{"doi":"10.1093/cid/ciab319","title":"Adults Hospitalized With Coronavirus Disease 2019 (COVID-19)—United States, March–June and October–December 2020: Implications for the Potential Effects of COVID-19 Tier-1 Vaccination on Future Hospitalizations and Outcomes","abstract":"BACKGROUND: Because of the increased risk for severe coronavirus disease 2019 (COVID-19), the Advisory Committee on Immunization Practices (ACIP) initially prioritized COVID-19 vaccination for persons in long-term care facilities (LTCF), persons aged ≥65 years, and persons aged 16-64 years with high-risk medical conditions when there is limited vaccine supply. We compared characteristics and severe outcomes of hospitalized patients with COVID-19 in the United States between early and later in the pandemic categorized by groups at higher risk of severe COVID-19. METHODS: Observational study of sampled patients aged ≥18 years who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and admitted to one of 14 academic hospitals in the United States during March-June and October-December 2020. Demographic and clinical information were gathered from electronic health record data. RESULTS: Among 647 patients, 91% met ≥1 of the following risk factors for severe COVID-19 [91% March-June (n = 434); 90% October-December (n = 213)]; 19% were LTCF residents, 45% were aged ≥65-years, and 84% had ≥1 high-risk condition. The proportion of patients who resided in a LTCF declined significantly (25% vs 6%) from early to later pandemic periods. Compared with patients at lower risk for severe COVID-19, in-hospital mortality was higher among patients at high risk for severe COVID-19 (20% vs 7%); these differences were consistently observed between March-June and October-December. CONCLUSIONS: Most adults hospitalized with COVID-19 were those recommended to be prioritized for vaccination based on risk for developing severe COVID-19. These findings highlight the continued urgency to vaccinate patients at high risk for severe COVID-19 and monitor vaccination impact on hospitalizations and outcomes.","journal":"Clinical Infectious Diseases","year":2021,"id":209182,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9585,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":105978,"name":"Mark W. Tenforde","orcid":"0000-0002-8702-8393","position":1,"is_corresponding":false},{"id":105916,"name":"H. Keipp Talbot","orcid":"0000-0003-0141-1760","position":2,"is_corresponding":false},{"id":105980,"name":"Christopher J. Lindsell","orcid":"0000-0002-3297-2811","position":3,"is_corresponding":false},{"id":105986,"name":"Jay S. Steingrub","orcid":"0000-0002-6019-6725","position":4,"is_corresponding":false},{"id":105982,"name":"Nathan I. Shapiro","orcid":"0000-0003-3508-4390","position":5,"is_corresponding":false},{"id":105999,"name":"Adit A. Ginde","orcid":"0000-0003-2325-206X","position":6,"is_corresponding":false},{"id":503654,"name":"David J. Douin","orcid":"0000-0002-5215-6854","position":7,"is_corresponding":false},{"id":242315,"name":"Matthew E. Prekker","orcid":"0000-0002-3969-3022","position":8,"is_corresponding":false},{"id":105985,"name":"Heidi L. Erickson","orcid":"0000-0001-5537-8893","position":9,"is_corresponding":false},{"id":105995,"name":"Samuel M. Brown","orcid":"0000-0003-1206-6261","position":10,"is_corresponding":false},{"id":105996,"name":"Ithan D. Peltan","orcid":"0000-0003-1730-234X","position":11,"is_corresponding":false},{"id":105988,"name":"Michelle N. Gong","orcid":"0000-0001-7952-5384","position":12,"is_corresponding":false},{"id":105993,"name":"Akram Khan","orcid":"0000-0003-3091-632X","position":13,"is_corresponding":false},{"id":105990,"name":"Matthew C. Exline","orcid":"0000-0001-6797-158X","position":14,"is_corresponding":false},{"id":105983,"name":"D. Clark Files","orcid":"0000-0002-1595-4080","position":15,"is_corresponding":false},{"id":105984,"name":"Kevin W. Gibbs","orcid":"0000-0002-5272-2289","position":16,"is_corresponding":false},{"id":105997,"name":"Todd W. Rice","orcid":"0000-0002-7136-5408","position":17,"is_corresponding":false},{"id":242316,"name":"Jonathan D. Casey","orcid":"0000-0002-0977-290X","position":18,"is_corresponding":false},{"id":105907,"name":"Carlos G. Grijalva","orcid":"0000-0002-2329-7797","position":19,"is_corresponding":false},{"id":106000,"name":"William B. Stubblefield","orcid":"0000-0003-3817-1414","position":20,"is_corresponding":false},{"id":616171,"name":"Kelsey N. Womack","orcid":"0000-0002-4628-8615","position":21,"is_corresponding":false},{"id":105998,"name":"David N. Hager","orcid":"0000-0002-5148-4872","position":22,"is_corresponding":false},{"id":105994,"name":"Nida Qadir","orcid":"0000-0001-7791-049X","position":23,"is_corresponding":false},{"id":285645,"name":"Steven Y. Chang","orcid":"0000-0002-7365-5265","position":24,"is_corresponding":false},{"id":105991,"name":"Daniel J. Henning","orcid":null,"position":25,"is_corresponding":false},{"id":237081,"name":"Jennifer G. Wilson","orcid":"0000-0002-4254-8475","position":26,"is_corresponding":false},{"id":106002,"name":"Wesley H. Self","orcid":"0000-0002-9300-3045","position":27,"is_corresponding":false},{"id":242318,"name":"Manish M. 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