Nearly half of COVID-19 hospitalizations in Massachusetts are ‘incidental’ cases, new state data show

COVID hospitalization data.Ryan Huddle

New state data show 51 percent of COVID hospitalizations in Massachusetts on Tuesday were patients who were seriously ill from the virus, while 49 percent of patients were admitted for other reasons but happened to test positive upon admission.

The state launched its new method of reporting primary vs. incidental COVID-19 hospitalizations on Thursday, reporting that on Jan. 18, 1,624 people were in the hospital primarily because they were seriously sick with the virus while 1,563 patients had tested positive for COVID-19 while being hospitalized for other reasons.

Some specialists told the Globe the information is crucial to understanding the impact of the latest COVID-19 surge on hospital capacity, while others feared it would obscure the pandemic’s true burden on the health care system. Some critics also worried that without a regional breakdown, the numbers could obscure COVID’s toll in parts of the state that have lower vaccination rates and a higher percentage of people hospitalized due to the virus.

To identify patients admitted for COVID-19, the Baker administration is using the drug dexamethasone as a proxy. The powerful steroid, used to quell the inflammatory storm in severely ill COVID patients, is also commonly used to treat other conditions, such as septic shock or swelling in the brain.

State epidemiologist Dr. Catherine Brown told the Globe dexamethasone is the current standard treatment for the illness and is given to at least 90 percent of patients seriously sickened by the virus.

The information is easy to pull from patient records and involves a method that can work consistently for hospital systems across the state, she said.

The state is considering patients as being hospitalized for COVID-19 if they tested positive and were also treated with dexamethasone. Those who test positive but do not receive dexamethasone will be counted as incidental.

But some hospital officials said COVID-positive patients who are not receiving dexamethasone are still acutely ill with other issues, and even those whose symptoms are not acute but test positive may still require significant care, especially those with psychiatric issues who may not understand why they are being isolated for infection control.

Kay Lazar of the Globe staff contributed to this report.