C37-03 The First Three Years of Covid-19 Pandemic: National In-hospital Mortality and Predictors of Poor Outcomes

Rationale This study is to investigate the mortality of patients admitted to hospitals with COVID-19 and predictors on all cause in-hospital mortality during the first three years of pandemic 2020-2022. Methods We performed a retrospective descriptive study on the United States National Inpatient Sample, using ICD-10 code and Stata 19.5 to identify patients admitted to hospitals with a principal diagnosis of COVID-19 (U07.1) from 01/2020 to 12/2022. Then we investigated the mortality rate, endotracheal intubation rate, and hospital mean length of stay of these patients. We used multivariate logistic regression to identify factors associated with mortality including age, gender, race, household income, and residence location. Results The number of cases was 1,058,815 (2020); 1,549,446 (2021) and 822,179 (2022). Peak admissions were observed during the winter months. The overall mortality rate was 11.08% (2020), 11.15% (2021), and 7.25% (2022). 7.90 % of patients were intubated during this period and the mortality rate in this group was 63.09%. Compared with male, female had lower mortality by odd ratio (OR) 0.69, p < 0.01.Independent factors increased mortality including age (OR 1.02, p < 0.01); comorbidity index (OR 1.29, p < 0.01); non-white race (OR 1.23, p < 0.01), rural residence (OR 1.18, p < 0.01); lower household income less than $56,000 (OR 1.10, p < 0.01). Conclusion The number of COVID-19 hospitalization and hospital mortality gradually declined towards the year of 2022 which marks the end of pandemic. Mortality was significantly affected by socioeconomic and racial factors. This highlighted the necessity of targeted interventions to address health inequities in pandemic response.