Albert Roso-Llorach , Xavier Serra-Picamal , Francesc X. Cos , Meritxell Pallejà-Millán , Lourdes Mateu , Antoni Rosell , Benito Almirante , Jaume Ferrer , Mercè Gasa , Carlota Gudiol , Anna Maria Moreno , Jose Luís Morales-Rull , Maria Rexach , Gladis Sabater , Teresa Auguet , Francesc Vidal , Ana Lerida , Josep Rebull , Kamlesh Khunti , Josep M. Argimon , Roger Paredes
{"title":"西班牙加泰罗尼亚连续COVID-19疫情期间住院受试者死亡率和临床结果的变化","authors":"Albert Roso-Llorach , Xavier Serra-Picamal , Francesc X. Cos , Meritxell Pallejà-Millán , Lourdes Mateu , Antoni Rosell , Benito Almirante , Jaume Ferrer , Mercè Gasa , Carlota Gudiol , Anna Maria Moreno , Jose Luís Morales-Rull , Maria Rexach , Gladis Sabater , Teresa Auguet , Francesc Vidal , Ana Lerida , Josep Rebull , Kamlesh Khunti , Josep M. Argimon , Roger Paredes","doi":"10.1016/j.gloepi.2022.100071","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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).</p></div><div><h3>Findings</h3><p>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.</p></div><div><h3>Interpretation</h3><p>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.</p></div><div><h3>Funding</h3><p>This work did not receive specific funding.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/05/main.PMC8739818.pdf","citationCount":"25","resultStr":"{\"title\":\"Evolving mortality and clinical outcomes of hospitalized subjects during successive COVID-19 waves in Catalonia, Spain\",\"authors\":\"Albert Roso-Llorach , Xavier Serra-Picamal , Francesc X. Cos , Meritxell Pallejà-Millán , Lourdes Mateu , Antoni Rosell , Benito Almirante , Jaume Ferrer , Mercè Gasa , Carlota Gudiol , Anna Maria Moreno , Jose Luís Morales-Rull , Maria Rexach , Gladis Sabater , Teresa Auguet , Francesc Vidal , Ana Lerida , Josep Rebull , Kamlesh Khunti , Josep M. Argimon , Roger Paredes\",\"doi\":\"10.1016/j.gloepi.2022.100071\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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).</p></div><div><h3>Findings</h3><p>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.</p></div><div><h3>Interpretation</h3><p>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.</p></div><div><h3>Funding</h3><p>This work did not receive specific funding.</p></div>\",\"PeriodicalId\":36311,\"journal\":{\"name\":\"Global Epidemiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/05/main.PMC8739818.pdf\",\"citationCount\":\"25\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Global Epidemiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2590113322000013\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Epidemiology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2590113322000013","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Evolving mortality and clinical outcomes of hospitalized subjects during successive COVID-19 waves in Catalonia, Spain
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.