Archive for the ‘hospitalization’ Category

COVID-19 hospital data is a hot mess after feds take control

July 31st, 2020
Members of the medical staff treat a patient in the COVID-19 intensive care unit at the United Memorial Medical Center on July 28, 2020 in Houston, Texas. COVID-19 cases and hospitalizations have spiked since Texas reopened, pushing intensive-care units to full capacity and sparking concerns about a surge in fatalities as the virus spreads.

Enlarge / Members of the medical staff treat a patient in the COVID-19 intensive care unit at the United Memorial Medical Center on July 28, 2020 in Houston, Texas. COVID-19 cases and hospitalizations have spiked since Texas reopened, pushing intensive-care units to full capacity and sparking concerns about a surge in fatalities as the virus spreads. (credit: Getty | Go Nakamura)

As COVID-19 hospitalizations in the US approach the highest levels seen in the pandemic so far, national efforts to track patients and hospital resources remain in shambles after the federal government abruptly seized control of data collection earlier this month.

The Trump administration issued a directive to hospitals and states July 10, instructing them to stop submitting their daily COVID-19 hospital data to the US Centers for Disease Control and Prevention—which has historically handled such public health data—and instead submit it to a new database in the hands of the Department of Health and Human Services. The change was ostensibly made to streamline federal data collection, which is critical for assessing the state of the pandemic and distributing needed resources, such as personal protective equipment and remdesivir, an antiviral drug shown to shorten COVID-19 recovery times.

Watchdogs and public health experts were immediately aghast by the switch to the HHS database, fearing the data would be manipulated for political reasons or hidden from public view all together. However, the real threat so far has been the administrative chaos. The switch took effect July 15, giving hospitals and states just days to adjust to the new data collection and submission process.

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Posted in CDC, COVID-19, data, database, healthcare IT, HHS, hospitalization, Infectious disease, IT, pandemic, public health, SARS-CoV-2, science | Comments (0)

First look at the outcomes of COVID-19 patients in NY hospitals

April 23rd, 2020
Health worker in protective gear enters hospital door labeled COVID.

Enlarge (credit: PASCAL POCHARD-CASABIANCA / Getty Images)

On March 1, New York City confirmed its first case of SARS-CoV-2 infection. By the end of the month, thousands were infected, and hospitals were struggling to manage the influx of patients. On Wednesday, JAMA published an analysis of the outcomes of thousands of patients who ended up at a large hospital system in the city and surrounding areas. While the data is annoyingly incomplete, it does provide a broad overview of how the pandemic is interacting with the health demographics in the United States.

Some of this is expected, as the sorts of pre-existing conditions that exacerbate COVID-19—obesity, hypertension, and diabetes—cause problems here. The study also suggests some dramatically bad outcomes for older patients who ended up on ventilators, with 97 percent mortality for those over 65. But the study period ended before the outcomes of most patients could be tracked, so this number has to be treated with significant caution.

At admission

The work is based on the electronic patient records from the Northwell Health hospital system, which has a dozen hospitals in New York City and the surrounding suburbs. The researchers (Safiya Richardson, Jamie S. Hirsch, and Mangala Narasimhan) pulled out the records of anyone with a confirmed SARS-CoV-2 infection from the period between March 1 and April 4 of this year. This produced a study population of 5,700 patients, which is quite large. However, the study cut off tracking the patients on April 4; if a case hadn't resulted in discharge or death by then, the outcomes couldn't be analyzed. Follow-ups for those who were discharged were also limited, with the medium length being only four days.

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Posted in COVID-19, dialysis, hospitalization, medicine, SARS-CoV-2, science, ventilators | Comments (0)