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Improving COVID-19 Disease Severity Surveillance Measures: Statewide Implementation Experience
Shira Doron1, Paul A Monach2, Catherine M Brown3
1Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts (S.D.).
Annals of Internal Medicine
|May 15, 2023
Summary
Standardizing COVID-19 hospital burden metrics is crucial. Massachusetts hospitals tracked COVID-19 hospitalizations and dexamethasone use, finding dexamethasone use decreased over time, reflecting declining illness severity.
Area of Science:
- Public Health
- Epidemiology
- Health Informatics
Background:
- Measuring the burden of COVID-19 on hospitals is vital for public health.
- Existing metrics lack standardization due to variations in testing and policies.
- Dexamethasone administration correlates with COVID-19 severity and changing epidemiology.
Purpose of the Study:
- To assess the feasibility of enhancing COVID-19 hospitalization surveillance.
- To track the frequency of severe COVID-19 cases using dexamethasone administration as a proxy.
- To provide actionable data for health authorities and policymakers.
Main Methods:
- Mandated daily reporting of COVID-19 hospitalizations and dexamethasone use from 68 Massachusetts acute care hospitals.
- Data collected over a 1-year period (January 10, 2022, to January 9, 2023).
- Analysis of trends in dexamethasone administration proportion among hospitalized COVID-19 patients.
Main Results:
- A total of 44,196 COVID-19 hospitalizations were recorded.
- 34% of all COVID-19 hospitalizations were associated with dexamethasone administration.
- The proportion of dexamethasone use decreased from 49.6% to a stable average of ~33% by April 2022.
Conclusions:
- Adding dexamethasone data to surveillance is feasible and provides valuable insights into severe COVID-19.
- Surveillance methods must adapt to evolving public health needs.
- This approach offers a standardized metric for tracking COVID-19 severity in hospitalized populations.
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