National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
United States Public Health Service Commissioned Corps, Rockville, Maryland, USA.
Influenza Other Respir Viruses. 2024 Nov;18(11):e70021. doi: 10.1111/irv.70021.
Screening for SARS-CoV-2 infection among hospital admissions made interpretation of COVID-19 hospitalization data challenging as SARS-CoV-2-positive persons with mild or asymptomatic infection may be incorrectly identified as COVID-19-associated hospitalizations. The study objective is to estimate the proportion of hospitalizations likely attributable to COVID-19 among SARS-CoV-2-positive hospitalized patients.
A sample of laboratory-confirmed SARS-CoV-2-positive hospitalizations from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) from June 2020 to September 2023 was analyzed, with a focus on July 2022 to September 2023. Likely COVID-19-attributable hospitalizations were defined as hospitalizations among SARS-CoV-2-positive non-pregnant adults ages ≥ 18 years with COVID-19-related presenting complaint, treatment, or discharge diagnosis.
Among 44,816 sampled hospitalizations, 90% met the definition of likely COVID-19-attributable. Among the 9866 admissions occurring during July 2022 to September 2023, 86% were likely COVID-19-attributable; 87% had a COVID-19-related presenting complaint, 64% received steroids or COVID-19-related treatment, 47% had respiratory- and 10% had coagulopathy-related discharge diagnoses, and 39% had COVID-19 as the principal discharge diagnosis code. More than 70% met ≥ 2 criteria. Compared with likely COVID-19-attributable hospitalizations, SARS-CoV-2-positive patients who did not meet the case definition were more likely to be ages 18-49 years (27% vs. 13%), have no underlying medical conditions (14% vs. 4%), or be asymptomatic for COVID-19 upon admission (46% vs. 10%) (all p < 0.05).
Most hospitalizations among SARS-CoV-2-positive adults in a recent period were likely attributable to COVID-19. COVID-19-attributable hospitalizations are less common among younger SARS-CoV-2-positive hospitalized adults but still account for nearly three quarters of all admissions among SARS-CoV-2-positive adults in this age group.
在对住院患者进行 SARS-CoV-2 感染筛查时，由于轻度或无症状感染的 SARS-CoV-2 阳性者可能被错误地认定为与 COVID-19 相关的住院治疗，因此对 COVID-19 住院数据的解释具有挑战性。本研究旨在估计 SARS-CoV-2 阳性住院患者中归因于 COVID-19 的住院比例。
分析了 2020 年 6 月至 2023 年 9 月期间 COVID-19 相关住院监测网络（COVID-NET）中实验室确诊的 SARS-CoV-2 阳性住院患者样本，重点分析 2022 年 7 月至 2023 年 9 月的数据。可能归因于 COVID-19 的住院治疗定义为 SARS-CoV-2 阳性、年龄≥18 岁的非孕妇成年人中与 COVID-19 相关的就诊、治疗或出院诊断的住院治疗。
在 44816 例抽样住院治疗中，90%符合可能归因于 COVID-19 的住院治疗标准。在 2022 年 7 月至 2023 年 9 月期间发生的 9866 例住院治疗中，86%为可能归因于 COVID-19 的住院治疗；87%的患者有 COVID-19 相关的就诊主诉，64%接受了类固醇或 COVID-19 相关治疗，47%有呼吸系统和 10%有凝血障碍相关的出院诊断，39%的患者的主要出院诊断代码为 COVID-19。超过 70%的患者符合≥2 项标准。与符合可能归因于 COVID-19 的住院治疗标准的患者相比，不符合病例定义的 SARS-CoV-2 阳性患者更有可能年龄在 18-49 岁（27% vs. 13%）、无基础疾病（14% vs. 4%）或入院时无症状（46% vs. 10%）（均 P<0.05）。
在近期，大多数 SARS-CoV-2 阳性成年人的住院治疗归因于 COVID-19。在该年龄段的 SARS-CoV-2 阳性住院患者中，年轻的 SARS-CoV-2 阳性住院患者的 COVID-19 归因住院治疗不太常见，但仍占所有 SARS-CoV-2 阳性住院患者的近四分之三。
