Re-thinking all-cause COVID-19 hospitalizations as a surrogate measure for severe illness in observational surveillance studies.

Autor: Kelly JD; San Francisco VA Medical Center, 4150 Clement Street 111A1, San Francisco, CA, 94121, USA. Dan.Kelly@ucsf.edu.; Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA. Dan.Kelly@ucsf.edu.; Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA. Dan.Kelly@ucsf.edu.; F.I. Proctor Foundation, UCSF, San Francisco, CA, USA. Dan.Kelly@ucsf.edu., Leonard S; San Francisco VA Medical Center, 4150 Clement Street 111A1, San Francisco, CA, 94121, USA., Boscardin WJ; Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA., Hoggatt KJ; San Francisco VA Medical Center, 4150 Clement Street 111A1, San Francisco, CA, 94121, USA.; Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA., Lum EN; San Francisco VA Medical Center, 4150 Clement Street 111A1, San Francisco, CA, 94121, USA., Austin CC; Department of Veterans Affairs (VA) Health Services and Development (HSR&D) Center for Health Information and Communication (CHIC), Department of Medicine, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA., Byers AL; San Francisco VA Medical Center, 4150 Clement Street 111A1, San Francisco, CA, 94121, USA.; Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.; Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, USA., Tien PC; San Francisco VA Medical Center, 4150 Clement Street 111A1, San Francisco, CA, 94121, USA.; Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA., Bravata DM; Department of Veterans Affairs (VA) Health Services and Development (HSR&D) Center for Health Information and Communication (CHIC), Department of Medicine, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.; Regenstrief Institute, Indianapolis, IN, USA., Keyhani S; San Francisco VA Medical Center, 4150 Clement Street 111A1, San Francisco, CA, 94121, USA. Salomeh.Keyhani@ucsf.edu.; Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA. Salomeh.Keyhani@ucsf.edu.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Jun 24; Vol. 14 (1), pp. 14555. Date of Electronic Publication: 2024 Jun 24.
DOI: 10.1038/s41598-024-61244-7
Abstrakt: All-cause COVID-19 hospitalization ≤ 30 days of infection is a common outcome for severe illness in observational/surveillance studies. Milder COVID-19 disease and COVID-19-specific measurements calls for an evaluation of this endpoint. This was a descriptive, retrospective cohort study of adults ≥ 18 who were established in primary care at Veteran Health Administration (VHA) facilities. The outcome was hospitalization within 30 days of a laboratory-confirmed, symptomatic SARS-CoV-2 infection. Between December 15, 2021 and May 1, 2022, a simple random sample of all VA facilities, excluding Puerto Rico or Philippines, was drawn to identify these hospitalized cases and determine whether hospitalization was due to COVID-19-specific causes. A chart review was conducted to record the inpatient clinical team's diagnosis and whether the inpatient team classified the diagnosis as COVID-19 related or not. These data were used to classify hospitalizations as either due to COVID-19-specific causes (direct manifestations of SARS-CoV-2 infection) or non-COVID-19-specific hospitalizations (incidental SARS-CoV-2 infection), A simple random sample of 9966 (12.3%) all-cause hospitalizations (95% CI: 12.1%, 12.5%) was used to select 300 representative patients. Of these, 226/300 (75.3%) were determined to be COVID-19-specific. COVID-19 pneumonia was most common (147/226, 65.0%). The highest proportion of COVID-19-specific hospitalizations occurred among unvaccinated (85.0%), followed by vaccinated but not boosted (73.7%) and boosted (59.4%) (p < 0.001). The proportion of non-COVID-19-specific hospitalizations was higher in the later period (15-30 days: 55.0%) than the early (0-15 days: 22.5%) (p = 0.003). This study supports the outcome of COVID-19-specific hospitalization instead of all-cause hospitalization in observational studies. The earlier outcome period (0-15 days) was less susceptible to potential measurement bias.
(© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
Databáze: MEDLINE
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