完善住院率:采用混合方法区分原发性 COVID-19 和偶发病例

IF 1.8 Q3 INFECTIOUS DISEASES
M. Misailovski , D. Koller , S. Blaschke , M. Berens , A.M. Köster , R. Strobl , R. Berner , P. Boor , M. Eisenmann , S. von Stillfried , D. Krefting , M. Krone , J. Liese , P. Meybohm , G. Ulrich- Merzenich , S. Zenker , S. Scheithauer , E. Grill
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引用次数: 0

摘要

目的迄今为止,住院率(HR)一直是衡量与 COVID-19 相关的医疗负担的指标之一。为确保住院率充分发挥其潜力,必须区分 COVID-19 引起的住院病例(原发病例)和 SARS-CoV-2 检测结果偶然呈阳性的住院病例(偶然病例)。本研究旨在综合现有证据,对原发病例和偶发病例的住院标准进行区分。此外,还邀请了在 COVID-19 护理方面具有专长的资深临床医生进行了半结构化定性访谈。此外,还对 2020 年 3 月至 2022 年 12 月期间发表的文献进行了快速查阅。结果在在线调查(n=30,回复率 56%)中,肺炎和急性上呼吸道感染是原发病例最有参考价值的诊断。相比之下,恶性肿瘤和急性心肌梗塞最有可能与偶发病例有关。根据专家(n=6)的意见,诊断、病房、入院类型(急诊或择期入院)、低血氧饱和度、需要补充氧气以及开始使用 COVID-19 治疗都表明是原发性病例。文献综述发现,呼吸综合征和症状、氧气支持和炎症标志物水平升高与原发性病例有关。最终,更新后的 HR 有可能成为 COVID-19 相关医疗负担的更准确指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Refining the hospitalization rate: A mixed methods approach to differentiate primary COVID-19 from incidental cases

Purpose

Until now, the Hospitalization Rate (HR) served as an indicator (among others) for the COVID-19 associated healthcare burden. To ensure that the HR accomplishes its full potential, hospitalizations caused by COVID-19 (primary cases) and hospitalizations of patients with incidental positive SARS-CoV-2 test results (incidental cases) must be differentiated. The aim of this study was to synthesize the existing evidence on differentiation criteria between hospitalizations of primary cases and incidental cases.

Methods

An online survey of the members of the German Network University Medicine (NUM) was conducted. Additionally, senior clinicians with expertise in COVID-19 care were invited for qualitative, semi-structured interviews. Furthermore, a rapid literature review was undertaken on publications between 03/2020 and 12/2022.

Results

In the online survey (n=30, response rate 56%), pneumonia and acute upper respiratory tract infections were the most indicative diagnoses for a primary case. In contrast, malignant neoplasms and acute myocardial infarctions were most likely to be associated with incidental cases. According to the experts (n=6), the diagnosis, ward, and type of admission (emergency or elective), low oxygen saturation, need for supplemental oxygen, and initiation of COVID-19 therapy point to a primary case. The literature review found that respiratory syndromes and symptoms, oxygen support, and elevated levels of inflammatory markers were associated with primary cases.

Conclusion

There are parameters for the differentiation of primary from incidental cases to improve the objective of the HR. Ultimately, an updated HR has the potential to serve as a more accurate indicator of the COVID-19 associated healthcare burden.

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来源期刊
Infection Prevention in Practice
Infection Prevention in Practice Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
0.00%
发文量
58
审稿时长
61 days
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