Distribution in Place of Death for <scp>COVID</scp>‐19–Related Mortality in the United States

Chuzi, Sarah; Molsberry, Rebecca; McCabe, Megan; Yancy, Clyde W.; Ogunseitan, Adeboye; Allen, Norrina B.; Khan, Sadiya S.

doi:10.1111/jgs.16721

Cited by 10 publications

(7 citation statements)

References 4 publications

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“…The vast majority of COVID-19 deaths occurred inhospital, specifically in the ICU. Compared with 5.2% of patients who died at home nationally, 1 4.5% of patients in our study died outside the hospital. However, few inpatient decedents received CPR and most received palliative care, likely demonstrating heightened awareness of CPR's ineffectiveness for dying COVID-19 patients 2,3 and institutional efforts to disseminate palliative care best practices.…”

contrasting

confidence: 68%

Place of Death and End-of-Life Care Utilization among COVID-19 Decedents in a Massachusetts Health Care System

Chua

Shi

Levine

2021

Journal of Palliative Medicine

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In the United States, coronavirus disease 2019 (COVID-19) deaths have surpassed 240,000. The risk and burden of delivering end-of-life care for patients with COVID-19 may prohibit patients from dying at home. Recent data suggest that most patients with COVID-19 die in the hospital. 1 However, less is known about care intensity at the end-oflife according to place of death among patients who died of COVID-19. Therefore, we characterized end-of-life care by place of death among COVID-19 decedents at Mass General Brigham (MGB), the largest health system in Massachusetts.

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contrasting

confidence: 68%

Place of Death and End-of-Life Care Utilization among COVID-19 Decedents in a Massachusetts Health Care System

Chua

Shi

Levine

2021

Journal of Palliative Medicine

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“…To address this limitation, the mortality counts reported by the CDC were shifted to better align the deaths with the admitted patients. Since the overwhelming majority of COVID-19 deaths occur in hospitals (Chua, Shi, & Levine, 2021;Chuzi et al, 2020), since CCP is only authorized for use in hospitals, and since death generally occurs a few days to weeks after admission, mortality was adjusted for the time lag between admission and death. The median time between admission and death has been reported as 9 days in the US (Horwitz et al, 2021) and 6.7 days in Belgium (Faes et al, 2020).…”

Section: Methodsmentioning

confidence: 99%

Convalescent plasma use in the USA was inversely correlated with COVID-19 mortality

Casadevall

Dragotakes

Johnson

et al. 2021

eLife

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Background. The US Food and Drug Administration authorized Convalescent Plasma (CCP) therapy for hospitalized COVID-19 patients via the Expanded Access Program (EAP) and the Emergency Use Authorization (EUA), leading to use in about 500,000 patients during the first year of the pandemic for the US.Methods. We tracked the number of CCP units dispensed to hospitals by blood banking organizations and correlated that usage with hospital admission and mortality data.Results. CCP usage per admission peaked in Fall 2020, with more than 40% of inpatients estimated to have received CCP between late September and early November 2020. However, after randomized controlled trials failed to show a reduction in mortality, CCP usage per admission declined steadily to a nadir of less than 10% in March 2021. We found a strong inverse correlation (r = -0.52, P = 0.002) between CCP usage per hospital admission and deaths occurring two weeks after admission, and this finding was robust to examination of deaths taking place one, two or three weeks after admission. Changes in the number of hospital admissions, SARS-CoV-2 variants, and age of patients could not explain these findings. The retreat from CCP usage might have resulted in as many as 29,000 excess deaths from mid-November 2020 to February 2021.Conclusions. A strong inverse correlation between CCP use and mortality per admission in the USA provides population level evidence consistent with the notion that CCP reduces mortality in COVID-19 and suggests that the recent decline in usage could have resulted in excess deaths.Funding. There was no specific funding for this study. AC was supported in part by RO1 HL059842 and R01 AI1520789; MJJ was supported in part by 5R35HL139854. This project has been funded in whole or in part with Federal funds from the Department of Health and Human Services; Office of the Assistant Secretary for Preparedness and Response; Biomedical Advanced Research and Development Authority under Contract No. 75A50120C00096.

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“…To address this limitation, the mortality counts reported by the CDC were shifted to better align the deaths with the admitted patients. Since the overwhelming majority of COVID-19 deaths occur in hospitals 20,21 , since CCP is only authorized for use in hospitals, and since death generally occurs a few days to weeks after admission, mortality was adjusted for the time lag between admission and death. The median time between admission and death has been reported as 9 days in the US 22 and 6.7 days in Belgium 23 .…”

Section: Methodsmentioning

confidence: 99%

Convalescent Plasma Use in the United States was inversely correlated with COVID-19 Mortality: Did Plasma Hesitancy cost lives?

Casadevall

Dragotakes

Johnson

et al. 2021

Preprint

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The US Food and Drug Administration (FDA) authorized treatment of hospitalized COVID-19 patients with Convalescent Plasma (CCP) via the Expanded Access Program (EAP) and the Emergency Use Authorization (EUA), leading to the use of CCP in some 500,000 patients during the first year of the pandemic. We tracked the number of CCP units dispensed to hospitals by blood banking organizations and correlated that usage with hospital admission and mortality data over the course of the year. CCP usage per admission peaked after issuance of the EUA, with more than 40% of inpatients estimated to have received CCP between late September and early November 2020. However, following reports of randomized controlled trials that failed to show clear benefit from CCP, usage/admissions declined steadily to a nadir of less than 10% in March 2021. We found a strong inverse correlation (Pearson correlation coefficient of -0.5176 with P = 0.00242) between CCP usage/hospital admission and deaths occurring two weeks after admission, and this finding was robust to examination of deaths taking place one, two or three weeks after admission. Changes in the number of hospital admissions, prevalence of variants, and age of patients could not explain these findings. We estimate that the retreat from CCP usage, a phenomenon we termed plasma hesitancy, might have resulted in 29,000 to 36,000 excess deaths in the period from mid-November 2020 to February 2021. These results highlight the need for additional studies to ascertain the variables associated with efficacy and/or provide other explanations for the robust relationships observed in this study.

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Distribution in Place of Death for COVID‐19–Related Mortality in the United States

Cited by 10 publications

References 4 publications

Place of Death and End-of-Life Care Utilization among COVID-19 Decedents in a Massachusetts Health Care System

Place of Death and End-of-Life Care Utilization among COVID-19 Decedents in a Massachusetts Health Care System

Convalescent plasma use in the USA was inversely correlated with COVID-19 mortality

Convalescent Plasma Use in the United States was inversely correlated with COVID-19 Mortality: Did Plasma Hesitancy cost lives?

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