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COVID-19 Insights & Analytics Issue 2

Jun 4, 2020

Overview

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The COVID-19 Insights & Analytics newsletter is designed to quantify national trends that may help in COVID response planning. The included data and analytics are derived from electronic patient data from 338 participating U.S. hospitals initiated on March 1, 2020 through May 31, 2020 unless otherwise indicated.

Executive Summary

  • Coastal states experienced a higher and earlier peak of daily positive patients than Central states, and have experienced several weeks of declining daily positives. Central states have not seen rates decrease yet.
  • COVID positive patients have longer length of stay (LOS) and higher mortality than negative tested patients.
  • There are early signals that overall hospital bed utilization is starting to increase.

Testing Insights

Figure 1: Test positive by Central states

Figure 2: Test positive by Coastal states

Figure 1 and 2 Commentary:

  • Coastal and Central state groups are of similar size (~300K tested samples).
  • While total positives in both groups continue to rise, the rate of new daily positives in Coastal states declined from April 1 through mid-May and appear to be plateauing during last two weeks in May. Central states have experienced a plateau in the rate of new daily positives for past 30+ days.
  • Coastal states positivity rate is 100 basis points higher (11.0% vs 10.0%) than Central states. Potentially, this could be due to the inclusion of NY and NJ where higher % positives were observed.
  • Average age of positive tested patients is 5 years older for Coastal states (55 vs 50); this average is influenced by the inclusion of NJ whose average positive age is 62.
  • Not all states are represented due to not having a participating member hospital in that state.

Figure 3: COVID testing Turnaround Time (TAT)

Figure 3 Commentary:

  • Coastal states have a longer test TAT ~1.5 days vs. Central states at ~1 day. This difference could be due to higher utilization of reference labs vs. on-site testing. Additionally, the longer TAT could be influenced by more constrained testing capacity in the Coastal states.

Figure 4 Mortality and Length of Stay (LOS)

Figure 4 Commentary:

  • Mortality is determined from the patient discharge disposition. If the discharge information is incomplete, patients are not included in the above analysis.
  • COVID positive patients have a longer LOS than negative tested patients. This is true with both the recovered and expired subsets.
  • For COVID positive patients, an increase in mortality correlates to a longer LOS. The mortality rate is ~10 points higher within the first few days of stay and increases to ~15 points higher by day 15.
  • The patient mortality for negative tested patients that did not require ICU stay was 1.7%. Mortality for COVID positive patients was ~6x greater (10.6%) among those not requiring ICU stay.
  • In the ICU, the patient mortality for negative tested patients was 12.5%, whereas COVID positive tested patients had a ~3x greater mortality (37.4%).

Figure 5: Hospital Admission compared to prior year maximum

Figure 5 Commentary:

  • Total hospital admissions declined for 4 weeks, followed by 3 weeks of flat and low utilization, and has now experience 6 weeks of growth.
  • All 3 cohorts have increased capacity utilization, but the Intermediate cohort (grey) has experience the greatest gain from its lowest point.
  • The increased utilization potentially represents resuming some non-emergent procedures.
  • Additionally, this trend could also be driven by an increase in patient willingness to seek care at a hospital, as we have observed an increase in ER utilization in the Intermediate and Low cohorts (not pictured).

Admissions Benchmark key

Top 20% of positive COVID specimens (High): Orange Line (n=56 hospitals)
Middle 60% of positive COVID specimens (Intermediate): Grey Line (n=150 hospitals)
Bottom 20% of positive COVID specimens (Low): Blue Line (n=45 hospitals)

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