Mortality trends and length of stays among hospitalized patients with COVID-19 in Ontario and Québec (Canada): a population-based cohort study of the first three epidemic waves

Xia, Yiqing; Ma, Huiting; Buckeridge, David L.; Brisson, Marc; Sander, Beate; Chan, Adrienne K.; Verma, Aman; Ganser, Iris; Kronfli, Nadine; Mishra, Sharmistha; Maheu‐Giroux, Mathieu

doi:10.1016/j.ijid.2022.04.048

Cited by 17 publications

(17 citation statements)

References 46 publications

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“…Studies in South Africa, Belgium, England, US and Canada also concluded that the LoS in hospitals decrease throughout the time (i.e., waves or weeks) [8,10,17,25]. Contrary to our results, previous studies in England, US, and Canada concluded that the LoS in ICU also decreases throughout time [8,17,26]. However, none of these studies had an explanation for this tendency.…”

Section: Association Between Los and Covariablescontrasting

confidence: 99%

Hospital length of stay throughout bed pathways and factors affecting this time: a non-concurrent cohort study of Colombia COVID-19 patients and an unCoVer network project

Galvis

Aguirre

Bedoya

et al. 2022

Preprint

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Predictions of hospital beds occupancy depends on hospital admission rates and the length of stay (LoS) according to bed type (hospital and intensive care unit beds). The objective of this study was to describe the LoS of COVID-19 hospital patients in Colombia during 2020-2021. Accelerated failure time models were used to estimate the LoS distribution according to each bed type and throughout each bed pathway. Acceleration factors and 95% confidence intervals were calculated to measure the effect on LoS of the outcome, sex, age, admission period during the epidemic (i.e., epidemic waves, peaks or valleys, and before/after vaccination period), and patients’ geographic origin. Most of the admitted COVID-19 patients occupied just hospital bed. Recovered patients spent more time in the hospital and intensive care unit than deceased patients. Men had longer LoS than women. In general, the LoS increased with age. Finally, the LoS varied along epidemic waves. It was lower in epidemic valleys than peaks, and became shorter after vaccinations began in Colombia than before. Our study highlights the necessity of analyzing local data on hospital admission rates and LoS to design strategies to prioritize hospital beds resources during the current and future pandemics.

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Section: Association Between Los and Covariablescontrasting

confidence: 99%

Hospital length of stay throughout bed pathways and factors affecting this time: a non-concurrent cohort study of Colombia COVID-19 patients and an unCoVer network project

Galvis

Aguirre

Bedoya

et al. 2022

Preprint

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“…A total of 825 in-patients were involved, with an over-representation of men, as already reported [ 8 , 20 ]. The median age of the patients was 72 years, which was higher than that reported by other Italian and international studies [ 8 , 21 , 22 , 23 ]. More than half of the subjects were hospitalized during the first wave, while those admitted during the second and even more in the third waves were significantly fewer, in agreement with other literature [ 23 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 54%

Long-Term Survival among Patients Hospitalized for COVID-19 during the First Three Epidemic Waves: An Observational Study in a Northern Italy Hospital

Bertolotti

Betti

Giacchero

et al. 2022

IJERPH

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The mortality rate of hospitalized COVID-19 patients differed strongly between the first three pandemic waves. Nevertheless, their long-term survival has been poorly assessed. The aim of this study was to compare the clinical characteristics and mortality rates of 825 patients with coronavirus disease 2019 (COVID-19) infection who were hospitalized at the Alessandria hub hospital, in Northern Italy, during the first fifty days of the first three pandemic waves. Each subject was followed in terms of vital status for six months from the date of hospital admission or until deceased. Patients admitted during the three waves differed in age (p = 0.03), disease severity (p < 0.0001), Charlson comorbidity index (p = 0.0002), oxygen therapy (p = 0.002), and invasive mechanical ventilation (p < 0.0001). By the end of follow-up, 309 deaths (38.7%) were observed, of which 186 occurred during hub hospitalization (22.5%). Deaths were distributed differently among the waves (p < 0.0001), resulting in being higher amongst those subjects admitted during the first wave. The COVID-19 infection was reported as the main cause of death and patients with a higher mortality risk were those aged ≥65 years [adjusted HR = 3.40 (95% CI 2.20–5.24)], with a higher disease severity [adjusted HR = 1.87 (95%CI 1.43–2.45)], and those requiring oxygen therapy [adjusted HR = 2.30 (95%CI 1.61–3.30)]. In conclusion, COVID-19 patients admitted to our hub hospital during the second and the third waves had a lower risk of long-term mortality than those admitted during the first. Older age, more severe disease, and the need for oxygen therapy were among the strongest risk factors for poor prognosis.

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“…In another rather smaller study, percentages of intensive care requirement were comparable to those of our cohort ( 8 ). Focusing on studies that extended their observational period to include the third pandemic wave in early 2021, comparable observations of a decrease of the proportion of patients receiving mechanical ventilation and lower in-hospital mortality were made ( 29 – 31 ). Moreover, our findings of a decreasing age of hospitalized patients as well as a shortened length-of-stay were confirmed ( 30 , 31 ).…”

Section: Discussionmentioning

confidence: 99%

“…Focusing on studies that extended their observational period to include the third pandemic wave in early 2021, comparable observations of a decrease of the proportion of patients receiving mechanical ventilation and lower in-hospital mortality were made ( 29 – 31 ). Moreover, our findings of a decreasing age of hospitalized patients as well as a shortened length-of-stay were confirmed ( 30 , 31 ). Of note, in the report of Xia et al, which partly covers the pandemic phase with alpha virus variant dominance, no specific risk for the utilization of mechanical ventilation is provided.…”

Section: Discussionmentioning

confidence: 99%

Changing trends of patient characteristics and treatment pathways during the COVID-19 pandemic: A cross-sectional analysis of 72,459 inpatient cases from the German Helios database

König

Hohenstein

Pellissier

et al. 2022

Front. Public Health

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BackgroundThis study compared patient profiles and clinical courses of SARS-CoV-2 infected inpatients over different pandemic periods.MethodsIn a retrospective cross-sectional analysis, we examined administrative data of German Helios hospitals using ICD-10-codes at discharge. Inpatient cases with SARS-CoV-2 infection admitted between 03/04/2020 and 07/19/2022 were included irrespective of the reason for hospitalization. All endpoints were timely assigned to admission date for trend analysis. The first pandemic wave was defined by change points in time-series of incident daily infections and compared with different later pandemic phases according to virus type predominance.ResultsWe included 72,459 inpatient cases. Patients hospitalized during the first pandemic wave (03/04/2020–05/05/2020; n = 1,803) were older (68.5 ± 17.2 vs. 64.4 ± 22.6 years, p < 0.01) and severe acute respiratory infections were more prevalent (85.2 vs. 53.3%, p < 0.01). No differences were observed with respect to distribution of sex, but comorbidity burden was higher in the first pandemic wave. The risk of receiving intensive care therapy was reduced in all later pandemic phases as was in-hospital mortality when compared to the first pandemic wave. Trend analysis revealed declines of mean age and Elixhauser comorbidity index over time as well as a decline of the utilization of intensive care therapy, mechanical ventilation and in-hospital mortality.ConclusionCharacteristics and outcomes of inpatients with SARS-CoV-2 infection changed throughout the observational period. An ongoing evaluation of trends and care pathways will allow for the assessment of future demands.

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Mortality trends and length of stays among hospitalized patients with COVID-19 in Ontario and Québec (Canada): a population-based cohort study of the first three epidemic waves

Cited by 17 publications

References 46 publications

Hospital length of stay throughout bed pathways and factors affecting this time: a non-concurrent cohort study of Colombia COVID-19 patients and an unCoVer network project

Hospital length of stay throughout bed pathways and factors affecting this time: a non-concurrent cohort study of Colombia COVID-19 patients and an unCoVer network project

Long-Term Survival among Patients Hospitalized for COVID-19 during the First Three Epidemic Waves: An Observational Study in a Northern Italy Hospital

Changing trends of patient characteristics and treatment pathways during the COVID-19 pandemic: A cross-sectional analysis of 72,459 inpatient cases from the German Helios database

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