Some hospitals are seeing more patients with incidental COVID-19 cases, or patients who were primarily admitted for other ailments and test positive.
Officials from New York City-based NYU Langone Health told The New York Times in a Jan. 4 report that about 65 percent of its COVID-19 patients were "incidentally" found to be infected after admission for other reasons. New York Gov. Kathy Hochul asked hospitals to adjust their reporting on COVID-19 hospitalizations beginning Jan. 4 to make the distinction between those admitted for the virus as their primary condition and those who incidentally test positive.
Hospitals across the U.S. reported similar trends. Fifty three percent of 471 COVID-19 patients at Jackson (Fla.) Health System were primarily admitted for other reasons, and at Baltimore-based Johns Hopkins Medicine, about 20 percent of patients seeking non-COVID-19-related care are tesing positive.
In a series of tweets Jan. 4, Ashish Jha, MD, dean of Brown University's School of Public Health in Providence, R.I., who practices at Providence VA Medical Center, explained the distinction between patients hospitalized "for COVID-19" and those hospitalized "with COVID-19."
"We have a few patients in the hospital for COVID, but not many, thank goodness," Dr. Jha tweeted. "More common on our service is folks admitted with COVID. That is, they came to the hospital for something else and found to have COVID." Although it's tempting to dismiss such cases as incidental, they can still pose significant risks for patients with other issues, complicate care and add stress to the health system, Dr. Jha said.
At Nashville, Tenn.-based Vanderbilt Health, 201 patients were hospitalized with COVID-19 for the seven-day period ending Jan. 1. Some of the patients "may have incidental COVID infection," though the data have some limitations, the system said in a Jan. 3 update, adding that tracking incidental cases at the hospital level is challenging.
Hospitals treating a surge in COVID-19 patients are also seeing a smaller proportion of those patients requiring admission to the intensive care unit or mechanical ventilation, physicians told the Times.
"We’re not sending as many patients to the ICU, we’re not intubating as many patients, and actually, most of our patients that are coming to the emergency department that do test positive are actually being discharged," Rahul Sharma, MD, emergency physician in chief at New York-Presbyeterian/Weill Cornell Hospital in New York City, told the Times.
Still, an overall rise in hospitalizations disrupts care delivery by delaying nonemergent procedures and increases the risk of spread to uninfected patients, health experts told the Times.