COVID-19 Scan for Mar 10, 2022

Non-COVID post-hospital deaths highlight pandemic consequencesWhile Medicare beneficiary hospitalizations for non–COVID-19 diagnoses fell sharply in March and April 2020 and stayed low through September 2021, death rates after hospitalization rose substantially—particularly for Black and Hispanic patients, finds a study yesterday in JAMA Network Open.University of Texas and Johns Hopkins researchers analyzed claims data from 8,448,758 Medicare admissions to 4,626 US hospitals for non-COVID indications from January 2019 through September 2021.

Average patient age was 73.7 years.A multilevel logistic regression analysis showed that the death rate in the 30 days after hospitalization rose from 9.4% in 2019 to 11.5% from Apr 1, 2020, to Mar 31, 2021 (odds ratio [OR], 1.20).The higher death rate, which held throughout the first 18 months of the pandemic, varied by race (ORs, 1.27 for Black, 1.25 for Hispanic, and 1.18 for White participants), Medicaid eligibility (OR, 1.25 for Medicaid-eligible vs 1.18 for noneligible patients), and hospital quality score (1 to 5 stars, with 1 being the worst) (OR, 1.27 for 1 star vs 1.11 for 5 stars).Greater increases in the odds of death from the prepandemic to pandemic periods were associated with greater hospital COVID-19 prevalence.

For example, when comparing deaths in October through December 2020 with those in the same period in 2019, the OR was 1.44 for hospitals in the top quartile of COVID admissions vs 1.19 for admissions to those in the lowest."The prolonged elevation in mortality rates after hospital admission in 2020 and 2021 for non–SARS-CoV-2 diagnoses contrasts with reports of improvement in hospital mortality during 2020 for SARS-CoV-2," the study authors wrote. "The