Assessing the Impact of the Pandemic on Outcomes for Hospitalized Patients

New research published in JAMA Network Open sought to examine whether outcomes for patients hospitalized with non-COVID-19 conditions but without concomitant SARS-CoV-2 infection were different before versus during the pandemic. 

The researchers compared patient hospitalizations between April 1, 2018, and September 30, 2019, with those from April 1, 2020, and September 30, 2021, in 235 acute care hospitals located in Alberta and Ontario. The data included almost 250,000 patient hospitalizations for common medical conditions, which included heart failure (HF), chronic obstructive pulmonary disease (COPD) or asthma, urinary tract infection or urosepsis, acute coronary syndrome, and stroke.

The researchers found that although patients with a most responsible diagnosis of any of the common medical conditions and concomitant SARS-CoV-2 infection had worse outcomes (longer hospital length of stay and higher mortality), for those patients without SARS-CoV-2 infection hospitalized during the pandemic, only those with HF or with COPD/asthma showed a significantly higher risk-adjusted rate of death within 30 days of admission to the hospital during the pandemic (16% and 41% higher, respectively). They also determined that as COVID-19 caseloads rose, lengths of stay and risk-adjusted rate of death increased for patients with COVID-19 but not for those with non-COVID-19 conditions.

These findings show that the majority of patients hospitalized with non-COVID-19 conditions (excluding those with HF or with COPD/asthma) displayed similar risk-adjusted outcomes during the pandemic if they didn’t have concurrent SARS-CoV-2 infection, even during COVID-19 caseload surges. The researchers highlight that this demonstrates a high degree of resilience by the Canadian hospital system in the face of major strains on hospital occupancy and resources. 

This research was conducted by members of the CORONA Collaboration, and CVC co-authors included Drs. Finlay McAlister and Sean van Diepen. Additional publications from the CORONA Collaboration can be viewed here