Risk factors for hospitalization among persons with COVID-19-Colorado

PLoS One. 2021 Sep 2;16(9):e0256917. doi: 10.1371/journal.pone.0256917. eCollection 2021.


Background: Most current evidence on risk factors for hospitalization because of coronavirus disease 2019 (COVID-19) comes from studies using data abstracted primarily from electronic health records, limited to specific populations, or that fail to capture over-the-counter medications and adjust for potential confounding factors. Properly understanding risk factors for hospitalization will help improve clinical management and facilitate targeted prevention messaging and forecasting and prioritization of clinical and public health resource needs.

Objectives: To identify risk factors for hospitalization using patient questionnaires and chart abstraction.

Methods: We randomly selected 600 of 1,738 laboratory-confirmed Colorado COVID-19 cases with known hospitalization status and illness onset during March 9-31, 2020. In April 2020, we collected demographics, social history, and medications taken in the 30 days before illness onset via telephone questionnaire and collected underlying medical conditions in patient questionnaires and medical record abstraction.

Results: Overall, 364 patients participated; 128 were hospitalized and 236 were non-hospitalized. In multivariable analysis, chronic hypoxemic respiratory failure with oxygen requirement (adjusted odds ratio [aOR] 14.64; 95% confidence interval [CI] 1.45-147.93), taking opioids (aOR 8.05; CI 1.16-55.77), metabolic syndrome (aOR 5.71; CI 1.18-27.54), obesity (aOR 3.35; CI 1.58-7.09), age ≥65 years (aOR 3.22; CI 1.20-7.97), hypertension (aOR 3.14; CI 1.47-6.71), arrhythmia (aOR 2.95; CI 1.00-8.68), and male sex (aOR 2.65; CI 1.44-4.88), were significantly associated with hospitalization.

Conclusion: We identified patient characteristics, medications, and medical conditions, including some novel ones, associated with hospitalization. These data can be used to inform clinical and public health resource needs.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 / diagnosis
  • COVID-19 / therapy*
  • COVID-19 / virology
  • Colorado
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Risk Factors
  • SARS-CoV-2 / isolation & purification*
  • SARS-CoV-2 / physiology
  • Surveys and Questionnaires*
  • Young Adult

Grants and funding

There was no specific funding for this work. The case investigations, analysis, and manuscript preparation were completed as part of official duties at CDC and the Colorado Department of Public Health and Environment (CDPHE).