20% of hospitalizations have a cause other than the virus

20% of hospitalizations have a cause other than the virus

In the intensive care unit of the University Hospital of Strasbourg, January 13, 2022.

More than 25,000 people who have declared themselves infected with Covid-19 are currently hospitalized in France. However, a large part of it is for reasons other than the effects of the disease. This bias that has been identified since the beginning of the pandemic – launch Reported February 2021 – tends to increase in the context of strong virus circulation.

In the week of January 3-9, 2022, nearly 20% of hospitalized patients with SARS-CoV-2 were treated for a cause other than Covid-19, according to the epidemiological update published by Public Health France (SPF) in January. 13. It was 13% on average over the whole of 2021.

In critical care units, patients admitted for a reason other than Covid-19 simultaneously accounted for 8% of all patients declared to have the virus at that time. Covid-19 (compared to 5% in the week of December 20, 2021). On the other hand, the proportion remains constant (5%) for admission to intensive care.

Read also Covid-19: Nine times as many unvaccinated people are admitted to critical care

This discrepancy between hospitalization for ‘for’ and ‘with’ Covid is more pronounced among young people. At the beginning of January, 44% of 20- to 29-year-olds hospitalized and diagnosed with Covid-19 tested positive there for another medical reason (18% in critical care), and 40% of 30-39 years (14) % in critical cases (care).

All of these items were calculated from data entered into SI-Vic (“Information System for Victim Monitoring”), the monitoring system implemented in the aftermath of the November 2015 attacks and which has been since the beginning of the pandemic. “Hospital Statistics Hub for Covid-19 Patients”According to the Department of Research, Studies, Evaluation and Statistics (Aldrees).

Variant posted a few months ago by SPF, then withdrawn

During the first wave, No medical information was entered other than hospital stay status. Which, in the opinion of DREES, did not pose any major difficulties at the time. In fact, as “Basic hospital activity has almost ceased, and most patients admitted to the SI-Vic were admitted because of their injury. Then, gradually, testing capabilities increased and testing became more frequent for patients admitted to the hospital.. At the same time, after the peak of the epidemic wave, the planned operations have gradually been resumed. ». Thus, people infected with SARS-CoV-2 who were hospitalized due to an appendicitis attack or a road accident were able to enter the database, without showing significant symptoms associated with Covid-19.

Why not replace freely accessible hospital data with information extracted from this more subtle variant?

Next, a variable indicating the reason for hospitalization was added to the SI-Vic. It makes it possible to distinguish between patients hospitalized due to Covid-19 and those who have been admitted for another reason. If this data was used for a few months in the weekly SPF score, it was removed because of that ‘He was very stable’The agency explains. Why not replace the freely accessible hospital data with the information extracted from this new, more accurate variant? Was it not possible to add a column in these files used to feed the dashboards for several media? When asked, the SPF replied that the goal was Maintaining a stable monitoring system over time To facilitate comparisons with other countries.

Excellence in other countries

However, the same question arose among our neighbors. In Spain, a daily newspaper Country It was estimated on January 14 that in hospital indicators for Covid-19 monitoring, between 25% and 40% of patients were hospitalized for other reasons. In the UK, the proportion of people treated primarily for Covid-19 among all people declared to have the disease also appears to be decreasing, according to hospital data published by the National Health Service. But these data must be interpreted with caution: it is not always easy to distinguish between what causes Covid-19 and what is not: the disease can generate a certain number of complications, and the classification “with and” for “Covid-19” is not necessarily clear.

Read also COVID-19: The majority of patients in intensive care are not immunized

Despite these reservations, free access to the number of patients hospitalized due to Covid-19, and not just “with” Covid-19, would improve monitoring of the situation in the midst of the Omicron wave. It is also a matter of transparency. “While this does not change the severity of the situation in Ontario hospitals, it is important to share this data to provide additional context on the state of the epidemic.”, and thus indicates on Twitter Christine Elliott, Minister of Health of Ontario (Canada), where public data over the past few days distinguished between patients who were hospitalized with Covid-19, and those who were declared infected but were admitted for other reasons (47%). In France, the sun protection factor (SPF) monitors this indicator “daily” and announces its publication In open data soon.

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