Evidence map›Paper›PMID 40691741›Full record

Observational studyJournal of racial and ethnic health disparities2026

Incidence Rates of COVID-19-Associated Hospitalization and Risk Factors for Severe Disease Among American Indian and Alaska Native Persons in the Southwest USA and Alaska.

Chelsea S Lutz, Catherine G Sutcliffe, James W Keck, Rachel M Hartman, Christine Desnoyers, Amy Swango-Wilson, Amanda B Burrage, Angela P Campbell, Loretta Christensen, Ryan M Close and 16 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Chelsea S LutzDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Catherine G SutcliffeDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
James W KeckAlaska Native Tribal Health Consortium, Anchorage, AK, USA.
Rachel M HartmanDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Christine DesnoyersYukon-Kuskokwim Health Corporation, Bethel, AK, USA.
Amy Swango-WilsonAlaska Native Tribal Health Consortium, Anchorage, AK, USA.
Amanda B BurrageTuba City Regional Health Care Corporation, Tuba City, AZ, USA.
Angela P CampbellCoronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Loretta ChristensenIndian Health Service, Rockville, MD, USA.
Ryan M CloseWhiteriver Service Unit, Phoenix Area Indian Health Service, Whiteriver, AZ, USA.
Shawnell DamonNavajo Area Indian Health Service, St. Michaels, AZ, USA.
Jennifer DobsonYukon-Kuskokwim Health Corporation, Bethel, AK, USA.
Starla GarciaDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Natasha HalasaVanderbilt University Medical Center, Nashville, TN, USA.
Elvira HonieDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Verlena LittleDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Meredith L McMorrowCoronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Dennie ParkerDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Mila M PrillCoronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jennifer RichardsDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Puthiery VaChinle Service Unit, Navajo Area, Indian Health Service, Chinle, AZ, USA.
Mark VeazieChinle Service Unit, Navajo Area, Indian Health Service, Chinle, AZ, USA.
Dan VanDeRietDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Del YazzieNavajo Epidemiology Center, Window Rock, AZ, USA.
Rosalyn J SingletonAlaska Native Tribal Health Consortium, Anchorage, AK, USA.
Laura L HammittDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. lhammitt@jhu.edu.

Funding

CDC HHS U01 IP001116
6 · The paper itself

Abstract

introductionCOVID-19 causes significant morbidity in the USA, particularly among American Indian/Alaska Native (AI/AN) persons. Estimates of COVID-19 burden among AI/AN communities are needed to identify health outcome disparities and inform prevention strategies, but under-ascertainment of AI/AN status in national data may result in underestimation of COVID-19 disease burden.

methodsSurveillance for acute respiratory illness was conducted among AI/AN persons at eight healthcare facilities in Arizona and Alaska to identify COVID-19-associated hospitalizations and outpatient visits. Weekly and annual incidence rates of COVID-19-associated hospitalizations per 100,000 persons were calculated overall and by site and age. Risk factors for COVID-19-associated hospitalizations (versus outpatient visits) were assessed.

resultsFrom January 2021 to December 2022, 1159 COVID-19-associated hospitalizations were identified. Incidence rates were 439.8 per 100,000 in 2021 and 332.6 per 100,000 in 2022 and highest among adults ≥ 65 years at all sites. Compared to national estimates from 2021 to 2022, incidence rates by time and age were similar among older adults, whereas incidence rates among AI/AN children were over twice as high. Among adults, older age, chronic lung disease, chronic kidney disease, and diabetes increased the risk of hospitalization; frequent mask use outside the home and COVID-19 vaccination were protective, particularly if vaccinated within the past year. Among children, younger age and heart conditions increased the risk of hospitalization.

conclusionsThe findings demonstrate a substantial burden of COVID-19 in AI/AN persons and provide critically needed data regarding the risks for severe outcomes. AI/AN children experience a disproportionate burden of COVID-19 disease.

Indexed as

COVID-19HospitalizationAdolescentAdultAgedAlaskaAmerican Indian or Alaska NativeArizonaChildChild, PreschoolFemaleHumansIncidenceInfantMaleMiddle AgedCOVID-19Indigenous healthRisk factorSARS-CoV-2

Identifiers

PMID40691741
PMCPMC13346257

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.