Clinical characteristics and outcomes of SARS-Cov-2 B.1.1.529 infections in hospitalized patients and multi-surge comparison in Louisiana.

BACKGROUND: Peer reviewed data describing SARS-CoV-2 Omicron variant symptoms and clinical outcomes as compared to prior surges in the United States is thus far limited. We sought to determine disease severity, presenting features, and epidemiologic factors of the SARS-CoV-2 Omicron variant compared to prior surges. METHODS: Retrospective cohort analysis was performed on patients admitted during five surges in Louisiana between March 2020 and January 2022. Patient data was pulled from the medical record and a subset of patients during Surge 5 were manually abstracted. Patients who were admitted to one of six Louisiana hospitals with a positive SARS-CoV-2 test during the 5 defined surge periods were included. Surges were compared using chi-squared tests and one way ANOVA for age, sex, vaccination status, length of stay, ICU status, ventilation requirement, and disposition at discharge. The records of patients admitted during the omicron surge were analyzed for presenting symptoms and incidental SARS-CoV-2 diagnosis. RESULTS: With each subsequent surge, a smaller proportion of patients presenting to the emergency department were admitted. Patients admitted during surge 5 had shorter lengths of stay and fewer comorbidities than prior surges. Fewer patients in surge 5 presented with a respiratory condition and fewer required ICU admission. In surges 4 and 5, fewer vaccinated patients were admitted compared to their unvaccinated counterparts. Overall mortality was lower in surge 5 (9%) than in surge 4 (15%) p < .0005. Of the SARS-Cov-2 admissions in surge 5, 22.3% were felt to be incidental diagnoses. CONCLUSIONS: As the COVID-19 pandemic progressed, a younger and less vaccinated population was associated with higher risk for severe disease, fewer patients required ICU admission and overall mortality decreased. Vaccinations seemed to be protective for overall risk of hospitalization but once admitted did not seem to confer additional protection against severe illness during the omicron surge. Age also contributed to patient outcomes.

Reduced turnaround times through multi-sectoral community collaboration during the first surge of SARS-CoV-2 and associated effect on patient care and hospital operations.

BACKGROUND: In March 2020, an influx of admissions in COVID-19 positive patients threatened to overwhelm healthcare facilities in East Baton Rouge Parish, Louisiana. Exacerbating this problem was an overall shortage of diagnostic testing capability at that time, resulting in a delay in time-to-result return. An improvement in diagnostic testing availability and timeliness was necessary to improve the allocation of resources and ultimate throughput of patients. The management of a COVID-19 positive patient or patient under investigation requires infection control measures that can quickly consume personal protective equipment (PPE) stores and personnel available to treat these patients. Critical shortages of both PPE and personnel also negatively impact care in patients admitted with non-COVID-19 illnesses. METHODS: A multisectoral partnership of healthcare providers, facilities and academicians created a molecular diagnostic lab within an academic research facility dedicated to testing inpatients and healthcare personnel for SARS-CoV-2. The purpose of the laboratory was to provide a temporary solution to the East Baton Rouge Parish healthcare community until individual facilities were self-sustaining in testing capabilities. We describe the partnership and the impacts of this endeavor by developing a model derived from a combination of data sources, including electronic health records, hospital operations, and state and local resources. FINDINGS: Our model demonstrates two important principles: the impact of reduced turnaround times (TAT) on potential differences in inpatient population numbers for COVID-19 and savings in PPE attributed to the more rapid TAT.