Changing patterns of clinical presentation of COVID-19 in hospital admissions: With, or because of, COVID?

•In this article we demonstrate the changing nature of COVID admissions from January 2021 to January 2022.•In January 2021 most admissions with SARS-CoV2 positive PCR had acute COVID-19 related disease.•Comparatively, in January 2022 the majority of admissions had incidental COVID-19.•Incidental disease may be related to increasing vaccination rates or change in virulence of the virus with subsequent variants.•We suggest monitoring proportion of patients admitted with COVID-19 disease to plan service provision and monitor impact.