COVID patient analysis shows too many unnecessary antibiotics

June 18, 2021

More than 120,000 times in the past 15 months, COVID-19 has made Michiganders sick enough to need hospital care, as three huge waves of coronavirus infections swept across the state.

Since April 2020, a statewide effort called the Mi-COVID19 initiative, collected data from the 40-hospital network to analyze and share data from thousands of COVID patients, applying the findings almost immediately in hospitals across the state.

Most important: the study found that 10% of those who survived an ICU stay would go on to die within 60 days of leaving the hospital, signaling an urgent need for more intensive follow-up care.

Early data show that nausea and vomiting were key COVID-19 onset symptoms. Knowing this, when coronavirus testing wasn’t widely available, helped inform care decisions in the first months and beyond.

The registry for COVID-19 patients actually used a framework for studying sepsis patients that was just about to launch in early 2020.The sepsis framework became a springboard for rapid-turnaround COVID-19 data collection. At each of the 40 hospitals, staff who normally do detailed analysis of patient records for several CQIs pivoted to focus on the records of COVID-19 patients.

For instance, at the start of the pandemic, most COVID-19 patients left the participating hospitals with no follow-up primary care appointment booked on their calendar. Now, many more do.

Some hospitals gave “just in case” doses of antibiotics to almost all patients, others to a minority. Few turned out to actually need them, and Mi-COVID19 data showed a single blood test could determine who could benefit most. Education efforts since that discovery have reduced unneeded prescribing and the risk that patients will suffer side effects.

Mi-COVID19 team members are also focusing on the long-term mental health effects of COVID-19 on patients and health providers alike. They’re also looking at patterns of how many patients were sent home from the hospital with prescriptions for drugs that can affect the brain and behavior in risky ways, such as opioids and benzodiazepines.

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