Adding a single data point to COVID-19 reporting may more accurately convey the real-time burden of infection in health care settings

Abstract: https://www.acpjournals.org/doi/10.7326/M23-0618 

URL goes live when the embargo lifts

In a new ‘Medicine and Public Issues,’ authors from Tufts Medical Center, Veterans Affairs Boston Healthcare System, Harvard Medical School and the Massachusetts Department of Public Health advocate for the inclusion of both the total number of COVID-19 hospitalizations daily and the number of inpatients who received dexamethasone at any point during their hospital stay. The authors emphasize that the addition of this data element is an easy and much-needed update to COVID-19 surveillance efforts that may help to more accurately convey the real-time burden of a rapidly changing infection in health care settings. The article is published in Annals of Internal Medicine.  

On 10 January 2022, the Massachusetts Department of Public Health (MDPH) began requiring hospitals to expand surveillance to include reports of both the total number of COVID-19 hospitalizations daily and the number of inpatients who received dexamethasone at any point during their hospital stay. This requirement was added because dexamethasone administration had been shown to be highly correlated with disease severity and was sensitive to the changing epidemiology of new immune-evasive COVID-19 variants.

The authors highlight that the purpose of the ongoing requirement by the MDPH to report dexamethasone is not to minimize pandemic impacts, but to instead understand the ongoing burden of the pandemic in the setting of a changing landscape of population immunity and viral variants. The authors point to COVID-19 data collected from all 68 acute care hospitals in Massachusetts between January 2022 and January 2023, which show that the proportion of persons hospitalized for COVID-19 who received dexamethasone decreased from 49.6 to 33 percent. According to the authors, these data have been used to communicate risk and weigh community-level recommendations by health authorities. They also emphasize that their experience highlights the importance of ongoing review and reevaluation to maintain the utility and predictive value of public health surveillance definitions.

Media contacts: For an embargoed PDF, please contact Angela Collom at [email protected]. To speak with corresponding author Shira Doron, MD, MS, please email Jeremy Lechan at [email protected].