Previous research has suggested that advanced age, male gender and certain comorbidities are risk factors for COVID-19 mortality. To shed further light on these risk factors in privately insured patients, FAIR Health, in collaboration with the West Health Institute and Marty Makary, MD, MPH, from Johns Hopkins University School of Medicine, undertook an analysis using the nation's largest private healthcare claims database, the FAIR Health National Private Insurance Claims (FH NPIC) repository. Evaluating all patients in FH NPIC's longitudinal dataset, we identified 467,773 patients diagnosed with COVID-19 from April 1, 2020, through August 31, 2020. We examined relationships between the outcome of mortality (dependent variable) and the following independent variables: age, gender and preexisting comorbidities. The results of this analysis could help inform protocols for vaccine distribution as well as prevention and treatment protocols. Among the findings: (1) Mortality rate. Of patients diagnosed with COVID-19, 0.59 percent died. (2) Gender. Males accounted for 60.07 percent of total COVID-19 deaths, females for 39.93 percent. (3) Age. Patients over age 69 accounted for 4.82 percent of COVID-19 diagnoses but 42.43 percent of total deaths from COVID-19. (4) Developmental disorders. Across all age groups, COVID-19 patients with developmental disorders (e.g., developmental disorders of speech and language, developmental disorders of scholastic skills, central auditory processing disorders) had the highest odds of dying from COVID-19 (odds ratio [OR]=3.06, 95 percent confidence interval [CI], 1.554-6.008, P=0.0105). (5) Cancer. In patients under age 70, two types of cancer ranked among the top four risk factors for COVID-19 mortality: Lung cancer was number one; leukemia and lymphomas ranked fourth. The results indicate that, in the under-70 age cohort, patients with COVID-19 and lung cancer were nearly seven times more likely to die (OR=6.74, 95 percent CI, 4.711-9.639, P<0.0001) than patients who had COVID-19 but not lung cancer. In the same age cohort, COVID-19 patients with leukemia or lymphoma were nearly three times more likely to die (OR=2.89, 95 percent CI, 2.110-3.958, P<0.0001) than COVID-19 patients without those malignancies. (6) Intellectual disabilities and related conditions. Across all age groups, COVID-19 patients with intellectual disabilities and related conditions (e.g., Down syndrome and other chromosomal anomalies; mild, moderate, severe and profound intellectual disabilities; congenital malformations, such as certain disorders that cause microcephaly) had the third highest risk of COVID-19 death (OR=2.75, 95 percent CI, 1.657-4.558, P=0.0005). Among COVID-19 patients under age 70, intellectual disabilities and related conditions still had the third highest risk (OR=3.61, 95 percent CI, 1.878-6.930, P=0.0007). (7) Chronic kidney disease (CKD) and heart failure. Across all age groups, the OR for COVID-19 mortality for patients with CKD was 1.85 (95 percent CI, 1.666-2.051, P<0.0001); for patients with heart failure, it was 1.58 (95 percent CI, 1.383-1.797, P<0.0001). (8) All age groups versus patients under age 70. The risk of COVID-19 mortality was generally higher for a comorbidity for patients under age 70 than it was for the same comorbidity for patients of all age groups. (9) Lack of comorbidities. Lack of comorbidities was partially protective against COVID-19 mortality, but not completely. Of COVID-19 patients who died, 83.29 percent had a preexisting comorbidity, while 16.71 percent did not, per the medical claims data. (10) Multiple comorbidities. As a patient's number of comorbidities increased, so did the odds of dying from COVID-19.
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