The Distinction Between Being Hospitalized “For COVID” and “WITH COVID”

 

  • Some hospitals have begun to distinguish individuals who arrive at the hospital for COVID-19 from those who arrive for another reason and test positive on screening.
  • In New York, 57% of coronavirus-positive patients were hospitalized “for COVID,” whereas the remaining patients were admitted “with COVID.”
  • All coronavirus-positive patients in the hospital represent a danger to healthcare staff and other patients, even if the patient was in for a cause other than COVID.

As a result of the fast spread of the Omicron variant, many persons admitted to the hospital for causes other than COVID are now testing positive for coronavirus as part of standard screening. To address this, New York and Massachusetts have begun recording these so-called accidental COVID-19 hospitalizations separately from patients treated for COVID-19 or its consequences.

As of Jan. 7, 57 percent of coronavirus-positive patients in New York had been hospitalized “for COVID,” while the remainder had been admitted “with COVID” (incidental cases). Other healthcare systems divide hospitalization data into these two groups as well.

In Ontario, Canada, 54 percent of coronavirus-positive patients were hospitalized to hospitals for COVID-19. However, “for COVID” patients account for 83 percent of the province’s ICU patients. This difference is meant to more accurately reflect the pandemic’s impact on healthcare systems and society.

“In certain circumstances, tracking these two sorts of patients helps us prioritize who might benefit from [particular] medications,” said Dr. Tammy Lundstrom, an infectious disease expert and Trinity Health’s chief medical officer.

COVID-positive peoples put additional load on hospitals.

All coronavirus-positive persons in the hospital represent a danger to healthcare staff and other patients, even if the patient was in for a cause other than COVID. “There are many people for whom [coronavirus] infection might increase their existing illness – those with diabetes, cancer, underlying heart or lung disease, for example,” Lundstrom said.

According to the Toronto Star, at least 800 individuals have died in Ontario from COVID-19 in a hospital epidemic, including those who may have caught the virus in the hospital. This report is from September of last year, before the outbreak of the extremely infectious Omicron. Furthermore, COVID-positive patients may be unable to obtain mental health therapies, dialysis, or other services outside of the hospital until they are no longer able to spread the virus. These therapy delays may have a negative impact on their health.

According to Lundstrom, both “for COVID” and “with COVID” patients are isolated to¬†reduce viral transmission in the hospital. When working with these patients, staff must also wear personal protection equipment. Staff caring for COVID-19 patients are also unable to treat patients who do not have the coronavirus. According to Lundstrom, this may exacerbate hospital staffing concerns, but “we need to make sure we operate in a manner that offers the best possible treatment without exposing other patients to illness.”

Due to an increase of COVID-19 patients, healthcare systems are under significant strain. In the United Kingdom, for example, there is a significant increase in both “for COVID” and “with COVID” hospitalizations in several places. Many hospitals are already understaffed as a result of employees quitting the profession or staying at home because they have the coronavirus.

The distinction between ‘for COVID’ and ‘with COVID’ is not always clear

While calculating the number of patients in the hospital or ICU is simple, determining whether a person is in the hospital “with” or “for” COVID is not always clear. Specific COVID-positive hospitalizations are plainly accidental, such as a person involved in a vehicle accident or a toddler who fractures an arm falling off a swing. However, since the coronavirus may damage various organs, including the heart, lungs, kidneys, skin, and brain, as well as induce blood clotting, COVID-19 can manifest itself in a variety of ways.

Dr. Ashish Jha, dean of the Brown University School of Public Health, provided an example of an 86-year-old man with renal illness who had COVID-19 with fever and a sore throat in a Jan. 4 Twitter thread. “After two days of fevers, he became dehydrated [and] went into severe renal failure,” Jha wrote.

While some physicians may identify this case as an accidental COVID-19 patient, others may argue that the guy would not have had renal failure if the coronavirus infection had not occurred. “Many patients arrive for a work-up of atypical symptoms, including those linked to diarrhea/enteritis or blood clotting/vascular symptoms,” Yale School of Medicine professor Dr. Howard Forman posted on Twitter. “However, we have clear evidence that people who test positive for COVID are at a greater risk for these illnesses.”

Clarification is required on how to monitor COVID-19 hospitalizations.

Another dilemma is what happens if a coronavirus-positive patient admitted to the hospital for another reason gets COVID-19 or complications from their infection while in the hospital. Are they transferred from one category to another? Should these patients be classified in a third category?

Due to the lack of clarity, some clinicians have asked the Centers for Disease Control and Prevention (CDC) to produce a standard definition of accidental COVID-19 hospitalizations, comparable to the agency’s recommendations for other forms of health data. This might help state and local health authorities share more accurate and valuable statistics.

It may also help to lessen some of the polarization that is currently occurring in the wake of inadvertent COVID-19 hospitalizations, with some individuals claiming that these instances are “proof” that Omicron is “moderate.” Even while most vaccinated persons, particularly those who have been vaccinated and boosted, are highly protected against severe sickness caused by Omicron, the unvaccinated are still at danger.

During the present outbreak, unvaccinated persons are at a greater risk of hospitalization and death from COVID-19 than vaccinated ones. “We strongly urge everyone who is eligible to be vaccinated and boosted, since this is the single most effective approach to avoid hospitalization and serious sickness,” Lundstrom added. “On top of vaccination boosters, masking and physical separation provide further layers of protection.”

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