{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T15:18:36Z","timestamp":1771082316713,"version":"3.50.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"2","funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["75D30120C07986"],"award-info":[{"award-number":["75D30120C07986"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Westat, Inc","award":["75D30120C07765"],"award-info":[{"award-number":["75D30120C07765"]}]},{"name":"Kaiser Foundation Hospitals"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The epidemiology of coronavirus disease 2019 (COVID-19) continues to develop with emerging variants, expanding population-level immunity, and advances in clinical care. We describe changes in the clinical epidemiology of COVID-19 hospitalizations and risk factors for critical outcomes over time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included adults aged \u226518 years from 10 states hospitalized with COVID-19 June 2021\u2013March 2023. We evaluated changes in demographics, clinical characteristics, and critical outcomes (intensive care unit admission and\/or death) and evaluated critical outcomes risk factors (risk ratios [RRs]), stratified by COVID-19 vaccination status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 60 488 COVID-19\u2013associated hospitalizations were included in the analysis. Among those hospitalized, median age increased from 60 to 75 years, proportion vaccinated increased from 18.2% to 70.1%, and critical outcomes declined from 24.8% to 19.4% (all P &amp;lt; .001) between the Delta (June\u2013December, 2021) and post-BA.4\/BA.5 (September 2022\u2013March 2023) periods. Hospitalization events with critical outcomes had a higher proportion of \u22654 categories of medical condition categories assessed (32.8%) compared to all hospitalizations (23.0%). Critical outcome risk factors were similar for unvaccinated and vaccinated populations; presence of \u22654 medical condition categories was most strongly associated with risk of critical outcomes regardless of vaccine status (unvaccinated: adjusted RR, 2.27 [95% confidence interval {CI}, 2.14\u20132.41]; vaccinated: adjusted RR, 1.73 [95% CI, 1.56\u20131.92]) across periods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The proportion of adults hospitalized with COVID-19 who experienced critical outcomes decreased with time, and median patient age increased with time. Multimorbidity was most strongly associated with critical outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad505","type":"journal-article","created":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T22:18:40Z","timestamp":1693088320000},"page":"338-348","source":"Crossref","is-referenced-by-count":25,"title":["Clinical Epidemiology and Risk Factors for Critical Outcomes Among Vaccinated and Unvaccinated Adults Hospitalized With COVID-19\u2014VISION Network, 10 States, June 2021\u2013March 2023"],"prefix":"10.1093","volume":"78","author":[{"given":"Eric P","family":"Griggs","sequence":"first","affiliation":[{"name":"Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick K","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Westat, Inc , Rockville, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Lazariu","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Westat, Inc , Rockville, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manjusha","family":"Gaglani","sequence":"additional","affiliation":[{"name":"Section of Pediatric Infectious Diseases, Department of Pediatrics, Baylor Scott & White Health, Temple, Texas, USA"},{"name":"Department of Medical Education, Texas A&M University College of Medicine , Temple, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlene","family":"McEvoy","sequence":"additional","affiliation":[{"name":"Department of Research, HealthPartners Institute , Minneapolis, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola P","family":"Klein","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Vaccine Study Center, Division of Research, Kaiser Permanente Northern California , Oakland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nimish R","family":"Valvi","sequence":"additional","affiliation":[{"name":"Center for Biomedical Informatics, Regenstrief Institute , Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie A","family":"Irving","sequence":"additional","affiliation":[{"name":"Department of Science Programs, Kaiser Permanente Center for Health Research , Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noah","family":"Kojima","sequence":"additional","affiliation":[{"name":"Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Stenehjem","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare , Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley","family":"Crane","sequence":"additional","affiliation":[{"name":"Department of Science Programs, Kaiser Permanente Center for Health Research , Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suchitra","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, School of Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaun J","family":"Grannis","sequence":"additional","affiliation":[{"name":"Center for Biomedical Informatics, Regenstrief Institute , Indianapolis, Indiana, USA"},{"name":"School of Medicine, Indiana University Department of Family Medicine, , Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J","family":"Embi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University Medical Center , Nashville, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anupam B","family":"Kharbanda","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Children's Minnesota , Minneapolis, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toan C","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, School of Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado, 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Bassett","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Westat, Inc , Rockville, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malini B","family":"DeSilva","sequence":"additional","affiliation":[{"name":"Department of Research, HealthPartners Institute , Minneapolis, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Dickerson","sequence":"additional","affiliation":[{"name":"Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepika","family":"Konatham","sequence":"additional","affiliation":[{"name":"Department of Research Analytics and Development, Baylor Scott & White Research Institute, Baylor Scott & White Health , Temple, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Fireman","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Vaccine Study Center, Division of Research, Kaiser Permanente Northern California , Oakland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie S","family":"Allen","sequence":"additional","affiliation":[{"name":"Center for Biomedical Informatics, Regenstrief Institute , Indianapolis, Indiana, USA"},{"name":"Fairbanks School of Public Health, Indiana University , Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle A","family":"Barron","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, School of Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maura","family":"Beaton","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Arndorfer","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare , Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Vazquez-Benitez","sequence":"additional","affiliation":[{"name":"Department of Research, HealthPartners Institute , Minneapolis, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shikha","family":"Garg","sequence":"additional","affiliation":[{"name":"Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, 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