Atlanta—Patients diagnosed with COVID-19 are increasingly confused about when they should tough out symptoms at home and when they need stepped-up care in a hospital. As a result, they are seeking guidance from pharmacists and other healthcare professionals.

Knowing which patients are most likely to have the most serious outcome from novel coronavirus—death—can help make sure that those most at risk get the level of care they need.

The CDC used national case-based surveillance and supplementary data reported from 16 jurisdictions to describe the characteristics of more than 10,000 patients who died of laboratory-confirmed COVID-19.

The report notes that more than one-third of Hispanic decedents (34.9%) and nearly a third (29.5%) of nonwhite decedents were younger than age 65 years, but only 13.2% of white decedents were younger than that age.

“Consistent with reports describing the characteristics of deaths in persons with COVID-19 in the United States and China, approximately three fourths of decedents had one or more underlying medical conditions reported (76.4%) or were aged ≥65 years (74.8%),” according to the article in the CDC’s Morbidity & Mortality Weekly Report.

The authors point out that, among reported underlying medical conditions, cardiovascular disease and diabetes were the most common, adding, “Diabetes prevalence among decedents aged <65 years (49.6%) was substantially higher than that reported in an analysis of hospitalized COVID-19 patients aged <65 years (35%) and persons aged <65 years in the general population (<20%) (5–7).”

The CDC researchers also raise concerns that 7.8% of patients died in an emergency department or at home, explaining, “These out-of-hospital deaths might reflect lack of health care access, delays in seeking care, or diagnostic delays.”

The report suggests that health communications campaigns could encourage patients, especially those with underlying medical conditions, to seek medical care earlier in their illnesses.

The CDC also urges pharmacists and other healthcare providers to consider the possibility of severe disease among younger persons who are Hispanic, nonwhite, or have underlying medical conditions.

“More prompt diagnoses could facilitate earlier implementation of supportive care to minimize morbidity among individuals and earlier isolation of contagious persons to protect communities from SARS-CoV-2 transmission,” the authors write.

The study also calls the relatively high percentages of Hispanic and nonwhite decedents younger than age 65 years “notable,” adding, “The median age of nonwhite persons (31 years) in the United States is lower than that of white persons (44 years); these differences might help explain the higher proportions of Hispanic and nonwhite decedents among those aged <65 years. The median ages among Hispanic and nonwhite decedents (71 and 72 years, respectively) were 9–10 years lower than that of white decedents (81 years).”

The report points out, however, that the percentage of Hispanic decedents aged <65 years (33.9%) exceeded the percentage of Hispanic persons aged <65 years in the U.S. population (20%), while the percentage of nonwhite COVID-19 decedents aged <65 years (40.2%) also exceeded the overall percentage of nonwhite decedents aged <65 years (23%) in the U.S. population.

The authors call for further study to understand the reasons for these differences.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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