How Many SARS-CoV-2-Infected People Require Hospitalization? Using Random Sample Testing to Better Inform Preparedness Efforts.
J Public Health Manag Pract
; 27(3): 246-250, 2021.
Article
in English
| MEDLINE | ID: covidwho-1138026
ABSTRACT
CONTEXT Existing hospitalization ratios for COVID-19 typically use case counts in the denominator, which problematically underestimates total infections because asymptomatic and mildly infected persons rarely get tested. As a result, surge models that rely on case counts to forecast hospital demand may be inaccurately influencing policy and decision-maker action. OBJECTIVE:
Based on SARS-CoV-2 prevalence data derived from a statewide random sample (as opposed to relying on reported case counts), we determine the infection-hospitalization ratio (IHR), defined as the percentage of infected individuals who are hospitalized, for various demographic groups in Indiana. Furthermore, for comparison, we show the extent to which case-based hospitalization ratios, compared with the IHR, overestimate the probability of hospitalization by demographic group.DESIGN:
Secondary analysis of statewide prevalence data from Indiana, COVID-19 hospitalization data extracted from a statewide health information exchange, and all reported COVID-19 cases to the state health department.SETTING:
State of Indiana as of April 30, 2020. MAIN OUTCOMEMEASURES:
Demographic-stratified IHRs and case-hospitalization ratios.RESULTS:
The overall IHR was 2.1% and varied more by age than by race or sex. Infection-hospitalization ratio estimates ranged from 0.4% for those younger than 40 years to 9.2% for those older than 60 years. Hospitalization rates based on case counts overestimated the IHR by a factor of 10, but this overestimation differed by demographic groups, especially age.CONCLUSIONS:
In this first study of the IHR based on population prevalence, our results can improve forecasting models of hospital demand-especially in preparation for the upcoming winter period when an increase in SARS CoV-2 infections is expected.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Population Surveillance
/
Civil Defense
/
COVID-19
/
Hospitalization
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
/
Young adult
Country/Region as subject:
North America
Language:
English
Journal:
J Public Health Manag Pract
Journal subject:
Public Health
/
Health Services
Year:
2021
Document Type:
Article
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