Patients Treated at COVID-19-Dedicated Hospitals had Better Disease Outcomes
Minnesota hospitals established to care exclusively for COVID-19 patients saw lower rates of mortality than general hospitals.
Shortly after the outbreak of the coronavirus pandemic in March 2020, the M Health Fairview Hospital System established hospitals dedicated solely to treating COVID-19 patients.
A new study, published today in the Journal of the American Medical Association (JAMA), analyzed whether these specialized COVID-19 treatment centers were associated with better patient outcomes than traditional hospitals.
The retrospective cohort study included 5504 COVID-19 patients admitted from March 1, 2020-June 30, 2021. The investigators evaluated data collected from 11 Minnesota hospitals, including 2 facilities that only cared for COVID-19 patients.
The patient data consisted of demographic characteristics such as age, sex, race, ethnicity, language, ZIP code, and socioeconomic indicators. The investigators also analyzed the treatments administered and outcomes of all patients admitted with a confirmed COVID-19 diagnosis.
The investigators performed multivariate analyses, such as risk-adjusted logistic regression and propensity score matching. The primary study endpoint was in-hospital mortality, and secondary outcomes included complications and use of therapeutics specific to COVID-19. Patients were considered to have complications if they experienced 1 or more of these events: ventilator or hospital-acquired pneumonia, bacteremia, urinary tract infections, stroke, acute myocardial infarction, pulmonary embolism, DVT, acute kidney injury, liver failure, and bleeding events.
Notably, the 2 COVID-19-devoted hospitals underwent considerable modifications. More ICU beds were added, but renovations also included installing telemetry capabilities, updating interventional radiologic and procedural suites, and creating negative airflow in hospital rooms with HEPA-filter fans.
Of the 5504 COVID-19 patients admitted during the study period, 51.9% (n=2854) were women, and the average age was 62.5 years. A total of 37.7% (n=2077) of the patients included in the study were treated at 1 of the 2 COVID-19-specific hospitals.
At the COVID-19-dedicated hospitals, the mortality rate was 11.6% (n=241), compared to 8% (n=274) in the traditional hospitals. However, the COVID-19-specific facilities had much higher levels of patient illness severity. After adjusting for risks such as comorbidities, the rate of in-hospital mortality was significantly lower at the COVID-19-dedicated healthcare facilities.
For the secondary outcomes, the rate of complications in the propensity-score matched cohort was also significantly lower for the patients admitted to 1 of the 2 COVID-19-specialized hospitals. Additionally, the administration of COVID-19 therapeutics like deep vein thrombosis prophylaxis, high-dose corticosteroids, tocilizumab, and remdesivir, were all higher in the COVID-19-dedicated hospitals.
The investigators concluded that the COVID-19-dedicated hospitals reduced patient mortality. The specialized treatment facilities also were more effective at providing repetitive treatments at high volumes and isolating infected patients.