MCW Collaborative for Healthcare Delivery Science (CHDS) COVID-19 Projects
Current Projects
- Association between COVID-19 and Delirium Development while Hospitalized in the General Medical Units at an Academic Medical Center.
Completed Projects
- Racial Disparities in Incidence and Outcomes Among Patients With COVID-19
- Decrease in Positivity Rate of Influenza Tests Coinciding With Outbreak of SARS-CoV-2: Data From a Southeastern Wisconsin Laboratory
- The Impact of COVID-19 Viral Load at Admission
- Hospitalization Outcomes Among Patients With COVID-19 Undergoing Remote Monitoring
Association between COVID-19 and Delirium Development while Hospitalized in the General Medical Units at an Academic Medical Center
Overview
We examined 1) the association between COVID-19 diagnosis and incidence of delirium among patients admitted to acute care units, and 2) factors associated with the incidence of delirium among patients admitted with COVID-19.
Key Learnings & Impact
- There were no COVID-19 specific symptoms that are associated with developing delirium
- COVID-positive patients had 62% higher relative risk of developing delirium than COVID-negative patients
- Among COVID-positive patients, development of delirium was associated with male sex and age >60
- COVID-19 positive patients above age 60 are especially vulnerable for delirium and may benefit from extra screening for this often-under-recognized condition
Results Dissemination
- Oral presentation at Society of General Internal Medicine Annual Meeting, April 2022
- Manuscript preparation underway
Yilu ‘Bill’ Dong, PhD
Pediatrics-Emergency Medicine
CHDS Economist
Key Clinical Partner
Tom Heinrich, MD
Psychiatry and Behavioral Medicine
Project Team
Liliana Pezzin, PhD, JD
Ryan Hanson, MS
Annie Penlesky, MPH
Racial Disparities in Incidence and Outcomes Among Patients With COVID-19
Overview
We assessed COVID-19 positivity, hospitalization, intensive care unit admission, mechanical ventilation, and death among various racial groups, in addition to other important demographic factors, to learn the impact of these social determinants of health early in the COVID-19 pandemic.
Key Learnings & Impact
- Black race was associated with COVID-19 positivity
- Black race and poverty were associated with hospitalization due to COVID-19
- Poverty, but not Black race, was associated with ICU admission due to COVID-19
Results Dissemination
- Results published in JAMA Network Open, September 2020
Ann B. Nattinger, MD, MPH
Associate Provost for Research
CHDS Principal Investigator
Key Clinical Partner
Silvia Munoz-Price MD, PhD
Medicine-Infectious Disease
Project Team
Ryan Hanson, MS
Sid Singh, MD, MS, MBA
Liliana Pezzin, PhD, JD
Frida Rivera, MD, PhD
Cameron G. Gmehlin, BA
Adriana Perez, MS
Blake W. Buchan, PhD
Nathan A. Ledeboer, PhD
Decrease in Positivity Rate of Influenza Tests Coinciding With Outbreak of SARS-CoV-2: Data From a Southeastern Wisconsin Laboratory
Overview
Using laboratory data, we assessed the total number of weekly flu tests and test positivity rates during the 2019-2020 flu season – coinciding with the start of the COVID-19 pandemic – with previous flu seasons.
Key Learnings & Impact
- Flu positivity rates declined to 0% more quickly than in any of the 4 previous years
- 0% positivity was achieved 8 weeks ahead of the next earliest 0% positivity year: during the 2nd week of April (2019-2020) vs. during the final week of May (2017-2018)
Results Dissemination
- Published in the Wisconsin Medical Journal, December 2020
Sid Singh, MD, MS, MBA
CHDS Co-Executive Director
Chief Quality Officer, F & MCW
Project Team
Prakash Laud, PhD
Ryan Hanson, MS
Nathan A. Ledeboer, PhD
Jonathon D. Truwit, MD, MBA
The Impact of COVID-19 Viral Load at Admission
Overview
We studied whether patient demographics (race & poverty) were associated with varying COVID-19 viral loads at hospital admission. We also assessed if viral load was an indicator of length of stay and discharge disposition.
Key Learnings
- A higher COVID-19 viral load was associated with a longer length of stay and higher likelihood of death, but was not associated with discharge to SNF
- After accounting for viral load, poverty was associated with discharge to a SNF
Results Dissemination
- Results published in the Wisconsin Medical Journal, December 2021
CHDS Lead
Liliana Pezzin PhD, JD
Institute for Health & Equity
CHDS Economist
Key Clinical Partner
Silvia Munoz-Price MD, PhD
Medicine-Infectious Disease
Project Team
Ann B. Nattinger, MD, MPH
Sid Singh, MD, MS, MBA
Ryan Hanson, MS
Frida Rivera, MD
Cameron Gmehlin, BA
Adriana Perez, MS
Nathan Ledeboer, PhD
Blake Buchan, PhD
Hospitalization Outcomes Among Patients With COVID-19 Undergoing Remote Monitoring
Overview
We evaluated a daily remote patient monitoring (RPM) program for patients diagnosed with COVID-19 and are managing symptoms from home. We assessed whether patients managed with RPM were more likely to be admitted to the hospital compared to those not monitored.
Key Learnings & Impact
- Patients managed through RPM had a 30% lower odds of hospitalization
- Of hospitalized patients, those managed through RPM sought care escalation later than those not managed; however, RPM patients had a shorter length of stay and were less likely to be admitted to the ICU
Results Dissemination
- Oral presentation at Society of General Internal Medicine Annual Meeting, April 2022
- Results published in JAMA Network Open, July 2022
In Partnership with Inception Health
CHDS Lead
Brad Crotty, MD, MPH
Medical Director for Digital
Engagement, Inception Health
Project Team
Yilu ‘Bill’ Dong, PhD
Prakash Laud, PhD
Ryan Hanson, MS
Bradley Gershkowitz, BS - CHDS summer student ‘19
Annie Penlesky, MPH
Neemit Shah, BA - CHDS summer student ‘21
Sid Singh, MD, MS, MBA
Ann B. Nattinger, MD, MPH
Melek Somai, MD, MPH
Michael Anderes, MBA
Erin Green, RN
Karen Fickel, MD