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Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Fatality assessment and variant risk monitoring for COVID-19 using three new hospital occupancy related metrics
Ping-Wu Zhang1, Steven H Zhang2, Wei-Feng Li1
1Wilmer Eye Institute, Johns Hopkins University School of Medicine; Baltimore, MD, 21231, USA.
Insights
New metrics like hospital occupancy mortality rate (HOMR) offer reliable COVID-19 fatality risk assessment. These tools help monitor disease severity and variant impact, overcoming limitations of traditional measures like case fatality rate (CFR).
Area of Science:
- Epidemiology and Public Health
- Infectious Disease Modeling
- Biostatistics
Background:
- Traditional COVID-19 fatality metrics like Case Fatality Rate (CFR) exhibit significant temporal and spatial variability.
- Hospital Mortality Rate (HMR) is a useful severity indicator but lacks global accessibility.
- There is a need for novel, globally applicable metrics for assessing COVID-19 severity and fatality risk.
Purpose of the Study:
- To introduce new metrics for measuring and monitoring COVID-19 fatality risk.
- To develop a mathematical model for estimating average hospital length of stay for deceased and discharged patients.
- To provide dynamic assessment tools for COVID-19 severity and fatality risk.
Main Methods:
- Development of three novel metrics: Hospital Occupancy Mortality Rate (HOMR), Ratio of Total Deaths to Hospital Occupancy (TDHOR), and Ratio of Hospital Occupancy to Cases (HOCR).
- Utilized multiple data sources for comprehensive analysis.
- Mathematical modeling to estimate average hospital length of stay for deaths (Ldead) and discharges (Ldis).
Main Results:
- Estimated Ldead at 18.2 days and Ldis at 14.0 days for 501,079 COVID-19 hospitalizations in the US.
- Found that undiagnosed cases largely explain early pandemic fluctuations in COVID-19 CFR across 27 countries.
- Observed a 65.16% decrease in weekly mean HOCRs for the Omicron variant in the US by January 2022 compared to November 2021.
Conclusions:
- The proposed novel metrics offer reliable and dynamic assessment of COVID-19 fatality risk.
- These measurements can aid in monitoring risks associated with different COVID-19 variants.
- The findings provide valuable tools for public health surveillance and response.
Background:
Though case fatality rate (CFR) is widely used to reflect COVID-19 fatality risk, its use is limited by large temporal and spatial variation. Hospital mortality rate (HMR) is also used to assess the severity of COVID-19, but HMR data is not directly available globally. Alternative metrics are needed for COVID-19 severity and fatality assessment.
Methods:
We introduce new metrics for COVID-19 fatality risk measurements/monitoring and a new mathematical model to estimate average hospital length of stay for deaths (Ldead) and discharges (Ldis). Multiple data sources were used for our analyses.
Findings:
We propose three, new metrics: hospital occupancy mortality rate (HOMR), ratio of total deaths to hospital occupancy (TDHOR), and ratio of hospital occupancy to cases (HOCR), for dynamic assessment of COVID-19 fatality risk. Estimated Ldead and Ldis for 501,079 COVID-19 hospitalizations in 34 US states between 7 August 2020 and 1 March 2021 were 18·2(95%CI:17·9-18·5) and 14·0(95%CI:13·9-14·0) days, respectively. We found the dramatic changes in COVID-19 CFR observed in 27 countries during early stages of the pandemic were mostly caused by undiagnosed cases. Compared to the first week of November 2021, the week mean HOCRs (mimics hospitalization-to-case ratio) for Omicron variant (58·6% of US new cases as of 25 December 2021) decreased 65·16% in the US as of 16 January 2022.
Interpretation:
The new and reliable measurements described here could be useful for COVID-19 fatality risk and variant-associated risk monitoring.
Funding:
No specific funding was associated with the present study.
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