Risk stratification and healthcare disparities in COVID-19 outcomes: a retrospective cohort study of treatment pathways before and after infection

COVID-19 预后中的风险分层和医疗保健差异:一项关于感染前后治疗路径的回顾性队列研究

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Abstract

BACKGROUND: COVID-19 infections continue globally post-pandemic. Analyzing treatment pathways and clinical outcomes remains essential for understanding prognostic factors. METHODS: We reviewed medical records of COVID-19-positive outpatients and inpatients from Wenling Hospital of Traditional Chinese Medicine (January 2022-April 2024). Logistic regression (Python) evaluated hospitalization predictors. Paired t-tests (SPSS) and ICD-11-coded disease comparisons assessed pre/post-infection changes. RESULTS: Among 664 patients, outpatients (mean age 41.99) were younger than inpatients (mean age 74.48), with more females in outpatient care (57.69% vs. 43.45% inpatient). Patients aged 71-85 years comprised over 50% of hospitalizations. Women showed more mild cases while men had more severe infections. Logistic analysis associated hospitalization with age and urban residency, not gender. Rural residents had higher hospitalization rates than urban populations. Hospitalization odds increased with patient age (0-80 years). Outpatients demonstrated increased digestive system disorders post-infection, while inpatients showed 13.42% more total diseases, particularly neurological disorders. Outpatient disease outcomes remained stable pre/post-infection (P = 0.924), whereas inpatients showed significant changes (P = 0.031). CONCLUSIONS: Hospitalization correlated with age and urban/rural status, peaking in 71-85-year-olds (predominantly male). Rural residents faced higher hospitalization risk. Age showed linear relationship with hospitalization likelihood (50-70 years). Post-infection neurological disorders in inpatients and digestive issues in outpatients require clinical attention. More females sought outpatient care, though gender didn't predict hospitalization.

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