Khera R, Liu Y, de Lemos JA, et al. - An accelerated case growth trajectory is a predictor of poor COVID-19 outcomes in hospitals. These sites could be targets for additional resource influxes or triage strategies. Early detection of such hospital signatures that may foreshadow poor outcomes is critical as the healthcare system prepares for future health challenges.

• There were 85 hospitals with 1,5329 COVID-19 hospitalizations, with a median hospital case volume was 118 and a median growth rate of 2 cases/100 beds/week, but these figures varied significantly.

• No significant link was found between overall hospital COVID-19 case volume and risk-standardized in-hospital case-fatality rate (rsCFR).

• Hospitals with faster COVID-19 case growth, on the other hand, had higher rsCFR, which increased across case growth quartiles.

• While there were no differences in medical treatments or ICU therapies (mechanical ventilation, vasopressors), the highest case growth quartile had 4-fold higher chances of having above-median rsCFR than the lowest quartile.