Estimating COVID-19 Hospitalizations in the United States With Surveillance Data Using a Bayesian Hierarchical Model: Modeling Study
BackgroundIn the United States, COVID-19 is a nationally notifiable disease, meaning cases and hospitalizations are reported by states to the Centers for Disease Control and Prevention (CDC). Identifying and reporting every case from every facility in the United States may no...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2022-06-01
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| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2022/6/e34296 |
| _version_ | 1797735007761989632 |
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| author | Alexia Couture A Danielle Iuliano Howard H Chang Neha N Patel Matthew Gilmer Molly Steele Fiona P Havers Michael Whitaker Carrie Reed |
| author_facet | Alexia Couture A Danielle Iuliano Howard H Chang Neha N Patel Matthew Gilmer Molly Steele Fiona P Havers Michael Whitaker Carrie Reed |
| author_sort | Alexia Couture |
| collection | DOAJ |
| description |
BackgroundIn the United States, COVID-19 is a nationally notifiable disease, meaning cases and hospitalizations are reported by states to the Centers for Disease Control and Prevention (CDC). Identifying and reporting every case from every facility in the United States may not be feasible in the long term. Creating sustainable methods for estimating the burden of COVID-19 from established sentinel surveillance systems is becoming more important.
ObjectiveWe aimed to provide a method leveraging surveillance data to create a long-term solution to estimate monthly rates of hospitalizations for COVID-19.
MethodsWe estimated monthly hospitalization rates for COVID-19 from May 2020 through April 2021 for the 50 states using surveillance data from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) and a Bayesian hierarchical model for extrapolation. Hospitalization rates were calculated from patients hospitalized with a lab-confirmed SARS-CoV-2 test during or within 14 days before admission. We created a model for 6 age groups (0-17, 18-49, 50-64, 65-74, 75-84, and ≥85 years) separately. We identified covariates from multiple data sources that varied by age, state, and month and performed covariate selection for each age group based on 2 methods, Least Absolute Shrinkage and Selection Operator (LASSO) and spike and slab selection methods. We validated our method by checking the sensitivity of model estimates to covariate selection and model extrapolation as well as comparing our results to external data.
ResultsWe estimated 3,583,100 (90% credible interval [CrI] 3,250,500-3,945,400) hospitalizations for a cumulative incidence of 1093.9 (992.4-1204.6) hospitalizations per 100,000 population with COVID-19 in the United States from May 2020 through April 2021. Cumulative incidence varied from 359 to 1856 per 100,000 between states. The age group with the highest cumulative incidence was those aged ≥85 years (5575.6; 90% CrI 5066.4-6133.7). The monthly hospitalization rate was highest in December (183.7; 90% CrI 154.3-217.4). Our monthly estimates by state showed variations in magnitudes of peak rates, number of peaks, and timing of peaks between states.
ConclusionsOur novel approach to estimate hospitalizations for COVID-19 has potential to provide sustainable estimates for monitoring COVID-19 burden as well as a flexible framework leveraging surveillance data. |
| first_indexed | 2024-03-12T12:52:44Z |
| format | Article |
| id | doaj.art-a07753e6de6848b1aa31aedd97df5750 |
| institution | Directory Open Access Journal |
| issn | 2369-2960 |
| language | English |
| last_indexed | 2024-03-12T12:52:44Z |
| publishDate | 2022-06-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Public Health and Surveillance |
| spelling | doaj.art-a07753e6de6848b1aa31aedd97df57502023-08-28T22:12:54ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602022-06-0186e3429610.2196/34296Estimating COVID-19 Hospitalizations in the United States With Surveillance Data Using a Bayesian Hierarchical Model: Modeling StudyAlexia Couturehttps://orcid.org/0000-0002-4257-3697A Danielle Iulianohttps://orcid.org/0000-0001-8742-3687Howard H Changhttps://orcid.org/0000-0002-6316-1640Neha N Patelhttps://orcid.org/0000-0001-9228-9419Matthew Gilmerhttps://orcid.org/0000-0003-3283-0909Molly Steelehttps://orcid.org/0000-0001-7601-0924Fiona P Havershttps://orcid.org/0000-0001-9873-6195Michael Whitakerhttps://orcid.org/0000-0002-6256-0519Carrie Reedhttps://orcid.org/0000-0001-7944-7638 BackgroundIn the United States, COVID-19 is a nationally notifiable disease, meaning cases and hospitalizations are reported by states to the Centers for Disease Control and Prevention (CDC). Identifying and reporting every case from every facility in the United States may not be feasible in the long term. Creating sustainable methods for estimating the burden of COVID-19 from established sentinel surveillance systems is becoming more important. ObjectiveWe aimed to provide a method leveraging surveillance data to create a long-term solution to estimate monthly rates of hospitalizations for COVID-19. MethodsWe estimated monthly hospitalization rates for COVID-19 from May 2020 through April 2021 for the 50 states using surveillance data from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) and a Bayesian hierarchical model for extrapolation. Hospitalization rates were calculated from patients hospitalized with a lab-confirmed SARS-CoV-2 test during or within 14 days before admission. We created a model for 6 age groups (0-17, 18-49, 50-64, 65-74, 75-84, and ≥85 years) separately. We identified covariates from multiple data sources that varied by age, state, and month and performed covariate selection for each age group based on 2 methods, Least Absolute Shrinkage and Selection Operator (LASSO) and spike and slab selection methods. We validated our method by checking the sensitivity of model estimates to covariate selection and model extrapolation as well as comparing our results to external data. ResultsWe estimated 3,583,100 (90% credible interval [CrI] 3,250,500-3,945,400) hospitalizations for a cumulative incidence of 1093.9 (992.4-1204.6) hospitalizations per 100,000 population with COVID-19 in the United States from May 2020 through April 2021. Cumulative incidence varied from 359 to 1856 per 100,000 between states. The age group with the highest cumulative incidence was those aged ≥85 years (5575.6; 90% CrI 5066.4-6133.7). The monthly hospitalization rate was highest in December (183.7; 90% CrI 154.3-217.4). Our monthly estimates by state showed variations in magnitudes of peak rates, number of peaks, and timing of peaks between states. ConclusionsOur novel approach to estimate hospitalizations for COVID-19 has potential to provide sustainable estimates for monitoring COVID-19 burden as well as a flexible framework leveraging surveillance data.https://publichealth.jmir.org/2022/6/e34296 |
| spellingShingle | Alexia Couture A Danielle Iuliano Howard H Chang Neha N Patel Matthew Gilmer Molly Steele Fiona P Havers Michael Whitaker Carrie Reed Estimating COVID-19 Hospitalizations in the United States With Surveillance Data Using a Bayesian Hierarchical Model: Modeling Study JMIR Public Health and Surveillance |
| title | Estimating COVID-19 Hospitalizations in the United States With Surveillance Data Using a Bayesian Hierarchical Model: Modeling Study |
| title_full | Estimating COVID-19 Hospitalizations in the United States With Surveillance Data Using a Bayesian Hierarchical Model: Modeling Study |
| title_fullStr | Estimating COVID-19 Hospitalizations in the United States With Surveillance Data Using a Bayesian Hierarchical Model: Modeling Study |
| title_full_unstemmed | Estimating COVID-19 Hospitalizations in the United States With Surveillance Data Using a Bayesian Hierarchical Model: Modeling Study |
| title_short | Estimating COVID-19 Hospitalizations in the United States With Surveillance Data Using a Bayesian Hierarchical Model: Modeling Study |
| title_sort | estimating covid 19 hospitalizations in the united states with surveillance data using a bayesian hierarchical model modeling study |
| url | https://publichealth.jmir.org/2022/6/e34296 |
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