Study: Up to 1 in 5 people with COVID-19 in U.S. needs hospital care

July 13 (UPI) -- Nearly one in five people with COVID-19 in the United States requires hospital care for the disease, with those with pre-existing health conditions such as dementia or obesity at higher risk for serious illness, an analysis published Tuesday by JAMA Network Open found.

In addition, more than 20% of those hospitalized due to the coronavirus required intensive care treatment or ventilation support to breathe, or were discharged into hospice care, the data showed.

Of those admitted to the hospital after infection between March and October of last year, about 12% died.

However, the death rate among hospitalized patients declined to just under 9% by October from approximately 16% at the start of the pandemic as improved treatment approaches emerged.

Since Aug. 1, about 2.3 million people in the United States have been hospitalized with COVID-19, according to the Centers for Disease Control and Prevention.

More than 604,000 people with COVID-19 died in the United States over the course of the pandemic, the agency said.

"This study found that COVID-19 mortality decreased over time during 2020," wrote the researchers, from the National COVID Cohort Collaborative Consortium, a collective of physicians engaged in treating infected patients at 34 hospitals across the country.

It also identified "patient demographic characteristics and comorbidities were associated with higher clinical severity," they said.

Although virus-related hospitalization rates declined nationally through April and May this year, they have increased by about 9% since late June, coinciding with the rise of the more transmissible Delta variant, which now accounts for 50% of new cases, the CDC reported.

Unlike earlier stages of the pandemic, when older adults were at increased risk for hospitalization and severe illness, adults ages 18 to 49 years now make up about 40% of new admissions, the agency estimates.

For this study, National COVID Cohort Collaborative Consortium researchers analyzed electronic health records on nearly 2 million adults tested for COVID-19 at 34 hospitals in the United States between Jan. 1 and Dec. 7, 2020.

Roughly 175,000 of the adults included in the study tested positive for the virus, and just over 32,000 of them, or 19%, were hospitalized, the data showed.

Of those hospitalized, nearly 7,000, or more than 20%, required invasive ventilatory support or extracorporeal membrane oxygenation to breath or died or were discharged to hospice care following their illness.

Among those who tested positive, men were 60% more likely to suffer serious illness from COVID-19, while those who were obese, or severely overweight, had a nearly 40% higher risk.

Those with dementia before infection had a 26% higher risk for serious illness and those with preexisting liver disease had a 20% higher risk.

Echoing earlier studies on racial disparities in COVID-19 risk, Asian people and Black people included in the study were 33% and 12% more likely, respectively, to develop serious illness, the researchers said.

Based on their findings, patient age, respiratory rate and blood pressure helped predict disease severity, they said.

"The study ... established expected trajectories for many vital signs and laboratory values among patients with different clinical severities," the researchers wrote.

"Expected trajectories can contribute to practitioner decision-making about what a patient will need," they wrote.