Characterization of COVID-19 Hospitalized Patients in Three United States Electronic Health Record Databases

Patrick Saunders-Hastings; Cindy Ke Zhou; Shayan Hobbi; Eva Boyd; Patricia Lloyd; Nader Alawar; Timothy Burrell; Jeff Beers; Tainya C Clarke; Aaron Z Hettinger; Hui-Lee Wong; Azadeh Shoaibi

doi:10.3390/pathogens12030390

Characterization of COVID-19 Hospitalized Patients in Three United States Electronic Health Record Databases

Pathogens. 2023 Mar 1;12(3):390. doi: 10.3390/pathogens12030390.

Affiliations

¹ Gevity Consulting Inc., part of Accenture, Ottawa, ON K1P 1A4, Canada.
² Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD 20993, USA.
³ IBM Consulting, Bethesda, MD 20814, USA.
⁴ Center for Biostatistics, Informatics and Data Science, MedStar Health Research Institute, Hyattsville, MD 20782, USA.

Abstract

COVID-19 infections have contributed to substantial increases in hospitalizations. This study describes demographics, baseline clinical characteristics and treatments, and clinical outcomes among U.S. patients admitted to hospitals with COVID-19 during the prevaccine phase of the pandemic. A total of 20,446 hospitalized patients with a positive COVID-19 nucleic acid amplification test were identified from three large electronic health record databases during 5 February-30 November 2020 (Academic Health System: n = 4504; Explorys; n = 7492; OneFlorida: n = 8450). Over 90% of patients were ≥30 years of age, with an even distribution between sexes. At least one comorbidity was recorded in 84.6-96.1% of patients; cardiovascular and respiratory conditions (28.8-50.3%) and diabetes (25.6-44.4%) were most common. Anticoagulants were the most frequently reported medications on or up to 28 days after admission (44.5-81.7%). Remdesivir was administered to 14.1-24.6% of patients and increased over time. Patients exhibited higher COVID-19 severity 14 days following admission than the 14 days prior to and on admission. The length of in-patient hospital stay ranged from a median of 4 to 6 days, and over 85% of patients were discharged alive. These results promote understanding of the clinical characteristics and hospital-resource utilization associated with hospitalized COVID-19 over time.

Keywords: COVID-19; EHR; United States; epidemiology; hospitalization; treatment.

Grants and funding

This research was funded through the U.S. Food and Drug Administration Center for Biologics Evaluation and Research Biologics Effectiveness and Safety (BEST) Initiative. Several co-authors hold commercial affiliations with Accenture and IBM Consulting. Accenture provided support in the form of salaries for authors (P.S.-H., E.B. and S.H.), but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. IBM Consulting provided support in the form of salaries for authors (S.H., N.A. and T.B.), but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. All authors have read and agreed to the published version of the manuscript.