Refining the hospitalization rate: A mixed methods approach to differentiate primary COVID-19 from incidental cases

Misailovski, Martin ; Koller, Daniela ; Blaschke, Sabine ; Berens, Milena; Köster, A.M.; Strobl, Ralf ; Berner, Reinhard ; Boor, Peter; Eisenmann, Michael ; von Stillfried, Saskia; Krefting, Dagmar; Krone, Manuel ; Liese, Johannes; Meybohm, Patrick; Ulrich- Merzenich, Gudrun; Zenker, Sven; Scheithauer, Simone and Grill, Eva (2024): Refining the hospitalization rate: A mixed methods approach to differentiate primary COVID-19 from incidental cases. In: Infection Prevention in Practice, Vol. 6, No. 3, 100371

Abstract

Purpose: Until now, the Hospitalization Rate (HR) served as an indicator (among others) for the COVID-19 associated healthcare burden. To ensure that the HR accomplishes its full potential, hospitalizations caused by COVID-19 (primary cases) and hospitalizations of patients with incidental positive SARS-CoV-2 test results (incidental cases) must be differentiated. The aim of this study was to synthesize the existing evidence on differentiation criteria between hospitalizations of primary cases and incidental cases. Methods: An online survey of the members of the German Network University Medicine (NUM) was conducted. Additionally, senior clinicians with expertise in COVID-19 care were invited for qualitative, semi-structured interviews. Furthermore, a rapid literature review was undertaken on publications between 03/2020 and 12/2022. Results: In the online survey (n¼30, response rate 56%), pneumonia and acute upper respiratory tract infections were the most indicative diagnoses for a primary case. In contrast, malignant neoplasms and acute myocardial infarctions were most likely to be associated with incidental cases. According to the experts (n¼6), the diagnosis, ward, and type of admission (emergency or elective), low oxygen saturation, need for supplemental oxygen, and initiation of COVID-19 therapy point to a primary case. The literature review found that respiratory syndromes and symptoms, oxygen support, and elevated levels of inflammatory markers were associated with primary cases. Conclusion: There are parameters for the differentiation of primary from incidental cases to improve the objective of the HR. Ultimately, an updated HR has the potential to serve as a more accurate indicator of the COVID-19 associated healthcare burden.

• Item Type: Journal article
• Faculties: Medicine > Institute for Medical Information Processing, Biometry and Epidemiology; Medicine > Medical Center of the University of Munich > German Center for Vertigo and Balance Disorders
• Subjects: 600 Technology > 610 Medicine and health
• ISSN: 25900889
• Language: English