Hospitalization and case fatality rates of adult patients diagnosed with COVID-19 at a tertiary academic medical center in 2020

The objective of this study is to determine hospitalization and case-fatality rates in adult patients diagnosed with COVID-19 at a large academic medical center in the United States of America which predominately serves rural and underrepresented populations. EMR data abstraction of a cohort of lab-confirmed COVID-19, outpatient and inpatient, adult patients, who tested positive at Augusta University Medical Center (AUMC) in 2020 (N = 18,403) was conducted. Eligible patients were identified using the data mining tool, i2b2. COVID-19 hospitalization and case fatality rates were calculated. Logistic and Poisson regression models were constructed to identify characteristics associated with hospitalization, death, and hospital stay. The hospitalization rate was 3.97%. Patients aged 45-64 and 65+ had significantly higher hospitalization rates. Compared to White, hospitalization rates were higher in Black (AOR 2.35, 95% CI, 1.99-2.77, p 0.001) and Hispanic patients (AOR 1.92, 95% CI, 1.92-3.01, p 0.01). Overall COVID-19 case fatality rate was 0.62% and, in hospitalized patients, was 14.25%. Patients 65+ had higher odds of death (AOR 7.57, 95% CI, 3.25-22.13, p 0.001). Case fatality rates did not vary by race. In conclusion, in a primarily rural and underserved population prior to known effective therapy, overall and hospitalized case fatality rates were similar to studies from large urban areas. Keywords: COVID-19, case fatality, hospitalization rate, rural health.