Abstract
Abstract
Admissions are generally classified as COVID-19 hospitalizations if the
patient has a positive SARS-CoV-2 polymerase chain reaction (PCR) test. However,
because 35% of SARS-CoV-2 infections are asymptomatic, patients admitted for
unrelated indications with an incidentally positive test could be misclassified
as a COVID-19 hospitalization. EHR-based studies have been unable to distinguish
between a hospitalization specifically for COVID-19 versus an incidental
SARS-CoV-2 hospitalization. From a retrospective EHR-based cohort in four US
healthcare systems, a random sample of 1,123 SARS-CoV-2 PCR-positive patients
hospitalized between 3/2020–8/2021 was manually chart-reviewed and classified as
admitted-with-COVID-19 (incidental) vs. specifically admitted for COVID-19
(for-COVID-19). EHR-based phenotyped feature sets filtered out incidental
admissions, which occurred in 26%. The top site-specific feature sets had 79-99%
specificity with 62-75% sensitivity, while the best performing across-site
feature set had 71-94% specificity with 69-81% sensitivity. A large proportion
of SARS-CoV-2 PCR-positive admissions were incidental. Straightforward EHR-based
phenotypes differentiated admissions, which is important to assure accurate
public health reporting and research.
Publisher
Cold Spring Harbor Laboratory