The point prevalence survey was circulated on April 18, 2020 to 15 hospitals across the United States. Each site was asked to select a random sample of up to 30 patients and to complete data collection by May 8, 2020. Any hospitalized patient meeting inclusion criteria was eligible. Data were manually extracted from an electronic health record (EHR) system and entered into a standardized electronic survey form. Assigned study members performed data collection on any singular date that fell within the aforementioned study period. Data extraction from EHR systems was limited to data collected during the 24 hours prior to the index date of review, and no patient identifiers were collected. Study data were collected and managed using Research Electronic Data Capture (REDCap) electronic data capture tools (Vanderbilt University, Nashville, TN) hosted at Northwestern University. REDCap is a secure, web-based software platform designed to support data capture for research studies.10,11 Data validation was coordinated by the principal investigator and the respective site coordinators. Data elements collected included facility demographics, total number of hospital and intensive care unit (ICU) beds prior to the pandemic, US census region, patient populations served, facility type (eg, academic, community, inpatient rehabilitation), and active clinical trial site status. Given the noninterventional nature of the study, all patients were managed at each site according to each center’s standard of care and guidelines for the management of COVID-19.

In addition to whether patients were receiving supportive care or drug therapies targeting SARS-CoV-2, we collected basic patient demographic information and vital status (eg, age, sex, comorbidities, oxygen requirement, and ICU status). Data were abstracted from EHR systems—Epic (Epic Systems Corporation, Verona, WI) or Cerner (Cerner Corporation, Kansas City, MO)—by infectious diseases and antimicrobial stewardship pharmacists at each site. For each patient included, no follow-up or longitudinal outcomes were ascertained. Pediatric patients were eligible for inclusion.

Reported cumulative COVID-19 cases and attributable deaths in the United States, as reported by the Centers for Disease Control and Prevention (CDC), were collected as a frame of reference for the study period. Additionally, ongoing clinical trial updates and medication availability (eg, EUA activity) are provided to describe routinely used drug therapies at the time of the study (Figure 1).12-16

Timeline of events during early months of COVID-19 pandemic in the United States. Case data are those reported by Centers for Disease Control and Prevention as of the time of writing.12-16 EUA indicates emergency use authorization; FDA, Food and Drug Administration; NIH, National Institutes of Health.

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