- Learn how to use the PINC AI™ Healthcare Database (PHD) to further COVID-19 research.
- COVID-19 has been associated with a high risk of intensive care unit (ICU) admission and in-hospital mortality.
- Understand how the COVID-19 pandemic impacted outcomes in pregnant women, increased risk of myocarditis and healthcare resource utilization (HRU).
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In the third year of the pandemic, it’s safe to say that COVID-19 is likely going to coexist with us for a long time like HIV or influenza viruses. As we prepare for the next possible COVID-19 surge, which the White House warned could infect up to 100 million people this fall, we still have much to learn about COVID-19.
The PINC AI™ Applied Sciences (PAS) team continues to spearhead research in understanding outcomes of COVID-19 and its impact on pregnant women, increased risk of myocarditis and HRU. Armed with the PINC AI™ Healthcare Database (PHD), an administrative database from more than 1,175 hospitals and health systems, the team conducted important research work to help health systems better prepare for the next COVID-19 variants and surges to help direct health resources to the right clinical units.
What COVID-19 data is in the PHD?
As of June 28, 2022, the PHD has captured more than 5 million confirmed COVID-19 patients who were treated in inpatient and outpatient settings across 956 U.S. health systems and more than 3.5 million patients who received a COVID-19 vaccine in PHD hospitals and health systems. With an average lag time of two weeks to two months and comprehensive data on hospital visits, microbiology, general labs, vital signs and imaging, the PHD is one of the timeliest databases that can be used to study COVID-19.
Who has utilized the PHD COVID-19 Data?
The PAS research team along with academic centers including the Harvard School of Public Health as well as U.S. government agencies such as the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH) and the U.S. Food and Drug Administration (FDA) have leveraged the PHD data to characterize COVID-19 and its clinical outcomes, find better treatments, examine COVID-19 vaccine-related outcomes or assess the impact of the pandemic on healthcare service delivery and quality.
COVID-19: Variants and Treatment Options
The COVID-19 virus had many variants from the lethal Delta to Omicron, the highly transmissible variant, that caused infections in fully vaccinated people and reinfections in others. Despite the highly contagious nature of Omicron, it also brought us the use of antiviral pills and other therapeutics that helped those most vulnerable to the virus and reduced the risk of hospitalizations.
Even though the vaccines, antiviral pills and therapeutics are widely available, there is much to learn about their efficacy against future variants and at what cost. Currently, with COVID-19 case counts fluctuating and mask mandates lifted, we must begin the process of living and adjusting to this “new normal.”
The utilization of accurate, timely and standardized data, like the PHD, may help researchers and clinicians better understand the COVID-19 variants and the efficacy of treatment options that can help clinicians and patients make evidence-based decisions and help reduce costs, hospitalizations and deaths.
Below are four recent examples of how researchers and clinicians are using the PHD to learn more about COVID-19.
1. Did in-hospital mortality among COVID-19 patients change in the second year of the pandemic?
During the pandemic, researchers sought to understand drivers of ICU admissions and in-hospital mortality rates. One retrospective observational study conducted using the PHD data showed that in-hospital mortality rates for COVID-19 patients decreased from 12 percent to nine percent and then increased to 16 percent in February, April and September 2021 respectively with ICU admissions fluctuating between 20-27 percent.
This increase in mortality in September and October 2021 may be directly correlated to the emergence of the more lethal Delta variant. Even with wide availability of vaccines, many hospitalized COVID-19 patients throughout 2021 were unvaccinated and mortality among them were high.
During this year, it was unclear if increased mortality risk was linked to the Delta variant, unvaccinated patients, effects of caseload surges or all these factors. With new variants emerging, health systems should continue to monitor these factors to help direct resources and prepare for COVID-19’s unpredictable pattern not characteristic of other viral illnesses.
2. How did a COVID-19 diagnosis affect outcomes for pregnant women?
The effects of COVID-19 in pregnancy are not fully known. A recent study compared the clinical characteristics and outcomes of hospitalized women who gave birth with and without COVID-19.
It found that pregnant women who were hospitalized with COVID-19 were younger and more often Black and/or Hispanic and with diagnoses of diabetes and obesity.
Even though in-hospital mortality rates were low, researchers found it was highest in women diagnosed with COVID-19 and those women were at higher odds of having venous thromboembolism (VTE), preeclampsia and/or preterm births. During the pandemic, most studies investigating COVID-19 therapies excluded pregnant women and this data highlights the important need to ensure this population is included in future clinical trials for COVID-19 treatments and vaccines.
3. Is COVID-19 linked to a higher risk of myocarditis?
Viral infections are a common cause of myocarditis, an inflammation of the heart muscle that can result in hospitalization, heart failure and sudden death. During the pandemic, the CDC sought to understand if COVID-19 was associated with a higher risk of myocarditis. In their study, using PHD data, they found the occurrence of myocarditis inpatient encounters was 42 percent higher than pre-pandemic. The risk for myocarditis among patients with COVID-19 during the pandemic was nearly 16 times higher than for inpatients without COVID-19. The link between COVID-19 and myocarditis was also more pronounced among children younger than 16 and in adults 50 years of age or older.
They found that while overall myocarditis was uncommon, a diagnosis of COVID-19 significantly increased a patients’ risk. These findings underscore the importance of implementing evidence-based COVID-19 prevention strategies, including vaccination, to reduce the public health impact of COVID-19 and its associated complications.
4. How did COVID-19 affect healthcare resource utilization?
Over the course of the pandemic, health systems were overwhelmed with severe cases of COVID-19. One retrospective cohort study looked at the PHD data to determine the correlation between these severe cases of COVID-19 and an increase in HRU.
They found that hospitalized COVID-19 patients were associated with a high level of HRU and in-hospital mortality. It was noted that 95 percent of inpatients were admitted through the emergency department (ED), 22.5 percent required an ICU stay and 12.8 percent were put on invasive mechanical ventilation. Additionally, more than one-third of these patients required post hospital healthcare services after discharge including home health and skilled nursing facilities. After discharge, 2.7 percent returned to the ED and 5.3 percent were readmitted to the same hospital within 30 days.
This information is valuable to health systems as they plan and manage healthcare resources for future waves of COVID-19 patients and work to reduce the impact on patients without COVID-19.
Providing care for the COVID-19 viral illness has required clinicians, patients and researchers to navigate uncertainty. The past three years have seen improvements in our efforts and no doubt we will continue to enhance coordination of care and help patients recover and improve beyond hospitalization. Researchers are continuing to utilize the PHD to spur innovation and determine evidence-based treatment approaches that can impact communities, improve outcomes and help lower costs.
The COVID-19 pandemic has profoundly impacted healthcare and every aspect of our society around the world. As the first national database that became available for COVID-19 research at the early stage of the pandemic, the PHD has greatly contributed to our knowledge on COVID-19. Don’t miss an opportunity to partner with PAS and make the PINC AI™ Healthcare Database part of your research and product development strategy!
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