Big data evidence of the impact of COVID-19 hospitalizations on mortality rates of non-COVID-19 critically ill patients

Abstract

The COVID-19 virus caused a global pandemic leading to a swift policy response. While this response was designed to prevent the spread of the virus and support those with COVID-19, there is growing evidence regarding measurable impacts on non-COVID-19 patients. The paper uses a large dataset from administrative records of the Brazilian public health system (SUS) to estimate pandemic spillover effects in critically ill health care delivery, i.e. the additional mortality risk that COVID-19 ICU hospitalizations generate on non-COVID-19 patients receiving intensive care. The data contain the universe of ICU hospitalizations in SUS from February 26, 2020 to December 31, 2021. Spillover estimates are obtained from high-dimensional fixed effects regression models that control for a number of unobservable confounders. Our findings indicate that, on average, the pandemic increased the mortality risk of non-COVID-19 ICU patients by 1.296 percentage points, 95% CI 1.145–1.448. The spillover mortality risk is larger for non-COVID patients receiving intensive care due to diseases of the respiratory system, diseases of the skin and subcutaneous tissue, and infectious and parasitic diseases. As of July 2023, the WHO reports more than 6.9 million global deaths due to COVID-19 infection. However, our estimates of spillover effects suggest that the pandemic’s total death toll is much higher.

Exposure to Concurrent Heatwaves and Ozone Pollution and Associations with Mortality Risk: A Nationwide Study in China

“… 54 Third, residual confounding is possible in the estimated results because we did not control for other potential confounders, such as the air-conditioning utilization rate. Finally, uncertainty may exist in assessing excess deaths attributable to extreme events for 2013–2020, given that the influence of the COVID-19 pandemic (which started in 2019) was not considered, 55 , 56 and the mortality risk was estimated using data from 2013 to 2018.…”

Endemic means change as SARS-CoV-2 evolves

“…The reduction in cases caused by NPI measures is expected to result in a proportionate reduction in severe cases and deaths. Even a modest reduction (say 20%) can have non-linear benefits when hospitals are at capacity, improving care for all (Wichmann and Wichmann 2023). Achieving such benefits at a population level, however, requires that there be clear messaging and incentives to obtain the moderate to high levels of uptake required to impact population-wide infection rates.…”