1. Re-thinking all-cause COVID-19 hospitalizations as a surrogate measure for severe illness in observational surveillance studies
- Author
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Kelly, J Daniel, Leonard, Samuel, Boscardin, W John, Hoggatt, Katherine J, Lum, Emily N, Austin, Charles C, Byers, Amy L, Tien, Phyllis C, Bravata, Dawn M, and Keyhani, Salomeh
- Subjects
Health Services and Systems ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Coronaviruses ,Infectious Diseases ,Emerging Infectious Diseases ,Aetiology ,2.4 Surveillance and distribution ,Infection ,Good Health and Well Being ,Humans ,COVID-19 ,Hospitalization ,Male ,Female ,Middle Aged ,Retrospective Studies ,Aged ,SARS-CoV-2 ,Adult ,Severity of Illness Index ,United States - Abstract
All-cause COVID-19 hospitalization ≤ 30 days of infection is a common outcome for severe illness in observational/surveillance studies. Milder COVID-19 disease and COVID-19-specific measurements calls for an evaluation of this endpoint. This was a descriptive, retrospective cohort study of adults ≥ 18 who were established in primary care at Veteran Health Administration (VHA) facilities. The outcome was hospitalization within 30 days of a laboratory-confirmed, symptomatic SARS-CoV-2 infection. Between December 15, 2021 and May 1, 2022, a simple random sample of all VA facilities, excluding Puerto Rico or Philippines, was drawn to identify these hospitalized cases and determine whether hospitalization was due to COVID-19-specific causes. A chart review was conducted to record the inpatient clinical team's diagnosis and whether the inpatient team classified the diagnosis as COVID-19 related or not. These data were used to classify hospitalizations as either due to COVID-19-specific causes (direct manifestations of SARS-CoV-2 infection) or non-COVID-19-specific hospitalizations (incidental SARS-CoV-2 infection), A simple random sample of 9966 (12.3%) all-cause hospitalizations (95% CI: 12.1%, 12.5%) was used to select 300 representative patients. Of these, 226/300 (75.3%) were determined to be COVID-19-specific. COVID-19 pneumonia was most common (147/226, 65.0%). The highest proportion of COVID-19-specific hospitalizations occurred among unvaccinated (85.0%), followed by vaccinated but not boosted (73.7%) and boosted (59.4%) (p
- Published
- 2024