• Priyank Shah, Jack Owens, James Franklin, Akshat Mehta, William Heymann, William Sewell, Jennifer Hill, Krista Barfield, and Rajkumar Doshi.
• Department of Cardiology, Phoebe Putney Memorial Hospital, Albany, GA, USA.
• Ann. Med. 2020 Nov 1; 52 (7): 354360354-360.

BackgroundThere is limited data on outcomes in patients with coronavirus disease 2019 (Covid-19) in rural United States (US). This study aimed to describe the demographics, and outcomes of hospitalized Covid-19 patients in rural Southwest Georgia.MethodsUsing electronic medical records, we analyzed data from all hospitalized Covid-19 patients who either died or survived to discharge between 2 March 2020 and 6 May 2020.ResultsOf the 522 patients, 92 died in hospital (17.6%). Median age was 63 years, 58% were females, and 87% African-Americans. Hypertension (79.7%), obesity (66.5%) and diabetes mellitus (42.3%) were the most common comorbidities. Males had higher overall mortality compared to females (23 v 13.8%). Immunosuppression [odds ratio (OR) 3.6; (confidence interval (CI): 1.52-8.47, p=.003)], hypertension (OR 3.36; CI:1.3-8.6, p=.01), age ≥65 years (OR 3.1; CI:1.7-5.6, p<.001) and morbid obesity (OR 2.29; CI:1.11-4.69, p=.02), were independent predictors of in-hospital mortality. Female gender was an independent predictor of decreased in-hospital mortality. Mortality in intubated patients was 67%. Mortality was 8.9% in <50 years, compared to 20% in ≥50 years.ConclusionsImmunosuppression, hypertension, age ≥ 65 years and morbid obesity were independent predictors of mortality, whereas female gender was protective for mortality in hospitalized Covid-19 patients in rural Southwest Georgia. KEY MESSAGES Patients hospitalized with Covid-19 in rural US have higher comorbidity burden. Immunosuppression, hypertension, age ≥ 65 years and morbid obesity are independent predictors of increased mortality. Female gender is an independent predictor of reduced mortality.

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