to intensive care units (ICUs) between March 1 HGNCst to August 31st, 2020 with an objectively confirmed diagnosis of COVID19 MESHD. The diagnosis of COVID19 MESHD was confirmed by Reverse Transcriptase – Polymerase Chain Reaction (RT-PCR) on nasopharyngeal and/or throat swabs. Multivariate logistic regression and generalized linear regression were used. We considered a P value of < 0.05 statistically significant. ResultsA total of 560 patients met the inclusion criteria. The overall survival rate was 52.6 % (295 patients). Moreover, the overall ICU mortality rate within 30 days was 42.3 % (237 patients). The median ICU length of stay (LOS), hospital LOS, and mechanical ventilation duration were of 10 days (IQR 6.00-17.50), 17 days (IQR 11-25), and 9 days (IQR 3-17 days), respectively. The rate of ICU readmission for survival within three months was 9.7 %. An extensive list of clinical features was associated with ICU mortality rate within 30 days.ConclusionIn the most comprehensive report to date from Saudi Arabia, among patients with COVID19 MESHD who were admitted to the ICU, several variables were associated with increasing the risk of ICU death MESHD at 30 days, and the incidence of ICU mortality rate within 30 days 42.3%.

    The Individual and Social Determinants of COVID-19 MESHD in Ontario, Canada: A Population-Wide Study

    Authors: Maria Sundaram; Andrew Calzavara; Sharmistha Mishra; Rafal Kustra; Adrienne Chan; Mackenzie A. Hamilton; Mohamed Djebli; Laura A. Rosella; Tristan Watson; Hong Chen; Branson Chen; Stefan Baral; Jeff Kwong

    doi:10.1101/2020.11.09.20223792 Date: 2020-11-12 Source: medRxiv

    Importance: Optimizing the public health response to reduce coronavirus disease 2019 MESHD ( COVID-19 MESHD) burden necessitates characterizing population-level heterogeneity of COVID-19 MESHD risks. However, heterogeneity in severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) testing may introduce biased estimates depending on analytic design. Objective: Characterizing individual, environmental, and social determinants of SARS-CoV-2 testing and COVID-19 MESHD diagnosis. Design: We conducted cross-sectional analyses among 14.7 million people comparing individual, environmental, and social determinants among individuals who were tested versus not yet tested. Among those diagnosed, we used three analytic designs to compare predictors of: 1) individuals testing positive versus negative; 2) symptomatic individuals testing positive versus negative; and 3) individuals testing positive versus individuals not testing positive (i.e. testing negative or not being tested). Analyses included tests conducted between March 1 HGNC and June 20, 2020. Setting: Ontario, Canada. Participants: All individuals with [≥]1 healthcare system contact since March 2012, excluding individuals deceased before, or born after, March 1 HGNC, 2020, or residing in a long-term care facility. Exposures: Individual-level characteristics (age, sex, underlying health conditions, prior healthcare use), area-based environmental (air pollution) exposures, and area-based social determinants of health (income, education, housing, marital status, race/ethnicity, and recent immigration). Main Outcomes and Measures: Odds of SARS-CoV-2 test, and of COVID-19 MESHD diagnosis. Results: Of a total of 14,695,579 individuals, 758,691 had been tested, of whom 25,030 (3.3%) tested positive. The further the odds of testing from the null, the more variability observed in the odds of diagnosis across analytic design, particularly among individual factors. There was less variability in testing by social determinants across analytic design. Residing in areas with highest household density (adjusted odds ratio: 2.08; 95%CI: 1.95-1.21), lowest educational attainment (adjusted odds ratio: 1.52; 95%CI: 1.44-1.60), and highest proportion of recent immigrants (adjusted odds ratio: 1.12; 95%CI: 1.07-1.16) were consistently related to increased odds of COVID-19 MESHD across analytic designs. Conclusions and Relevance: Where testing is limited, risk factors may be better estimated using population comparators rather than test-negative comparators. Optimizing COVID-19 MESHD responses necessitates investment and sufficient coverage of structural interventions tailored to heterogeneity in social determinants of risk, including household crowding and systemic racism.

    Seroprevalence of Anti-SARS-CoV-2 Antibodies in a Cohort of New York City Metro Blood Donors using Multiple SARS-CoV-2 Serological Assays: Implications for Controlling the Epidemic and Reopening.

    Authors: Daniel K Jin; Daniel J Nesbitt; Jenny Yang; Haidee Chen; Julie Horowitz; Marcus Jones; Rianna Vandergaast; Timothy Carey; Samantha Reiter; Stephen J Russell; Christos Kyratsous; Andrea Hooper; Jennifer Hamilton; Manuel Ferreira; Sarah Deng; Donna Straus; Aris Baras; Christopher D Hillyer; Larry L Luchsinger

    doi:10.1101/2020.11.06.20220087 Date: 2020-11-07 Source: medRxiv

    Projections of the stage of the Severe Acute Respiratory Syndrome-Coronavirus-2 MESHD (SARS-CoV-2) pandemic and local, regional and national public health policies designed to limit the spread of the epidemic as well as reopen cities and states, are best informed by reproducible, high throughput, and statically credible antibody (Ab) assays. To date, a myriad of Ab tests, both available and authorized for emergency use by the FDA, has led to confusion MESHD rather than insight per se. The present study reports the results of a rapid, point-in-time 1,000-person cohort study using serial blood donors in the New York City metropolitan area (NYC) using multiple serological tests, including enzyme-linked immunosorbent assays (ELISAs) and high throughput serological assays (HTSAs). These were then tested and associated with assays for neutralizing Ab (NAb). Of the 1,000 NYC blood donor samples in late June and early July 2020, 12.1% and 10.9% were seropositive using the Ortho Total Ig and the Abbott IgG HTSA assays, respectively. These serological assays correlated with neutralization activity specific to SARS-CoV-2. The data reported herein suggest that seroconversion in this population occurred in approximately 1 in 8 blood donors from the beginning of the pandemic in NYC (considered March 1 HGNC, 2020). These findings deviate with an earlier seroprevalence study in NYC showing 13.7% positivity. Collectively however, these data demonstrate that a low number of individuals have serologic evidence of infection during this first wave and suggest that the notion of herd immunity at rates of ~60% or higher are not near. Furthermore, the data presented herein show that the nature of the Ab-based immunity is not invariably associated with the development of NAb. While the blood donor population may not mimic precisely the NYC population as a whole, rapid assessment of seroprevalence in this cohort and serial reassessment could aid public health decision making.

    Low-density lipoprotein cholesterol levels are associated with poor clinical outcomes in COVID-19 MESHD

    Authors: Alvaro Aparisi; Carolina Iglesias-Echeverria; Cristina Ybarra-Falcon; Ivan Cusacovich; Aitor Uribarri; Mario Garcia-Gomez; Raquel Ladron; Raul Fuertes; Jordi Candela; Williams Hinojosa; Carlos Duenas; Roberto Gonzalez; Leonor Nogales-Martin; Dolores Calvo; Manuel Carrasco-Moraleja; J. Alberto San Roman; Ignacio J Amat-Santos; David Andaluz Ojeda

    doi:10.1101/2020.10.06.20207092 Date: 2020-10-08 Source: medRxiv

    Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the sole causative agent of coronavirus infectious disease MESHD-19 ( COVID-19 MESHD). Methods: We performed a retrospective single-center study of consecutively admitted patients between March 1 HGNCst and May 15th, 2020, with a definitive diagnosis of SARS-CoV-2 infection MESHD. The primary endpoint was to evaluate the association of lipid markers with 30-days all-cause mortality in COVID-19 MESHD. Results: A total of 654 patients were enrolled, with an estimated 30-day mortality of 22.8% (149 patients). Non-survivors had lower total cholesterol (TC) and low-density lipoprotein cholesterol ( LDL-c HGNC) levels during the entire course of the disease with complete resolution among survivors. Both showed a significant inverse correlation with inflammatory markers and a positive correlation with lymphocyte count. In a multivariate analysis, LDL-c HGNC < 69 mg/dl (hazard ratio [HR] 1.94; 95% confidence interval [CI] 1.14-3.31), C-reactive protein HGNC > 88 mg/dl (HR 2.44; 95% CI, 1.41-4.23) and lymphopenia MESHD < 1000 cells/ml (HR 2.68; 95% CI, 1.91-3.78) at admission were independently associated with 30-day mortality. This association was maintained 7 days after admission. Conclusion: Hypolipidemia in SARS-CoV-2 infection MESHD SARS-CoV-2 infection MESHD may be secondary to an immune-inflammatory response, with complete recovery in survivors. Low LDL-c HGNC serum levels are independently associated with higher 30-day mortality in COVID-19 MESHD patients.

    Development and calibration of a simple mortality risk score for hospitalized COVID-19 MESHD adults

    Authors: Edwin Yoo; Bethany Percha; Max Tomlinson; Victor Razuk; Stephanie Pan; Madeleine Basist; Pranai Tandon; Jing Gennie Wang; Cynthia Gao; Sonali Bose; Umesh K Gidwani

    doi:10.1101/2020.08.31.20185363 Date: 2020-09-02 Source: medRxiv

    Objectives: Mortality risk scores, such as SOFA, qSOFA, and CURB-65, are quick, effective tools for communicating a patient's prognosis and guiding therapeutic decisions. Most use simple calculations that can be performed by hand. While several COVID-19 MESHD specific risk scores exist, they lack the ease of use of these simpler scores. The objectives of this study were (1) to design, validate, and calibrate a simple, easy-to-use mortality risk score for COVID-19 MESHD patients and (2) to recalibrate SOFA, qSOFA, and CURB-65 in a hospitalized COVID-19 MESHD population. Design: Retrospective cohort study incorporating demographic, clinical, laboratory, and admissions data from electronic health records. Setting: Multi-hospital health system in New York City. Five hospitals were included: one quaternary care facility, one tertiary care facility, and three community hospitals. Participants: Patients (n=4840) with laboratory-confirmed SARS-CoV2 infection MESHD who were admitted between March 1 HGNC and April 28, 2020. Main outcome measures: Gray's K-sample test for the cumulative incidence of a competing risk was used to assess and rank 48 different variables' associations with mortality. Candidate variables were added to the composite score using DeLong's test to evaluate their effect on predictive performance (AUC) of in-hospital mortality. Final AUCs for the new score, SOFA, qSOFA, and CURB-65 were assessed on an independent test set. Results: Of 48 variables investigated, 36 (75%) displayed significant (p<0.05 by Gray's test) associations with mortality. The variables selected for the final score were (1) oxygen support level, (2) troponin, (3) blood urea nitrogen, (4) lymphocyte percentage, (5) Glasgow Coma MESHD Score, and (6) age. The new score, COBALT, outperforms SOFA, qSOFA, and CURB-65 at predicting mortality in this COVID-19 MESHD population: AUCs for initial, maximum, and mean COBALT scores were 0.81, 0.91, and 0.92, compared to 0.77, 0.87, and 0.87 for SOFA. We provide COVID-19 MESHD specific mortality estimates at all score levels for COBALT, SOFA, qSOFA, and CURB-65. Conclusions: The COBALT score provides a simple way to estimate mortality risk in hospitalized COVID-19 MESHD patients with superior performance to SOFA and other scores currently in widespread use. Evaluation of SOFA, qSOFA, and CURB-65 in this population highlights the importance of recalibrating mortality risk scores when they are used under novel conditions, such as the COVID-19 pandemic MESHD. This study's approach to score design could also be applied in other contexts to create simple, practical and high-performing mortality risk scores.

    Comparison of deep learning with regression analysis in creating predictive models for SARS-CoV-2 outcomes

    Authors: Ahmed Abdulaal; Aatish Patel; Esmita Charani; Sarah Denny; Saleh A Alqahtani; Gary W Davies; Nabeela Mughal; Luke SP Moore

    doi:10.21203/rs.3.rs-52481/v4 Date: 2020-08-02 Source: ResearchSquare

    Background Accurately predicting patient outcomes in Severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) could aid patient management and allocation of healthcare resources. There are a variety of methods which can be used to develop prognostic models, ranging from logistic regression and survival analysis to more complex machine learning algorithms and deep learning MESHD. Despite several models having been created for SARS-CoV-2, most of these have been found to be highly susceptible to bias. We aimed to develop and compare two separate predictive models for death MESHD during admission with SARS-CoV-2.MethodBetween March 1 HGNC - April 24, 2020, 398 patients were identified with laboratory confirmed SARS-CoV-2 in a London teaching hospital. Data from electronic health records were extracted and used to create two predictive models using: 1) a Cox regression model and 2) an artificial neural network (ANN). Model performance profiles were assessed by validation, discrimination, and calibration.Results Both the Cox regression and ANN models achieved high accuracy (83.8%, 95% confidence interval (CI): 73.8 - 91.1 and 90.0%, 95% CI: 81.2 - 95.6, respectively). The area under the receiver operator curve (AUROC) for the ANN (92.6%, 95% CI: 91.1 - 94.1) was significantly greater than that of the Cox regression model (86.9%, 95% CI: 85.7 - 88.2), p=0.0136. Both models achieved acceptable calibration with Brier scores of 0.13 and 0.11 for the Cox model and ANN, respectively. ConclusionWe demonstrate an ANN which is non-inferior to a Cox regression model but with potential for further development such that it can learn as new data becomes available. Deep learning techniques are particularly suited to complex datasets with non-linear solutions, which make them appropriate for use in conditions with a paucity of prior knowledge. Accurate prognostic models for SARS-CoV-2 can provide benefits at the patient, departmental and organisational level. 

    Risk factors for mortality in a multicenter cohort of mechanically ventilated COVID-19 MESHD patients in Belgium.

    Authors: Bernard Lambermont; Marie Ernst; Pierre Demaret; Sandrine Boccar; Vincent Fraipont; Christine Gurdebeke; Cedric Van Brussel; Manuel Quinonez; Christophe J.J. Dubois; Thierry Lemineur; Thierry Njambou; Benoit Akando; Damien Wertz; Julien Higny; Marie Thys; Nathalie Maes; Jean-Luc Canivet; Grace Kisoka; Nathalie Layios; Didier Ledoux; Paul Massion; Philippe Morimont; Sonia Piret; Sebastien Robinet; Anne-Françoise Rousseau; Patricia Wiesen; Pierre Damas; Gilles Parzibut; Thierry Sottiaux; François Lejeune; Pierre François; Julien Guntz; Laurent Jadot; Frédéric Foret; Pierre Delanaye; Benoit Misset

    doi:10.21203/rs.3.rs-52427/v1 Date: 2020-08-01 Source: ResearchSquare

    Background: Considering the high mortality rate of severe Covid-19 MESHD patients, it is necessary to identify prognostic factors and therapies which could be valuable in this setting.Methods: The method consisted in a multicentric retrospective analysis in all consecutive Covid-19 MESHD patients admitted to intensive care unit (ICU) and mechanically ventilated for more than 24 hours from March 1 HGNC to April 25, 2020.Admission date, age, sex, body mass index, underlying conditions, treatments, physiological values, use of vasopressors, renal replacement therapy and extracorporeal membrane oxygenation, duration of mechanical ventilation, length of ICU stay, ICU and ventilator-free days at day 42 were collected. Primary outcome was survival. Simple and multiple time-dependent Cox regression models were used to assess the effects of factors on survival. Results: Out of 2003 patients hospitalized for SARS-CoV-2, 361 were admitted to the participating ICUs, 257 were ventilated for more than 24 hours and 247 were included in the study. The length of stay in ICU was 21 (12-32) days and the mortality rate was 45%. Using multiple regression, risk factors for mortality were age, high serum creatinine value, low mean arterial pressure, low lymphocytes count on day 0 and the absence of corticosteroid therapy during the first week of mechanical ventilation. The mortality rate of the patients who received corticosteroids was 34% and 48% for patients who did not (p = 0.01).Conclusion: In this multicenter cohort, the mortality of patients with SARS-CoV-2 pneumonia MESHD treated with mechanical ventilation was high. The risk factors for mortality included age, renal and circulatory dysfunction MESHD, lymphopenia MESHD and the absence of corticosteroid therapy during the first week of mechanical ventilation. 

    Corticosteroid Use in Severely Hypoxemic COVID-19 MESHD Patients: An Observational Cohort Analysis of Dosing Patterns and Outcomes in the Early Phase of the Pandemic

    Authors: Omar Rahman; Russel A Trigonis; Mitchell K Craft; Rachel M Kruer; Emily M Miller; Colin L Terry; Sarah A Persaud; Rajat Kapoor

    doi:10.1101/2020.07.29.20164277 Date: 2020-07-30 Source: medRxiv

    INTRODUCTION Hypoxemia in Severe Acute Respiratory Syndrome MESHD due to Novel Coronavirus of 2019 (SARS-CoV-2) is mediated by severe inflammation MESHD that may be mitigated by corticosteroids. We evaluated pattern and effects of corticosteroid use in these patients during an early surge of the pandemic. METHODS Observational study of 136 SARS-CoV-2 patients admitted to the Intensive care Unit between March 1 HGNC and April 27, 2020 at a tertiary care hospital in Indianapolis, USA. Statistical comparison between cohorts and dosing pattern analysis was done. Outcome measures included number of patients requiring intubation, duration of mechanical ventilation, length of ICU stay and inpatient mortality. RESULTS: Of 136 patients, 72 (53%) received corticosteroids. Groups demographics: Age (60.5 vs. 65; p .083), sex (47% male vs. 39% female; p .338) and comorbidities were similar. Corticosteroid group had increased severity of illness: PaO2/FiO2 (113 vs. 130; p .014) and SOFA (8 vs. 5.5; p < .001). Overall mortality (21% vs. 30%; p .234) or proportion of patients intubated (78 vs. 64%; p .078) was similar. Mortality was similar among mechanically ventilated (27% vs. 15%; p .151) however there were no deaths among patients who were not mechanically ventilated and received corticosteroids (0% vs. 57%; p

    Clinical Characteristics and Outcomes for 7,995 Patients with SARS-CoV-2 Infection MESHD

    Authors: Jacob McPadden; Frederick Warner; H. Patrick Young; Nathan C. Hurley; Rebecca A. Pulk; Avinainder Singh; Thomas JS Durant; Guannan Gong; Nihar Desai; Adrian Haimovich; Richard Andrew Taylor; Murat Gunel; Charles S. Dela Cruz; Shelli F Farhadian; Jonathan Siner; Merceditas Villanueva; Keith Churchwell; Allen Hsiao; Charles J. Torre Jr.; Eric J. Velazquez; Roy S. Herbst; Akiko Iwasaki; Albert I. Ko; Bobak J. Mortazavi; Harlan M. Krumholz; Wade L. Schulz

    doi:10.1101/2020.07.19.20157305 Date: 2020-07-21 Source: medRxiv

    Objective: Severe acute respiratory syndrome MESHD virus (SARS-CoV-2) has infected millions of people worldwide. Our goal was to identify risk factors associated with admission and disease severity in patients with SARS-CoV-2. Design: This was an observational, retrospective study based on real-world data for 7,995 patients with SARS-CoV-2 from a clinical data repository. Setting: Yale New Haven Health (YNHH) is a five-hospital academic health system serving a diverse patient population with community and teaching facilities in both urban and suburban areas. Populations: The study included adult patients who had SARS-CoV-2 testing at YNHH between March 1 HGNC and April 30, 2020. Main outcome and performance measures: Primary outcomes were admission and in-hospital mortality for patients with SARS-CoV-2 infection MESHD as determined by RT-PCR testing. We also assessed features associated with the need for respiratory support. Results: Of the 28605 patients tested for SARS-CoV-2, 7995 patients (27.9%) had an infection (median age 52.3 years) and 2154 (26.9%) of these had an associated admission (median age 66.2 years). Of admitted patients, 1633 (75.8%) had a discharge disposition at the end of the study period. Of these, 192 (11.8%) required invasive mechanical ventilation and 227 (13.5%) expired. Increased age and male sex were positively associated with admission and in-hospital mortality (median age 81.9 years), while comorbidities had a much weaker association with the risk of admission or mortality. Black race (OR 1.43, 95%CI 1.14-1.78) and Hispanic ethnicity (OR 1.81, 95%CI 1.50-2.18) were identified as risk factors for admission, but, among discharged patients, age-adjusted in-hospital mortality was not significantly different among racial and ethnic groups. Conclusions: This observational study identified, among people testing positive for SARS-CoV-2 infection MESHD, older age and male sex as the most strongly associated risks for admission and in-hospital mortality in patients with SARS-CoV-2 infection MESHD. While minority racial and ethnic groups had increased burden of disease and risk of admission, age-adjusted in-hospital mortality for discharged patients was not significantly different among racial and ethnic groups. Ongoing studies will be needed to continue to evaluate these risks, particularly in the setting of evolving treatment guidelines.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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