(P-269) A Descriptive Retrospective Cohort Study to Evaluate the Incidence of Severe COVID 19 Outcomes Among sars-cov-2 Infected Patients in the United States

Background: In December 2019, a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) was first identified in China). Information on the natural history of COVID-19 in persons infected with SARS-CoV-2 continues to emerge.

Objectives: We sought to describe patient characteristics and frequency of clinical outcomes of PCR-positive SARS-CoV-2 patients.

Methods: A cohort of persons aged 18 to 85 years who tested positive for SARS CoV 2 by reverse transcription polymerase chain reaction (rt-PCR) between January 1 2020 and September 16 2020 was identified in a US OPTUM Electronic Health Records (EHR) COVID database. Clinical events reportedly associated with severe COVID-19-illness (e.g., CDC) were identified using ICD-10 code based algorithms. Baseline characteristics of SARS-CoV-2 patients in 12-months prior to SARS-CoV-2 and crude incidence proportions of clinical events of interest in 30 days of index after SARS-CoV-2 are described.

Results: Of the 65,494 COVID-19 patients identified, 12,416 (19%) were hospitalized. Of those hospitalized, 2,137 (17%) received mechanical ventilation, and 1689 (14%) died in the hospital. Of the 53,078 non-hospitalized COVID-19 patients identified, 314 (0.6%) died. Hospitalized COVID-19 patients had a higher incidence proportion than non-hospitalized patients of: asthma, autoimmune disease, cancer, COPD, coronary artery disease, diabetes, Hepatitis C, hyperlipidemia, hypertension, liver disease, venous thromboembolism, corticosteroid use, and history of hospitalization.

Conclusions: Understanding the outcomes of severe COVID-19 in a large population of US patients with known demographics may help contextualize adverse events observed in clinical trials. Additionally, this approach allows for the flexibility to further refine cohorts by demographic and epidemiologic characteristics.