Population-Based Model of the Fraction of Incidental COVID-19 Hospitalizations during the Omicron BA.1 Wave in the United States
Population-Based Model of the Fraction of Incidental COVID-19 Hospitalizations during the Omicron BA.1 Wave in the United States
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美国 Omicron BA.1 浪潮期间偶发 COVID-19 住院比例的基于人群的模型
DOI：
10.3390/covid3050054
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
J. Harris
中科院分区：
文献类型：
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作者：
J. Harris
1. 背景：一些报告表明，在欧米克隆BA.1变异驱动波期间，多达一半的covid -19阳性住院患者是主要因病毒感染以外的原因入院的偶然病例。然而，迄今为止，还没有根据预先确定的标准对具有代表性的医院小组进行前瞻性纵向研究，以确定患者是否实际上因该疾病而入院。2. 材料和方法：为了填补这一空白，我们开发了一个公式来估计COVID-19意外住院的比例，该公式依赖于可测量的、基于人群的参数。我们将我们的方法应用于美国164个县的纵向面板，覆盖4周的间隔，结束于2022年1月的第一周。3. 结果：在该小组中，我们估计COVID-19的发病率以每天9.34%的速度呈指数增长（95% CI, 8.93-9.87）。假设公共当局仅报告了所有Omicron BA.1感染的四分之一，我们进一步估计1月第一周活动性SARS-CoV-2感染的总流行率为3.45%。在同一周内，在我们164个县的小组中，250家高冠状病毒量医院中，估计有四分之一的住院患者呈冠状病毒阳性。根据这些估计，我们计算出10.6%的covid -19阳性住院患者是偶然感染。在各个县，COVID-19意外住院率的中位数为9.5%，四分位数范围为6.7至12.7%。4. 结论：在欧米克隆BA.1波期间，偶然感染的COVID-19似乎占所有COVID-19阳性住院患者的很大一部分。然而，总的来说，因病毒感染并发症入院的患者负担要大得多。
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.