tetano
Editor, Senior Moderator
J Infect Chemother
. 2022 Jun 29;S1341-321X(22)00188-X.
doi: 10.1016/j.jiac.2022.06.013. Online ahead of print.
Temporal trends in clinical characteristics and in-hospital mortality among patients with COVID-19 in Japan for waves 1, 2, and 3: a retrospective cohort study
Hideki Endo[SUP] 1 [/SUP], Kyunghee Lee[SUP] 1 [/SUP], Tetsu Ohnuma[SUP] 2 [/SUP], Senri Watanabe[SUP] 1 [/SUP], Kiyohide Fushimi[SUP] 3 [/SUP]
Affiliations
Abstract
Introduction: Little information is available on the temporal trends in the clinical epidemiology and in-hospital mortality of patients with coronavirus disease 2019 (COVID-19) in Japan for waves 1, 2, and 3.
Methods: A national claims database was used to analyze the time trends in admission, medical procedure, and in-hospital mortality characteristics among patients with COVID-19. Patients who were ≥18 years and discharged from January 1, 2020 to February 28, 2021 were included.
Results: A multilevel logistic regression analysis of 51,252 patients revealed a decline in mortality in waves 2 and 3 (risk-adjusted mortality range = 2.17-4.07%; relative risk reduction = 23-59%; reference month of April 2020 = 5.32%). In the subgroup analysis, a decline in mortality was also observed in patients requiring oxygen support but not mechanical ventilation (risk-adjusted mortality range = 5.98-11.68%; relative risk reduction = 22-60%; reference month of April 2020 = 15.06%). Further adjustments for medical procedure changes in the entire study population revealed a decrease in mortality in waves 2 and 3 (risk-adjusted mortality range = 2.66-4.05%; relative risk reduction = 24-50%).
Conclusions: A decline in in-hospital mortality was observed in waves 2 and 3 after adjusting for patient/hospital-level characteristics and medical treatments. The reasons for this decline warrant further research to improve the outcomes of hospitalized patients.
Keywords: COVID-19; administrative database; cohort study; hospital mortality.
. 2022 Jun 29;S1341-321X(22)00188-X.
doi: 10.1016/j.jiac.2022.06.013. Online ahead of print.
Temporal trends in clinical characteristics and in-hospital mortality among patients with COVID-19 in Japan for waves 1, 2, and 3: a retrospective cohort study
Hideki Endo[SUP] 1 [/SUP], Kyunghee Lee[SUP] 1 [/SUP], Tetsu Ohnuma[SUP] 2 [/SUP], Senri Watanabe[SUP] 1 [/SUP], Kiyohide Fushimi[SUP] 3 [/SUP]
Affiliations
- PMID: 35779801
- DOI: 10.1016/j.jiac.2022.06.013
Abstract
Introduction: Little information is available on the temporal trends in the clinical epidemiology and in-hospital mortality of patients with coronavirus disease 2019 (COVID-19) in Japan for waves 1, 2, and 3.
Methods: A national claims database was used to analyze the time trends in admission, medical procedure, and in-hospital mortality characteristics among patients with COVID-19. Patients who were ≥18 years and discharged from January 1, 2020 to February 28, 2021 were included.
Results: A multilevel logistic regression analysis of 51,252 patients revealed a decline in mortality in waves 2 and 3 (risk-adjusted mortality range = 2.17-4.07%; relative risk reduction = 23-59%; reference month of April 2020 = 5.32%). In the subgroup analysis, a decline in mortality was also observed in patients requiring oxygen support but not mechanical ventilation (risk-adjusted mortality range = 5.98-11.68%; relative risk reduction = 22-60%; reference month of April 2020 = 15.06%). Further adjustments for medical procedure changes in the entire study population revealed a decrease in mortality in waves 2 and 3 (risk-adjusted mortality range = 2.66-4.05%; relative risk reduction = 24-50%).
Conclusions: A decline in in-hospital mortality was observed in waves 2 and 3 after adjusting for patient/hospital-level characteristics and medical treatments. The reasons for this decline warrant further research to improve the outcomes of hospitalized patients.
Keywords: COVID-19; administrative database; cohort study; hospital mortality.