Caseload strain linked to patient survival during delta wave of COVID-19

Across hospital types, there is a comparably detrimental relationship between COVID-19 caseload and patient survival, according to a study published online Sept. 10 in the Annals of Internal Medicine.

Maniraj Neupane, M.D., Ph.D., from the National Institutes of Health Clinical Center in Bethesda, Maryland, and colleagues conducted a retrospective cohort study to examine whether hospital type classified by capabilities and resources influenced COVID-19 volume-outcome relationships during the delta wave. The study included adult inpatients with COVID-19 admitted to 620 U.S. hospitals during July to November 2021.

Of the 620 hospitals recording 223,380 inpatients with COVID-19, 208 were extracorporeal membrane oxygenation-capable, 216 had multiple intensive care units (ICUs), 36 had large (≥200 beds) single ICUs, and 160 had small (<200 beds) single ICUs. The researchers found that 23 percent of the patients required admission to the ICU and 15.3 percent died. Per unit increase in the log surge index, the marginally adjusted probability for mortality was 5.51 percent (strain-attributable mortality: 7,375 or one in five COVID-19 deaths). Across the four hospital types, the test for interaction showed no difference in the log surge index-mortality relationship.

“We encourage future studies that examine whether the risks for high pandemic caseloads across hospital types identified in our study extend to patients with non-COVID-19 conditions during the pandemic and nonpandemic times,” the authors write.

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