Abstract:
Review began
07/20/2026
Review ended
09/09/2026
Published
09/21/2026
© Copyright 2026
Safai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
DOI: 10.7759/cureus.116652
Community Experience of COVID-19 Hospitalizations
Kourosh Safai , Alexis Case , Amanda Frugoli , Timothy Pisarski , Kaylie Heyer , Graal Diaz 1 1 1, 2 1 1 1
1. Graduate Medical Education, Community Memorial Healthcare, Ventura, USA 2. Pacific Inpatient Physicians, Community Memorial Hospital, Ventura, USA
Corresponding author: Amanda Frugoli, afrugoli@cmhshealth.org
Abstract
Background
Every American was affected by the COVID-19 pandemic. The novelty and virulence spurred the rapid evolution of treatment strategies. While large multicenter studies established key mortality risk factors and treatment efficacy, community hospital experiences are underrepresented.
Methods
This retrospective study examines clinical characteristics, mortality predictors, and outcome trends among 1,949 adults hospitalized with COVID-19 at a Southern California community hospital from January 31, 2020, through May 11, 2023.
Results
Overall mortality was 7.6%, and the mean length of stay was 9.2 days. Older age was independently associated with increased mortality, with the odds of death nearly doubling for every decade of life (adjusted odds ratio (aOR) 1.98, 95% CI 1.65-2.39, P < 0.001). Univariable laboratory predictors of inpatient mortality, and log transformation of D-dimer, demonstrated that D-dimer was the best predictor of inpatient mortality. Septic shock was associated with a twofold increase in mortality (aOR 2.26, 95% CI 1.11-4.63, P = 0.025). Respiratory failure requiring a mechanical ventilator is a marker for disease severity and was the strongest predictor of mortality in this cohort. Mechanical ventilation was associated with a 10-fold increase in the odds of death (aOR 10.07, 95% CI 6.18-16.38, P < 0.001). Multivariable analysis comparing mortality and pharmaceutical treatments identified that receipt of systemic corticosteroids was associated with higher odds of in-hospital mortality (aOR 6.70; 95% CI 4.00-11.22; P < 0.001). Receipt of tocilizumab was also associated with higher mortality (aOR 3.87; 95% CI 2.06-7.26; P < 0.001). Time-lapse analysis of the interval between admission and mortality demonstrated a 23% reduction in the odds of death per successive year (aOR 0.77 per year, 95% CI 0.62-0.96, P = 0.018).
Conclusion
Mortality decreased nearly one-fourth each year. D-dimer was the best laboratory predictor of death. Older age, septic shock, and ventilator need were associated with increased risk of inpatient mortality. Receipt of systemic steroids and tocilizumab was associated with higher mortality. These are not causal treatment effects, as medication receipt at that time was related to disease severity. These community hospital findings complement larger studies and reinforce the importance of early risk stratification and evidencebased treatments.
Categories: Public Health, Pulmonology, Internal Medicine
Keywords: acute respiratory distress syndrome (ards), ards, covid, covid 19, covid-19 pandemic, covid-induced ards, pandemic
DOI record:
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