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Concurrent Analysis of Hospital Stay Durations and Mortality of Emerging Severe Acute Respiratory Coronavirus Virus 2 (SARS-CoV-2) Variants Using Real-time Electronic Health Record Data at a Large German University Hospital

by Derek Hazard, Marlon Grodd, Adeline Makoudjou, Sara Lozano-Zahonero, Andrea Prunotto, Patric Tippmann, Daniela Zöller, Philipp Joschua Gebhard Mathé, Siegbert Rieg, Martin Wolkewitz · 2023

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Abstract: Multistate methodology proves effective in analyzing hospitalized coronavirus disease 2019 (COVID-19) patients with emerging variants in real time. An analysis of 2,548 admissions in Freiburg, Germany, showed reduced severity over time in terms of shorter hospital stays and higher discharge rates when comparing more recent phases with earlier phases of the pandemic.<br>Predicting the clinical progress of hospitalized coronavirus disease 2019 (COVID-19) patients in the face of emerging variants is a crucial challenge for the medical community. This undertaking has far-reaching consequences for not only the determination of high-risk groups for the disease in a dynamic situation but also the efficient allocation of medical resources (especially when they are scarce). We sought to estimate the duration of hospital stay and in-hospital mortality of COVID-19, analyses that are vulnerable to severe competing risks and time-dependent biases Reference Wolkewitz and Schumacher1 that can invalidate traditional methods of estimation. Furthermore, we sought to avert the selection bias that occurs when current cases are removed from the analysis; a bias that impaired some reports at the outset of the pandemic