Causes of Non-COVID-19 Hospitalization in the United States in 2019 and 2020

Introduction Although much literature has been devoted to the impact of Coronavirus disease 2019 (COVID-19) on various conditions, less is known about the impact on those hospitalized for non-COVID-related causes. We reviewed the top 20 diagnoses resulting in hospitalizations in 2019 and 2020, focusing on the changes from 2019 to 2020. Methods This retrospective cohort study was performed using the National Inpatient Sample database from 2019 and 2020. We identified all hospitalizations using their Clinical Classifications Software Refined categories. Descriptive statistics were performed to obtain mortality rates along with examining hospital-level factors such as length of stay (LOS) and hospitalization costs. Results are reported as percentages and mean for categorical and continuous variables, respectively. Results Total hospitalizations in 2019 were 30,219,558, and 26,618,621 in 2020. The top 5 causes of hospitalizations in 2019 were: septicemia, heart failure, osteoarthritis, complications specified during childbirth, and diabetes mellitus with complication. The top 5 causes in 2020 were: septicemia, heart failure, complications specified during childbirth, diabetes mellitus with complications, and osteoarthritis. Mortality increased by 0.2% in septicemia (3.52%), respiratory failure/insufficiency/arrest (1.51%), pneumonia (except that caused by tuberculosis) (1%), acute myocardial infarction (0.45%), heart failure (0.26%), cerebral infarction (0.26%), and acute and unspecified renal failure (0.2%). An increase in LOS by more than 0.15 days was observed in septicemia (0.72 days), respiratory failure/insufficiency/arrest (0.24 days), acute and unspecified renal failure (0.17 days), and schizophrenia spectrum and other psychotic disorders (0.16 days). Conclusions The COVID-19 pandemic in 2020 brought about changes in hospitalization patterns related to non-COVID-19 conditions. These changes could be attributed to hospitals being hesitant to admit non-COVID-19 patients, limited bed availability, and reduced resources for them. Understanding the impact of non-COVID-19 hospitalizations may help stakeholders plan for future pandemics to ensure that care for patients hospitalized for non-pandemic illnesses is not compromised.