Background
Methods
Study design and setting
Data source
Participants and procedures
Outcomes and predictors
Statistical methods and modeling
Results
Study population
Tested patients (N = 34,503) | Tested Positive (N = 2578) | Tested Negative (31,925) | ||||
---|---|---|---|---|---|---|
N | % | N | % | N | % | |
Sociodemographic | ||||||
Age | ||||||
< 18 | 1393 | 4.0 | 35 | 1.4 | 1358 | 4.3 |
18–29 | 4494 | 13.0 | 268 | 10.4 | 4226 | 13.2 |
30–39 | 5803 | 16.8 | 304 | 11.8 | 5499 | 17.2 |
40–49 | 5468 | 15.8 | 411 | 15.9 | 5057 | 15.8 |
50–59 | 5663 | 16.4 | 523 | 20.3 | 5140 | 16.1 |
60–69 | 5467 | 15.8 | 467 | 18.1 | 5000 | 15.7 |
70–79 | 3522 | 10.2 | 296 | 11.5 | 3226 | 10.1 |
80+ | 2693 | 7.8 | 274 | 10.6 | 2419 | 7.6 |
Gender | ||||||
Female | 21,209 | 59.6 | 1352 | 52.4 | 19,219 | 60.2 |
Male | 13,924 | 40.4 | 1225 | 47.5 | 12,699 | 39.8 |
Education | ||||||
Education < 12 years | 9565 | 27.7 | 826 | 32.0 | 8739 | 27.4 |
Employment | ||||||
Student | 1148 | 3.3 | 51 | 2.0 | 1097 | 3.4 |
Employed | 16,570 | 48.0 | 1311 | 50.9 | 15,259 | 47.8 |
Not Employed | 5872 | 17.0 | 362 | 14.0 | 5510 | 17.3 |
Retired | 7284 | 21.1 | 637 | 24.7 | 6647 | 20.8 |
Unknown | 3629 | 10.5 | 217 | 8.4 | 3412 | 10.7 |
Race | ||||||
White | 24,799 | 71.9 | 1437 | 55.7 | 23,362 | 73.2 |
American Indian | Alaska Native | 465 | 1.3 | 13 | 0.5 | 452 | 1.4 |
Asian | 1713 | 5.0 | 209 | 8.1 | 1504 | 4.7 |
Black | African American | 1649 | 4.8 | 159 | 6.2 | 1490 | 4.7 |
Native Hawaiian | Pacific Islander | 356 | 1.0 | 25 | 1.0 | 331 | 1.0 |
Unknown | 5521 | 16.0 | 735 | 28.5 | 4786 | 15.0 |
Ethnicity | ||||||
Other Ethnic Groups | 30,938 | 89.7 | 1940 | 75.3 | 28,998 | 90.8 |
Hispanic or Latino | 3565 | 10.3 | 638 | 24.7 | 2927 | 9.2 |
Religious Affiliation | ||||||
Agnostic | 10,938 | 31.7 | 661 | 25.6 | 10,277 | 32.2 |
Christian | 14,483 | 42.0 | 1219 | 47.3 | 13,264 | 41.5 |
Other Religion | 1181 | 3.4 | 103 | 4.0 | 1078 | 3.4 |
Unknown | 7901 | 22.9 | 595 | 23.1 | 7306 | 22.9 |
Relationship | ||||||
Single | 12,940 | 37.5 | 790 | 30.6 | 12,150 | 38.1 |
Divorced or Legally Separated | 5248 | 15.2 | 383 | 14.9 | 4865 | 15.2 |
Married or Significant Other | 15,173 | 44.0 | 1305 | 50.6 | 13,868 | 43.4 |
Unknown | 1142 | 3.3 | 100 | 3.9 | 1042 | 3.3 |
Language | ||||||
English | 32,277 | 93.5 | 2085 | 80.9 | 30,192 | 94.6 |
Sino-Tibetan | 286 | 0.8 | 55 | 2.1 | 231 | 0.7 |
Spanish | 1022 | 3.0 | 291 | 11.3 | 731 | 2.3 |
Other Languages | 918 | 2.7 | 147 | 5.7 | 771 | 2.4 |
Clinical | ||||||
Body Mass Index | ||||||
Normal | 7088 | 20.5 | 444 | 17.2 | 6644 | 20.8 |
Underweight | 554 | 1.6 | 30 | 1.2 | 524 | 1.6 |
Moderately Obese | 5667 | 16.4 | 452 | 17.5 | 5215 | 16.3 |
Overweight | 8009 | 23.2 | 670 | 26.0 | 7339 | 23.0 |
Severely Obese | 3080 | 8.9 | 243 | 9.4 | 2837 | 8.9 |
Very Severely Obese | 2835 | 8.2 | 208 | 8.1 | 2627 | 8.2 |
Unknown | 7270 | 21.1 | 531 | 20.6 | 6739 | 21.1 |
Number of Chronic Conditions | ||||||
0 | 11,893 | 34.5 | 1017 | 39.4 | 10,876 | 34.1 |
1–2 | 12,185 | 35.3 | 924 | 35.8 | 11,261 | 35.3 |
3–4 | 6563 | 19.0 | 406 | 15.7 | 6157 | 19.3 |
5+ | 3862 | 11.2 | 231 | 9.0 | 3631 | 11.4 |
Clinical Diagnosis | ||||||
Diagnosis of Diabetes | 4942 | 14.3 | 456 | 17.7 | 4486 | 14.1 |
Diagnosis of Kidney Disease | 65 | 0.2 | 6 | 0.2 | 59 | 0.2 |
Diagnosis of HIV/AIDS | 141 | 0.4 | 13 | 0.5 | 128 | 0.4 |
Diagnosis of Dementia | 1039 | 3.0 | 135 | 5.2 | 904 | 2.8 |
Polypharmacy | ||||||
0 Prescriptions | 8933 | 25.9 | 826 | 32.0 | 8107 | 25.4 |
1–9 Prescriptions | 18,066 | 52.4 | 1370 | 53.1 | 16,696 | 52.3 |
10–19 Prescriptions | 5307 | 15.4 | 298 | 11.6 | 5009 | 15.7 |
20–29 Prescriptions | 1549 | 4.5 | 61 | 2.4 | 1488 | 4.7 |
30+ Prescriptions | 648 | 1.9 | 23 | 0.9 | 625 | 2.0 |
Mental Health and Substance Use | ||||||
History of Illicit Drug Use | 4375 | 12.7 | 137 | 5.3 | 4238 | 13.3 |
History of Tobacco Use | 5606 | 16.2 | 162 | 6.3 | 5444 | 17.1 |
Diagnosis of Serious Persistent Mental Illness | 4507 | 13.1 | 177 | 6.9 | 4330 | 13.6 |
Diagnosis of Substance Use Disorder | 3605 | 10.4 | 112 | 4.3 | 3493 | 10.9 |
Primary Care Affiliation | ||||||
Internal Primary Care Provider | 14,682 | 42.55 | 894 | 34.7 | 13,788 | 43.2 |
External Primary Care Provider | 12,456 | 36.1 | 1026 | 39.8 | 11,430 | 35.8 |
Unknown Primary Care Provider | 7365 | 21.35 | 658 | 25.5 | 6707 | 21.0 |
Electronic Communication through the EMR | 22,158 | 64.2 | 1337 | 51.9 | 20,821 | 65.2 |
Symptoms | ||||||
Fever | 20,565 | 59.6 | 1995 | 77.4 | 18,570 | 58.2 |
Cough | 24,506 | 71.0 | 2062 | 80.0 | 22,444 | 70.3 |
Breath | 21,587 | 62.6 | 1857 | 72.0 | 19,730 | 61.8 |
Chills | 694 | 2.0 | 88 | 3.4 | 606 | 1.9 |
Myalgia | 955 | 2.8 | 145 | 5.6 | 810 | 2.5 |
Environmental | ||||||
Region | ||||||
Oregon | 10,486 | 30.4 | 454 | 17.6 | 10,032 | 31.4 |
Alaska | 1837 | 5.3 | 86 | 3.3 | 1751 | 5.5 |
Puget Sound | 6273 | 18.2 | 704 | 27.3 | 5569 | 17.4 |
Southern California | 3852 | 11 | 605 | 23.5 | 3247 | 10.2 |
Washington | Montana | 12,055 | 34.9 | 729 | 28.3 | 11,326 | 35.5 |
Age-Stratified Communal Living | ||||||
Non-Communal Living | 24,581 | 71.2 | 1766 | 68.5 | 22,815 | 71.5 |
Adult Community | 1619 | 4.7 | 143 | 5.5 | 1476 | 4.6 |
Adult and Youth | 5294 | 15.3 | 400 | 15.5 | 4894 | 15.3 |
Multigenerational | 1970 | 5.7 | 177 | 6.9 | 1793 | 5.6 |
Senior Living | 489 | 1.4 | 58 | 2.2 | 431 | 1.4 |
Other | 550 | 1.6 | 34 | 1.3 | 516 | 1.6 |
Financial Insecurity | 9993 | 29.0 | 768 | 29.8 | 9225 | 28.9 |
Housing Insecurity | 6743 | 19.5 | 709 | 27.5 | 6034 | 18.9 |
Transportation Insecurity | 10,429 | 30.2 | 810 | 31.4 | 9619 | 30.1 |
Low Air Quality | 9664 | 28.0 | 754 | 29.2 | 8910 | 27.9 |
Risk factors
OR | 95% CI | p-value | |
---|---|---|---|
Sociodemographic | |||
Age | |||
18–29 | – | – | – |
< 18 | 0.33 | [0.22–0.49] | <.0001 |
30–39 | 0.88 | [0.73–1.05] | 0.1574 |
40–49 | 1.27 | [1.06–1.52] | 0.011 |
50–59 | 1.69 | [1.41–2.02] | <.0001 |
60–69 | 1.65 | [1.36–2.01] | <.0001 |
70–79 | 1.59 | [1.24–2.05] | 0.0003 |
80+ | 1.64 | [1.24–2.17] | 0.0005 |
Gender | |||
Female | – | – | – |
Male | 1.32 | [1.21–1.44] | <.0001 |
Education | |||
Education < 12 years | 1.02 | [1.01–1.14] | 0.0435 |
Employment | |||
Student | – | – | – |
Employed | 1.85 | [1.39–2.46] | <.0001 |
Not Employed | 1.41 | [1.05–1.91] | 0.024 |
Retired | 2.06 | [1.54–2.76] | <.0001 |
Unknown | 1.37 | [1–1.87] | 0.0494 |
Race | |||
White | – | – | – |
American Indian | Alaska Native | 0.63 | [0.36–1.12] | 0.1156 |
Asian | 1.43 | [1.18–1.72] | 0.0002 |
Black| African American | 1.51 | [1.25–1.83] | <.0001 |
Native Hawaiian | Pacific Islander | 1.02 | [0.66–1.57] | 0.9438 |
Unknown | 1.34 | [1.18–1.52] | <.0001 |
Ethnicity | |||
Other Ethnic Groups | – | – | – |
Hispanic or Latino | 2.07 | [1.77–2.41] | <.0001 |
Religious Affiliation | |||
Agnostic | – | – | – |
Christian | 1.28 | [1.15–1.43] | <.0001 |
Other Religion | 1.01 | [0.77–1.24] | 0.1453 |
Unknown | 1.10 | [0.97–1.25] | 0.8752 |
Relationship | |||
Single | – | – | – |
Divorce or Legally Separated | 1.08 | [0.93–1.26] | 0.3293 |
Married or Significant Other | 1.12 | [1.01–1.25] | 0.0357 |
Unknown | 0.96 | [0.74–1.24] | 0.7468 |
Language | |||
English | – | – | – |
Sino-Tibetan | 1.98 | [1.38–2.84] | 0.0002 |
Spanish | 1.60 | [1.31–1.94] | <.0001 |
Other Languages | 2.09 | [1.7–2.57] | <.0001 |
Clinical | |||
Body Mass Index | |||
Normal | – | – | – |
Underweight | 0.80 | [0.54–1.2] | 0.2857 |
Moderately Obese | 1.25 | [1.08–1.45] | 0.0033 |
Overweight | 1.28 | [1.12–1.46] | 0.0003 |
Severely Obese | 1.45 | [1.21–1.73] | <.0001 |
Very Severely Obese | 1.58 | [1.31–1.91] | <.0001 |
Unknown | 0.99 | [0.84–1.16] | 0.8867 |
Number of Chronic Conditions | |||
0 | – | – | – |
1–2 | 0.83 | [0.74–0.93] | 0.001 |
3–4 | 0.63 | [0.54–0.74] | <.0001 |
5+ | 0.55 | [0.44–0.69] | <.0001 |
Clinical Diagnosis | |||
Diagnosis of Diabetes | 1.40 | [1.22–1.61] | <.0001 |
Diagnosis of Kidney Disease | 1.03 | [1.01–2.3] | 0.0385 |
Diagnosis of HIV/AIDS | 1.43 | [1.03–2.63] | 0.0252 |
Diagnosis of Dementia | 2.01 | [1.61–2.51] | <.0001 |
Polypharmacy | |||
0 Prescriptions | – | – | – |
1–9 Prescriptions | 0.76 | [0.68–0.86] | <.0001 |
10–19 Prescriptions | 0.60 | [0.5–0.71] | <.0001 |
20–29 Prescriptions | 0.43 | [0.32–0.59] | <.0001 |
30+ Prescriptions | 0.42 | [0.26–0.66] | 0.0002 |
Mental Health and Substance Use | |||
History of Illicit Drug Use | 0.63 | [0.53–0.77] | <.0001 |
History of Tobacco Use | 0.46 | [0.38–0.54] | <.0001 |
Diagnosis of Serious Persistent Mental Illness | 0.77 | [0.65–0.92] | 0.003 |
Diagnosis of Substance Use Disorder | 0.70 | [0.56–0.87] | 0.001 |
Primary Care Provider Affiliation | |||
Internal Primary Care Provider | – | – | – |
External Primary Care Provider | 1.23 | [1.1–1.37] | 0.0004 |
Unknown Primary Care Provider | 1.27 | [1.11–1.46] | 0.0005 |
Electronic Communication through the EMR | 0.72 | [0.66–0.8] | <.0001 |
Symptoms | |||
Symptoms of Fever | 2.39 | [2.15–2.65] | <.0001 |
Symptoms of Cough | 1.44 | [1.28–1.62] | <.0001 |
Shortness of Breath | 1.34 | [1.21–1.49] | <.0001 |
Symptoms of Chills | 1.40 | [1.09–1.79] | 0.0086 |
Myalgia | 1.80 | [1.47–2.2] | <.0001 |
Environmental | |||
Region | |||
Oregon | – | – | – |
Alaska | 1.31 | [1–1.7] | 0.0469 |
Puget Sound | 2.83 | [2.44–3.28] | <.0001 |
Southern California | 2.39 | [2.06–2.78] | <.0001 |
Washington Montana | 1.49 | [1.29–1.73] | <.0001 |
Age-Stratified Communal Living | |||
Non-Communal Living | – | – | – |
Adult Community | 1.30 | [1.07–1.58] | 0.0082 |
Adult and Youth | 1.07 | [0.95–1.21] | 0.2835 |
Multigenerational | 1.07 | [0.9–1.28] | 0.4563 |
Senior Living | 1.69 | [1.23–2.32] | 0.0011 |
Other | 1.12 | [0.77–1.64] | 0.5492 |
Financial Insecurity | 1.10 | [1.01–1.25] | 0.0392 |
Housing Insecurity | 1.32 | [1.16–1.5] | <.0001 |
Transportation Insecurity | 1.11 | [1.02–1.23] | 0.0285 |
Low Air Quality | 1.01 | [1–1.04] | 0.0502 |