Presence of CDC Risk Factors Associated with Increased Risk of Death from COVID-19

New JHEOR research on hospitalized COVID-19 patients with multiple Centers for Disease Control risk factors were significantly more likely to die.

New York, NY, November 07, 2020 --( A comparison of hospitalized COVID-19 patients based on the Centers for Disease Control (CDC) risk factors found that patients with multiple risk factors were significantly more likely to die, according to new research published in the Journal of Health Economics and Outcomes Research (JHEOR):

The presence of CDC risk factors was also associated with increased ICU utilization, longer ICU length of stay (LOS), and longer hospital LOS compared to those with no risk factors. Patients with hypertension and those administered statins were less likely to die.

“While the primary research results were not a big surprise,” said lead researcher Dr. Peter Mallow, director of health economics and clinical outcomes research and assistant professor at Xavier University. “We were able to quantify the correlation between the number of risk factors and mortality.”

Quantifying the role of CDC risk factors upon admission may improve risk stratification and identification of patients who may require closer monitoring and more intensive treatment.

The data for the research were obtained retrospectively from a commercially-available, all-payer administrative database of inpatient and hospital-based outpatient detailed claims across more than 300 acute care hospitals in the United States. Data contained information on demographic and clinical characteristics of all patient visits, including pharmaceuticals administered, diagnostic tests, and procedures performed during the hospitalization. Procedure and comorbidity data were captured using International Classification of Diseases 10th Revision (ICD-10) diagnosis and procedure codes. The research was conducted with a HIPAA compliant de-identified data set and was exempt from institutional review board review by Xavier University.

COVID-19 patient visits between March 15, 2020 and April 30, 2020 were identified using ICD-10 diagnosis code U07.1. CDC risk factors associated with severe illness from COVID-19 were identified by ICD-10 codes with the exception of age.

The study of more than 20,000 COVID-19 hospitalizations across the United States found that patients with three or more CDC risk factors were associated with a nearly 4.5 times increase in mortality. Further, it confirms that diabetes, obesity, and chronic kidney disease with dialysis were critical risk factors with respect to individuals requiring increased care. Significant increases in ICU bed utilization, longer ICU stay, and longer hospital LOS were associated with the presence of three or more risk factors.

One of the secondary results of the study was particularly interesting, said Dr. Mallow. The study found a decreased likelihood of in-hospital mortality with statin use. “Our findings suggest that patients administered statins in the hospital had a 46 percent lower risk of death than those not receiving statins.”

“As a researcher, it was exciting to discover this correlation and inspire further research,” he said. “Since the publication of our research in the Journal of Health Economics and Outcomes Research, Dr. David Fedson, a retired professor from the University of Virginia, Department of Medicine, reached out to us and introduced us to other research examining the use of generic medications to treat the host response.”


Mallow PJ, Belk KW, Topmiller M, Hooker EA. Outcomes of hospitalized COVID-19 patients by risk factors: Results from a United States hospital claims database. JHEOR. 2020;7(2):165-174. doi:10.36469/jheor.2020.17331
Journal of Health Economics and Outcomes Research
Melanie Matthews
Melanie Matthews, Managing Editor,