OBJECTIVES : This systematic literature review highlights the economic burden of hospitalized adults with COVID-19 in the USA.

METHODS : We searched MEDLINE, EMBASE, and EconLit from December 1, 2019 to October 26, 2020. All abstracts were reviewed according to the eligibility criteria, by two systematic reviewers independently. Studies with queries were referred to a third reviewer to reach agreement. Studies that met the inclusion criteria after review of full-text were extracted and critically appraised.

RESULTS : After removing duplicates, 845 citations were identified through database searches. A total of 45 citations were included for full-text screening; 9 observational studies were included (8 cohort studies and 1 case series). Patient age ranged from a mean of 50-69.2 years, and the proportion of males in all patients ranged from 50.5% to 61.9%. Mean length of stay (LOS) ranged from 1.4 days (SD 4.3) to 8.9 days. Black patients had a median LOS of 6 days compared to white patients of 7 days. One study reported mean LOS in the intensive care unit (ICU) of 15.5 days (range 3-46). The proportion of patients moved to the ICU ranged from 4% to 35.7%. The proportion of non-invasive ventilation ranged from 0.8% to 8.5% and the proportion of invasive ventilation ranged from 0% to 78.2%. Pharmacology therapy was well reported; treatments used in more than one study included: antibiotics, steroids, hydroxychloroquine, remdesivir, and tocilizumab. None of the included studies reported direct/indirect costs, nor data for productivity loss.

CONCLUSIONS : Research on the economic burden of COVID-19 in the USA is limited regarding resource utilization; we found no studies that focused on the cost burden associated with COVID-19. These results may be useful for future studies seeking to increase the information base on the economic burden of COVID-19 in the hospital setting.