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Objective To understand the epidemiology and burden of severe coronavirus disease 2019 (covid-19) during the first epidemic wave on the west coast of the United States. Design Prospective cohort study. Setting Kaiser Permanente integrated healthcare delivery systems serving populations in northern California, southern California, and Washington state. Participants 1840 people with a first acute hospital admission for confirmed covid-19 by 22 April 2020, among 9 596 321 healthcare plan enrollees. Analyses of hospital length of stay and c
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