Population-Based Model of the Fraction of Incidental COVID-19 Hospitalizations during the Omicron BA.1 Wave in the United States
Name
covid-03-00054.pdf
Size
2.73 MB
Format
Adobe PDF
Checksum (MD5)
91e0a38d2b52b9fbf6e23774c6315ead
Author(s)
Harris, Jeffrey E.
Date Issued
May 8, 2023
Publisher
Multidisciplinary Digital Publishing Institute
Citation
COVID 3 (5): 728-743 (2023)
Version
Final published version
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.
MIT Department
Massachusetts Institute of Technology. Department of Economics
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DOI of Published Version
https://doi.org/10.3390/covid3050054
