Clinical characteristics of the first three waves of hospitalised patients with COVID-19 in Japan prior to the widespread use of vaccination: a nationwide observational study

Matsunaga, Nobuaki; Hayakawa, Kayoko; Asai, Yasufumi; Tsuzuki, Shinya; Terada, Mari; Suzuki, Setsuko; Ohtsu, Hiroshi; Kitajima, Koji; Toyoda, Ako; Suzuki, Kumiko; Suzuki, Michiyo; Saito, Sho; Uemura, Yukari; Shibata, Taro; Kondo, Masashi; Nakamura‐Uchiyama, Fukumi; Yokota, Kazuhisa; Saito, Fumitake; Izumi, Kazuo; Sugiura, Wataru; Ohmagari, Norio

doi:10.1016/j.lanwpc.2022.100421

Cited by 30 publications

(39 citation statements)

References 17 publications

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“…Though the demographics of our patient population were not statistically different between periods, other non-collected characteristics of patients presenting to the ED may have differed (50), particularly as ED volumes were low during the beginning of the pandemic.…”

Section: Discussionmentioning

confidence: 92%

A study to assess the impact of cobas Liat point-of-care PCR assays (SARS-CoV-2 and Influenza A/B) on patient clinical management in the emergency department of the University of California at Davis Medical Center

May

Robbins

Canchola

et al. 2022

Preprint

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Background Rapid detection of SARS-CoV-2 is crucial for reduction of transmission and clinical decision-making. The cobas® SARS-CoV-2 & Influenza A/B nucleic acid test for use on the cobas Liat® System is a rapid (20 minutes) point-of-care (POC) polymerase chain reaction (PCR) method. Methods This unblinded, pre-post study enrolled consecutive patients with symptoms/signs consistent with SARS-CoV-2 infection presenting to the University of California, Davis emergency department (ED). Outcomes following implementation of the cobas Liat SARS-CoV-2 & Influenza A/B test (intervention period: December 2020 to May 2021) were compared with previous standard-of-care using centralized laboratory PCR methods (control period: April 2020 to October 2020). Results Electronic health records of 8879 symptomatic patients were analyzed, comprising 4339 and 4540 patient visits and 538 and 638 positive SARS-CoV-2 PCR test results in the control and intervention periods, respectively. Compared with the control period, turnaround time (TAT) was shorter in the intervention period (median 0.98 vs 12.3 hours; p<0.0001). ED length of stay (LOS) was generally longer in the intervention period compared with the control period, but for those SARS-CoV-2-negative who were admitted, ED LOS was shorter (median 12.53 vs 17.93 hours; p<0.0001). Overall, the rate of anti-infective prescribing was also lower in the intervention period than in the control period (antibiotics only: 38.11% vs 44.55%; p<0.0001 and antivirals only: 3.13% vs 0.94%; p<0.0001). Conclusion This real-world study confirms faster TAT with a POC PCR method in an emergency care setting and highlights the importance of rapid SARS-CoV-2 detection to aid patient management and inform treatment decisions.

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Section: Discussionmentioning

confidence: 92%

A study to assess the impact of cobas Liat point-of-care PCR assays (SARS-CoV-2 and Influenza A/B) on patient clinical management in the emergency department of the University of California at Davis Medical Center

May

Robbins

Canchola

et al. 2022

Preprint

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“…Moreover, in a large analysis involving more than 33,000 patients in Japan, some of the most commonly reported symptoms on admission were fever and a cough, which is consistent with our observations. These symptoms, along with dyspnea, are associated with a higher risk of hospitalization [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Do the Successive Waves of SARS-CoV-2, Vaccination Status and Place of Infection Influence the Clinical Picture and COVID-19 Severity among Patients with Persistent Clinical Symptoms? The Retrospective Study of Patients from the STOP-COVID Registry of the PoLoCOV-Study

Chudzik

Babicki

Kapusta

et al. 2022

JPM

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The severity of ailments caused by SARS-CoV-2 varies and the clinical picture has already evolved during the pandemic, complicating diagnostics. In Poland, no study has been performed to assess the clinical picture of patients across the successive pandemic waves. The aim of the study was to present the characteristics of patients who present to medical center because of persistent symptoms after COVID-19, and to study differences between hospitalized/non-hospitalized, vaccinated/non-vaccinated individuals and between different waves in Poland. This is a retrospective study evaluating the clinical presentation of COVID-19 patients from the STOP-COVID registry of the PoLoCOV-Study. This registry includes patients who present to the medical center because of persistent clinical symptoms after the isolation. The patients’ data were obtained from individuals who suffered from COVID-19 between September 2020 and December 2021.The patients were divided into groups according to the infection rate increase pattern (II/III/IV pandemic wave), status of vaccination and place of isolation. Regardless of the pandemic wave, the patients’ most commonly reported weaknesses were a cough and a headache. The arterial hypertension and hyperlipidemia were the most frequent concomitant chronic conditions. Hospitalized patients more often reported weakness or a cough while home-isolated patients were more likely to have rhinitis or a headache. Patients who completed the vaccination course showed a shorter duration of clinical symptoms and a lower mean number of symptoms. Additionally, vaccinated individuals reported less taste and/or olfactory dysfunction than unvaccinated individuals. To conclude, the persistence of the pandemic has resulted in significant changes observed in the clinical picture. Successive waves caused deterioration in the subjective assessment of the disease severity. A cough seemed to occur more frequently in the later pandemic waves.

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“…Healthcare facilities that voluntarily participated in the COVID-19 Registry Japan (COVIREGI-JP) [19,25], which is managed by the REBIND (Repository of Data and Biospecimen of Infectious Disease) project, enrolled the patients. Research collaborators in each facility manually entered the data into the registry.…”

Section: Methodsmentioning

confidence: 99%

“…Healthcare facilities that voluntarily participated in the COVID-19 Registry Japan (COVIREGI-JP) [19,25]…”

Section: Study Population and Datamentioning

confidence: 99%

“…Although previous studies have identified the risk factors associated with severe illness caused by other variants [5,[16][17][18], the same factors may not be applicable to the disease caused by Omicron VOC. Examining the risk factors associated with severe COVID-19 caused by the Omicron VOC is therefore desirable especially since, throughout the entire pandemic period, older Japanese adults have accounted for a large proportion of the severe COVID-19 cases that required hospitalization [19,20]. Because Japan is fast becoming an extremely aged society, an evaluation of the risk factors specific to the elderly population would be extremely valuable.…”

Section: Introductionmentioning

confidence: 99%

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Impact of dementia, living in a long-term care facility, and physical activity status on COVID-19 severity in older adults

Tsuzuki

Akiyama

Matsunaga

et al. 2022

Preprint

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BackgroundJapan is fast becoming an extremely aged society and older adults are known to be at risk of severe COVID-19. However, the impact of risk factors specific to this population for severe COVID-19 caused by the Omicron variant of concern (VOC) are not yet clear.MethodsWe performed an exploratory analysis using logistic regression to identify risk factors for severe COVID-19 illness among 4,868 older adults with a positive SARS-CoV-2 test result who were admitted to a healthcare facility between 1 January 2022 and 16 May 2022. We then conducted one-to-one propensity score (PS) matching for three factors—dementia, admission from a long-term care facility, and poor physical activity status—and used Fisher’s exact test to compare the proportion of severe COVID-19 cases in the matched data. We also estimated the average treatment effect on treated (ATT) in each PS matching analysis.ResultsOf the 4,868 cases analyzed, 1,380 were severe. Logistic regression analysis showed that age, male sex, cardiovascular disease, cerebrovascular disease, chronic lung disease, renal failure and/or dialysis, physician-diagnosed obesity, admission from a long-term care facility, and poor physical activity status were risk factors for severe disease. Vaccination and dementia were identified as factors associated with non-severe illness. The ATT for dementia, admission from a long-term care facility, and poor physical activity status was −0.04 (95% confidence interval −0.07, −0.01), 0.09 (0.06, 0.12), and 0.17 (0.14, 0.19), respectively.ConclusionsOur results suggest that poor physical activity status and living in a long-term care facility have a substantial impact on the risk of severe COVID-19 caused by the Omicron VOC, while dementia might be associated with non-severe illness.

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Clinical characteristics of the first three waves of hospitalised patients with COVID-19 in Japan prior to the widespread use of vaccination: a nationwide observational study

Cited by 30 publications

References 17 publications

A study to assess the impact of cobas Liat point-of-care PCR assays (SARS-CoV-2 and Influenza A/B) on patient clinical management in the emergency department of the University of California at Davis Medical Center

A study to assess the impact of cobas Liat point-of-care PCR assays (SARS-CoV-2 and Influenza A/B) on patient clinical management in the emergency department of the University of California at Davis Medical Center

Do the Successive Waves of SARS-CoV-2, Vaccination Status and Place of Infection Influence the Clinical Picture and COVID-19 Severity among Patients with Persistent Clinical Symptoms? The Retrospective Study of Patients from the STOP-COVID Registry of the PoLoCOV-Study

Impact of dementia, living in a long-term care facility, and physical activity status on COVID-19 severity in older adults

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