Abstract
Purpose: To evaluate the number, characteristics, and outcomes of patients identified hospitalized with coronavirus disease 2019 (COVID-19) using two different case definitions.
Procedures: Electronic Health Record data were evaluated from patients hospitalized with COVID-19 through May 2020 at 52 health systems across the United States. Characteristics of inpatients with positive laboratory tests for SARS-CoV-2 were compared with those with clinical diagnosis of COVID-19 but without a confirmatory lab result.
Findings: Of 14,371 inpatients with COVID-19, 6623 (46.1 %) had a positive laboratory result, and n = 7748 (52.9 %) had only a clinical diagnosis of COVID-19. Compared with clinically diagnosed cases, those with laboratory-confirmed COVID were similar in age and sex, but differed by race, ethnicity, and insurance status. Laboratory-confirmed cases were more likely to receive certain COVID-19 therapies including hydroxychloroquine, anti-IL6 agents and antivirals (p < 0.001). Those with laboratory-confirmed COVID-19 had lower rates of most complications such as myocardial infarction, but higher overall mortality (p < 0.001).
Conclusion: We observed a two-fold difference in the number of patients hospitalized with COVID-19 depending on whether the case definition required laboratory confirmation. Variations in case definitions also led to differences in cohort characteristics, treatments, and outcomes.
Keywords: COVID-19; Case definition; Electronic health records.
【저자키워드】 COVID-19, Case definition, Electronic health records., 【초록키워드】 coronavirus disease, SARS-CoV-2, therapy, Hospitalized, Hydroxychloroquine, Antiviral, outcome, Laboratory, COVID, outcomes, Health, Characteristics, Patient, Complication, health system, Myocardial infarction, Clinical diagnosis, Laboratory test, Inpatient, anti-IL6, overall mortality, Record, positive, laboratory confirmation, laboratory-confirmed, The United States, lab, cohort characteristics, evaluate, clinically, diagnosed, evaluated, required, age and sex, receive, patients hospitalized, with COVID-19, 【제목키워드】 Coronavirus infection, Hospitalized, Impact, Disease surveillance, EHR data, identify,