A comparison of two registry-based systems for the surveillance of persons hospitalised with COVID-19 in Norway, February 2020 to May 2022

Abstract

Background The surveillance of persons hospitalised with COVID-19 has been essential to ensure timely and appropriate public health response. Ideally, surveillance systems should distinguish persons hospitalised with COVID-19 from those hospitalised due to COVID-19. Aim We compared data in two national electronic health registries in Norway to critically appraise and inform the further development of the surveillance of persons hospitalised with COVID-19. Method We included hospitalised COVID-19 patients registered in the Norwegian Patient Registry (NPR) or the Norwegian Pandemic Registry (NoPaR) with admission dates between 17 February 2020 and 1 May 2022. We linked patients, identified overlapping hospitalisation periods and described the overlap between the registries. We described the prevalence of International Classification of Diseases (ICD-10) diagnosis codes and their combinations by main cause of admission (clinically assessed as COVID-19 or other), age and time. Results In the study period, 19,486 admissions with laboratory-confirmed COVID-19 were registered in NoPaR and 21,035 with the corresponding ICD-10 code U07.1 in NPR. Up to late 2021, there was a 90–100% overlap between the registries, which thereafter decreased to < 75%. The prevalence of ICD-10 codes varied by reported main cause, age and time. Conclusion Changes in patient cohorts, virus characteristics and the management of COVID-19 patients from late 2021 impacted the registration of patients and coding practices in the registries. Using ICD-10 codes for the surveillance of persons hospitalised due to COVID-19 requires age- and time-specific definitions and ongoing validation to consider temporal changes in patient cohorts and virus characteristics.