tetano
Editor, Senior Moderator
Glob Epidemiol
. 2022 Jan 7;4:100071.
doi: 10.1016/j.gloepi.2022.100071. Online ahead of print.
Evolving mortality and clinical outcomes of hospitalized subjects during successive COVID-19 waves in Catalonia, Spain
Albert Roso-Llorach[SUP] 1 2 [/SUP], Xavier Serra-Picamal[SUP] 3 [/SUP], Francesc X Cos[SUP] 3 [/SUP], Meritxell Pallejà-Millán[SUP] 4 [/SUP], Lourdes Mateu[SUP] 2 5 6 7 [/SUP], Antoni Rosell[SUP] 2 7 8 9 [/SUP], Benito Almirante[SUP] 2 10 11 [/SUP], Jaume Ferrer[SUP] 2 7 12 [/SUP], Mercè Gasa[SUP] 13 14 15 [/SUP], Carlota Gudiol[SUP] 14 15 16 [/SUP], Anna Maria Moreno[SUP] 17 [/SUP], Jose Luís Morales-Rull[SUP] 17 [/SUP], Maria Rexach[SUP] 18 19 [/SUP], Gladis Sabater[SUP] 18 [/SUP], Teresa Auguet[SUP] 20 21 22 [/SUP], Francesc Vidal[SUP] 20 21 22 [/SUP], Ana Lerida[SUP] 23 [/SUP], Josep Rebull[SUP] 24 [/SUP], Kamlesh Khunti[SUP] 25 [/SUP], Josep M Argimon[SUP] 3 [/SUP], Roger Paredes[SUP] 2 5 6 26 27 [/SUP]
Affiliations
Abstract
Background: The changes in shield strategies, treatments, emergence variants, and healthcare pathways might shift the profile and outcome of patients hospitalized with COVID-19 in successive waves of the outbreak.
Methods: We retrospectively analysed the characteristics and in-hospital outcomes of all patients admitted with COVID-19 in eight university hospitals of Catalonia (North-East Spain) between Feb 28, 2020 and Feb 28, 2021. Using a 7-joinpoint regression analysis, we split admissions into four waves. The main hospital outcomes included 30-day mortality and admission to intensive care unit (ICU).
Findings: The analysis included 17,027 subjects admitted during the first wave (6800; 39.9%), summer wave (1807; 10.6%), second wave (3804; 22.3%), and third wave (4616; 27.1%). The highest 30-day mortality rate was reported during the first wave (17%) and decreased afterwards, remaining stable at 13% in the second and third waves (overall 30% reduction); the lowest mortality was reported during the summer wave (8%, 50% reduction). ICU admission became progressively more frequent during successive waves. In Cox regression analysis, the main factors contributing to differences in 30-day mortality were the epidemic wave, followed by gender, age, diabetes, chronic kidney disease, and neoplasms.
Interpretation: Although in-hospital COVID-19 mortality remains high, it decreased substantially after the first wave and is highly dependent of patient's characteristics and ICU availability. Highest mortality reductions occurred during a wave characterized by younger individuals, an increasingly frequent scenario as vaccination campaigns progress.
Funding: This work did not receive specific funding.
Keywords: Clinical characteristics; Coronavirus disease 2019 (Covid-19); Hospital mortality; Risk factors; Socioeconomic characteristics.
. 2022 Jan 7;4:100071.
doi: 10.1016/j.gloepi.2022.100071. Online ahead of print.
Evolving mortality and clinical outcomes of hospitalized subjects during successive COVID-19 waves in Catalonia, Spain
Albert Roso-Llorach[SUP] 1 2 [/SUP], Xavier Serra-Picamal[SUP] 3 [/SUP], Francesc X Cos[SUP] 3 [/SUP], Meritxell Pallejà-Millán[SUP] 4 [/SUP], Lourdes Mateu[SUP] 2 5 6 7 [/SUP], Antoni Rosell[SUP] 2 7 8 9 [/SUP], Benito Almirante[SUP] 2 10 11 [/SUP], Jaume Ferrer[SUP] 2 7 12 [/SUP], Mercè Gasa[SUP] 13 14 15 [/SUP], Carlota Gudiol[SUP] 14 15 16 [/SUP], Anna Maria Moreno[SUP] 17 [/SUP], Jose Luís Morales-Rull[SUP] 17 [/SUP], Maria Rexach[SUP] 18 19 [/SUP], Gladis Sabater[SUP] 18 [/SUP], Teresa Auguet[SUP] 20 21 22 [/SUP], Francesc Vidal[SUP] 20 21 22 [/SUP], Ana Lerida[SUP] 23 [/SUP], Josep Rebull[SUP] 24 [/SUP], Kamlesh Khunti[SUP] 25 [/SUP], Josep M Argimon[SUP] 3 [/SUP], Roger Paredes[SUP] 2 5 6 26 27 [/SUP]
Affiliations
- PMID: 35018339
- PMCID: PMC8739818
- DOI: 10.1016/j.gloepi.2022.100071
Abstract
Background: The changes in shield strategies, treatments, emergence variants, and healthcare pathways might shift the profile and outcome of patients hospitalized with COVID-19 in successive waves of the outbreak.
Methods: We retrospectively analysed the characteristics and in-hospital outcomes of all patients admitted with COVID-19 in eight university hospitals of Catalonia (North-East Spain) between Feb 28, 2020 and Feb 28, 2021. Using a 7-joinpoint regression analysis, we split admissions into four waves. The main hospital outcomes included 30-day mortality and admission to intensive care unit (ICU).
Findings: The analysis included 17,027 subjects admitted during the first wave (6800; 39.9%), summer wave (1807; 10.6%), second wave (3804; 22.3%), and third wave (4616; 27.1%). The highest 30-day mortality rate was reported during the first wave (17%) and decreased afterwards, remaining stable at 13% in the second and third waves (overall 30% reduction); the lowest mortality was reported during the summer wave (8%, 50% reduction). ICU admission became progressively more frequent during successive waves. In Cox regression analysis, the main factors contributing to differences in 30-day mortality were the epidemic wave, followed by gender, age, diabetes, chronic kidney disease, and neoplasms.
Interpretation: Although in-hospital COVID-19 mortality remains high, it decreased substantially after the first wave and is highly dependent of patient's characteristics and ICU availability. Highest mortality reductions occurred during a wave characterized by younger individuals, an increasingly frequent scenario as vaccination campaigns progress.
Funding: This work did not receive specific funding.
Keywords: Clinical characteristics; Coronavirus disease 2019 (Covid-19); Hospital mortality; Risk factors; Socioeconomic characteristics.