Population-Based Model of the Fraction of Incidental COVID-19 Hospitalizations during the Omicron BA.1 Wave in the United States

Author:

Harris Jeffrey E.12ORCID

Affiliation:

1. Massachusetts Institute of Technology, Cambridge, MA 02139, USA

2. Eisner Health, Los Angeles, CA 90015, USA

Abstract

1. Background: Some reports have suggested that as many as one-half of all hospital inpatients identified as COVID-19-positive during the Omicron BA.1 variant-driven wave were incidental cases admitted primarily for reasons other than their viral infections. To date, however, there are no prospective longitudinal studies of a representative panel of hospitals based on pre-established criteria for determining whether a patient was, in fact, admitted as a result of the disease. 2. Materials and Methods: To fill this gap, we developed a formula to estimate the fraction of incidental COVID-19 hospitalizations that relies on measurable, population-based parameters. We applied our approach to a longitudinal panel of 164 counties throughout the United States, covering a 4-week interval ending in the first week of January 2022. 3. Results: Within this panel, we estimated that COVID-19 incidence was rising exponentially at a rate of 9.34% per day (95% CI, 8.93–9.87). Assuming that only one-quarter of all Omicron BA.1 infections had been reported by public authorities, we further estimated the aggregate prevalence of active SARS-CoV-2 infection during the first week of January to be 3.45%. During the same week, among 250 high-COVID-volume hospitals within our 164-county panel, an estimated one in four inpatients was COVID-positive. Based upon these estimates, we computed that 10.6% of such COVID-19-positive hospitalized patients were incidental infections. Across individual counties, the median fraction of incidental COVID-19 hospitalizations was 9.5%, with an interquartile range of 6.7 to 12.7%. 4. Conclusion: Incidental COVID-19 infections appear to have been a nontrivial fraction of all COVID-19-positive hospitalized patients during the Omicron BA.1 wave. In the aggregate, however, the burden of patients admitted for complications of their viral infections was far greater.

Publisher

MDPI AG

Subject

General Medicine

Reference42 articles.

1. Johns Hopkins University. United States (2022, June 15). Data Timeline: Daily COVID-19 Hospitalizations; Johns Hopkins Coronavirus Resource Center. Available online: https://coronavirus.jhu.edu/region/united-states.

2. Murray, S.G., Croci, R., and Wachter, R.M. (2022, January 07). Is a Patient Hospitalized ‘with’ COVID or ‘for’ COVID? It Can Be Hard to Tell; Washington Post. Available online: https://www.washingtonpost.com/outlook/2022/01/07/hospitalization-covid-statistics-incidental/.

3. Jackson Health System (2022, January 12). Jackson Health System Hospitals Currently Have 564 Patients Who Have Tested Positive for COVID-19 (Tweet). Twitter.com. Available online: https://twitter.com/JacksonHealth/status/1481268904970358790.

4. New York Governor (2022, January 07). Governor Hochul Updates New Yorkers on State’s Progress Combating COVID-19 Press Release, Available online: https://www.governor.ny.gov/news/governor-hochul-updates-new-yorkers-states-progress-combating-covid-19-131.

5. High Asymptomatic Carriage With the Omicron Variant in South Africa;Garrett;Clin. Infect. Dis.,2022

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