OBJECTIVES : The study gauged about the people who seemed to be at higher risk of worse prognosis and required intensive care unit after COVID-19 infection.

METHODS : This retrospective observational study included patients diagnosed with COVID-19 infection between 1^st April to 30^th September 2020 with ICD-10 CM diagnosis recorded in a large deidentified database of US health insurance claims. Only the patients having continuous enrollment between 1 year before (baseline period) to 3 months post (follow-up period) first diagnosis of COVID-19 (index date) were included in study. Comorbid conditions were identified using ICD-10 CM codes during the 1-year baseline period. The primary outcome variable was the advanced medical care admission due to COVID-19. Multivariate regression model was used to assess the association between sociodemographic characteristics, baseline comorbid conditions and advanced medical care admission related to COVID-19.

RESULTS : The study included 176,284 patients with diverse race/ethnicity (83,863 [47.6%] White, 18,708 [10.6%] African-American, and 27,211 [15.4%] Hispanic), a mean (SD) age of 55.5 (21.9) years and 44% males. Regression adjusted clinical predictors for ICU admission included asthma (OR: 1.32 CI: 1.16-1.50), chronic kidney disease (OR: 1.36 CI: 1.23-1.51), chronic obstructive pulmonary disease (OR: 1.35 CI: 1.20-1.52), diabetes (OR: 1.55 CI: 1.41-1.72), heart failure (OR: 1.15 CI: 1.01-1.31), hyperlipidemia (OR: 1.18 CI: 1.07-1.31), hypertension (OR: 1.81 CI: 1.61-2.01), rheumatoid arthritis / osteo arthritis (OR: 1.14 CI: 1.04-1.25). Demographics related risk factors included male sex (OR: 1.52 CI: 1.40-1.66) older age->=55 years (OR: 2.11 CI: 1.90-2.36) and African-American race (OR: 1.19 CI: 1.05-1.36) and Hispanic race (OR: 1.37 CI: 1.29-1.54).

CONCLUSIONS : Identification of patients at higher risk for complication was critical during COVID-19 pandemic. Mostly, elderly male population having high comorbidity burden required advanced care unit. These results call for further investigation of risk factors, additional studies should be performed on large potential cohorts to increase their validity.