COVIDView: A Weekly Surveillance Abstract of U.S. COVID-19 Exercise

The COVID-19-Associated Hospital Surveillance Network (COVID-NET) performs population-based surveillance for laboratory-confirmed COVID-19-associated hospital stays in selected countries participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP). .

Between March 1, 2020 and August 15, 2020, a total of 49,451 laboratory-confirmed COVID-19-associated hospital stays were reported at sites. The cumulative hospital stay rate was 151.7 per 100,000 population. Among the ages 0-4, 5-17, 18-49, 50-64, and ≥ 65 years, the highest rates of hospitalization were in adults ≥ 65 years of age, followed by adults aged 50 and over -64 years and adults aged 18-49 years.

Conclude

Hospital admission rates

Age group Cumulative rate per 100,000 population
All in all 151.7
0-4 years 14.7
5-17 years 8.1
18-49 years 102.2

18-29 years

64.1

30-39 years

100.9

40-49 years

152.9
50-64 years 228.1
65+ years 412.9

65-74 years

308.6

75-84 years

490.4

85+ years

751.2

Weekly hospitalization rates for all age groups peaked in the week ending April 18 (MMWR week 16) at 10.1 per 100,000 population, followed by a second high in the week ending July 18 (MMWR week 29) 8.0 per 100,000 population. Dates for the past few weeks are subject to change as additional recordings are reported during these weeks.

Laboratory Confirmed COVID-19 Associated Hospital StaysConclude

Of the 49,451 laboratory-confirmed COVID-19-associated hospital cases, 46,026 (93.1%) had race and ethnicity information, while racial and ethnicity records were pending for 3,425 (6.9%) cases. When we looked at total age-adjusted rates by race / ethnicity, non-Hispanic Native Americans or Alaskan Native Americans had an age-adjusted hospitalization rate that was approximately 4.9 times that of non-Hispanic whites. The rates for non-Hispanic blacks and Hispanic or Latino people were both about 4.7 times higher than for non-Hispanic whites.

When we looked at age-stratified raw hospitalization rates by race and ethnicity, raw hospitalization rates were 8.1 times higher in Hispanic or Latin American people aged 0-17 compared to non-Hispanic whites of the same age group. 8.8 times higher in both non-Hispanic Indians or Alaskan residents and Hispanic or Latin American individuals ages 18 to 49; 6.6 times higher in non-Hispanic or Alaskan Indians aged 50-64; and 3.8 times higher in non-Hispanic blacks aged ≥ 65 years.

Hospital stay rates per 100,000 population
by age, race and ethnicity – COVID-NET,
March 1, 2020 – August 15, 2020

Age category

Not spanish
American Indians or Alaskan Native Americans

Non-Hispanic black

Hispanic or Latino

Non-Hispanic Asian or Pacific Islander

Non-Hispanic white

rating1 Rate Ratio 2.3 Rate1 Rate Ratio 2.3 Rate1 Rate Ratio 2.3 Rate1 Rate Ratio 2.3 Rate1 Rate Ratio 2.3
0-17y 9.7 4.0 14.1 5.9 19.4 8.1 5.0 2.1 2.4 1.0
18-49y 237.0 8.8 160.7 6.0 237.9 8.8 47.4 1.8 26.9 1.0
50-64y 568.9 6.6 466.2 5.4 514.5 5.9 138.0 1.6 86.8 1.0
65 + y 660.3 2.7 936.7 3.8 665.8 2.7 257.5 1.0 247.2 1.0
Total rate4 (age-adjusted) 316.5 4.9 304.9 4.7 305.8 4.7 86.2 1.3 65.0 1.0

1 COVID-19 Associated Hospitalization Rates by Race / Ethnicity are calculated using COVID-NET cases in the hospital of known race and ethnicity for the numerator and NCHS bridged race estimates for the denominator.
2 For each age category, the rate ratios are the ratios between the raw hospitalization rates within each race / ethnic group and the raw hospitalization rate among non-Hispanic white people in the same age category.
3 The highest rate in each age category is given in bold.
4 The overall rates are adjusted to account for differences in age distribution within the racial / ethnicity strata in the COVID-NET catchment area. The age brackets used for adjustment include 0-17, 18-49, 50-64 and 65+ years.

Non-Hispanic blacks and non-Hispanic whites made up the highest proportions of hospital cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific islanders, and non-Hispanic or Alaskan Indians. However, some racial and ethnic groups are disproportionately represented in hospital cases compared to the total population of the catchment area. The prevalence rates showed a pattern similar to the age-adjusted hospitalization rates: non-Hispanic Indians or Alaskan Native Americans had the highest prevalence rate, followed by non-Hispanic blacks and Hispanic or Latin American individuals.

Comparing the proportions of COVID-19-associated hospital stays by race and ethnicity – COVID-NET, March 1 to August 15, 2020

Non-Hispanic or Alaskan Indians Non-Hispanic black Hispanic or Latino Non-Hispanic Asian or Pacific Islander Non-Hispanic white
Proportion of COVID-NET cases in hospital1 1.3% 33.0% 23.1% 5.0% 31.4%
Proportion of population in the COVID-NET catchment area 0.7% 17.9% 14.1% 8.9% 58.5%
Prevalence Ratios 2 1.9 1.8 1.6 0.6 0.5

1 People of multiple races (0.2%) or of unknown race and ethnicity (6%) are not represented in the table but are included as part of the denominator.
2 The prevalence rate is calculated as the ratio of the proportion of COVID-NET cases in the hospital to the proportion of the population in the COVID-NET catchment area.

Of 9,400 adults in the hospital with information on underlying diseases, 90.5% had at least one reported underlying disease. The most common reports of hypertension, obesity, metabolic diseases, and cardiovascular diseases. Of 254 hospitalized children with information about underlying diseases, 50.8% had at least one reported underlying disease. Obesity, neurological disorders, and asthma were the most commonly reported.

This graph shows data on laboratory-confirmed hospital stays with underlying conditions.Conclude

Additional data is available on demographics, signs and symptoms of admission, underlying illnesses, interventions, outcomes, and discharge diagnoses, stratified by age, gender, race, and ethnicity.

Additional information on monitoring hospitalization: Monitoring methods | Additional tariff data | Additional demographic and clinical data

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