RESP-LENS Secondary Analysis- Female biological advantage with COVID-19 Infection

This work is a secondary analysis of the Respiratory Virus Laboratory Emergency Department Network Surveillance (RESP-LENS) network. The network began data collection in August 2021, with twenty-four participating health systems (encompassing 91 hospitals) covering all ten U.S. Department of Health and Human Services regions reporting data as of April 2022. The individual site Institutional review boards (IRBs) reviewed the protocol, and the IRBs deemed the protocol to be either non-human subjects research (i.e., surveillance), exempted from review or approved with expedited review.

RESP-LENS reports number of tests ordered and percent positive for SARS CoV-2, influenza, and RSV. Our data analysts identified ED visits for ARI based on the presence of at least one of 130 ICD10 codes for discharge diagnoses associated with specific respiratory viral infection or symptoms, such as cough or rhinorrhea. For each ARI visit identified, an algorithm written by analysts extracted laboratory testing results and clinical and disposition data electronically from the medical record on a weekly basis with 30-day follow-up.

The “input” sample included all patients identified in real-time surveillance as having an ARI-defining ICD code and using this large sample of ARI patients, we compared data between groups stratified by sex. We reduced this sample to only those individuals tested for either COVID-19 or influenza and compared outcomes by sex for those who tested positive for either of those viruses. The primary outcomes included A) 30-day mortality and B) ICU admission requirement following an index visit.