Respiratory Medicine Department University of Ioannina Faculty of Medicine, Ioannina, Greece.
2nd Respiratory Medicine Department University of Athens Attikon Hospital, Athens, Greece.
Respiration. 2021;100(7):588-593. doi: 10.1159/000515323. Epub 2021 Apr 7.
During the first COVID-19 wave, a considerable decline in hospital admissions was observed worldwide.
This retrospective cohort study aimed to assess if there were any changes in the number of patients hospitalized for respiratory diseases in Greece during the first CO-VID-19 wave.
In the present study, we evaluated respiratory disease hospitalization rates across 9 tertiary hospitals in Greece during the study period (March-April 2020) and the corresponding period of the 2 previous years (2018-2019) that served as the control periods. Demographic data and discharge diagnosis were documented for every patient.
Of the 1,307 patients who were hospitalized during the study period, 444 (35.5%) were males with a mean (±SD) age of 66.1 ± 16.6 years. There was a 47 and 46% reduction in all-cause respiratory morbidity compared to the corresponding periods of 2018 and 2019, respectively. The mean incidence rate for respiratory diseases during the study period was 21.4 admissions per day, and this rate was significantly lower than the rate during the same period in 2018 (40.8 admissions per day; incidence rate ratio [IRR], 0.525; 95% confidence interval [CI], 0.491-0.562; p < 0.001) or the rate during 2019 (39.9 admissions per day; IRR, 0.537; 95% CI, 0.502-0.574; p < 0.001). The greatest reductions (%) in the number of daily admissions in 2020 were observed for sleep apnoea (87% vs. 2018 and 84% vs. 2019) followed by admissions for asthma (76% vs. 2018 and 79% vs. 2019) and chronic obstructive pulmonary disease (60% vs. 2018 and 51% vs. 2019), while the lowest reductions were detected in hospitalizations for pulmonary embolism (6% vs. 2018 and 23% vs. 2019) followed by tuberculosis (25% vs. both 2018 and 2019).
DISCUSSION/CONCLUSION: The significant reduction in respiratory admissions in 2020 raises the reasonable question of whether some patients may have avoided seeking medical attention during the COVID-19 pandemic and suggests an urgent need for transformation of healthcare systems during the pandemic to offer appropriate management of respiratory diseases other than COVID-19.
在第一波 COVID-19 期间，全球范围内观察到医院入院人数明显下降。
本回顾性队列研究旨在评估在第一波 COVID-19 期间，希腊因呼吸疾病住院的患者人数是否发生变化。
本研究评估了希腊 9 家三级医院在研究期间（2020 年 3 月至 4 月）和前两年（2018-2019 年）同期的呼吸疾病住院率，这两年作为对照期。记录每位患者的人口统计学数据和出院诊断。
在研究期间住院的 1307 名患者中，444 名（35.5%）为男性，平均（±SD）年龄为 66.1 ± 16.6 岁。与 2018 年和 2019 年同期相比，所有原因导致的呼吸发病率分别下降了 47%和 46%。研究期间呼吸疾病的平均发病率为每天 21.4 例住院，这一发病率明显低于 2018 年同期的发病率（每天 40.8 例住院；发病率比 [IRR]，0.525；95%置信区间 [CI]，0.491-0.562；p<0.001）或 2019 年同期的发病率（每天 39.9 例住院；IRR，0.537；95%CI，0.502-0.574；p<0.001）。2020 年每日住院人数降幅最大的疾病是睡眠呼吸暂停（87%比 2018 年和 84%比 2019 年），其次是哮喘（76%比 2018 年和 79%比 2019 年）和慢性阻塞性肺疾病（60%比 2018 年和 51%比 2019 年），而肺动脉栓塞（6%比 2018 年和 23%比 2019 年）和结核病（25%比 2018 年和 2019 年）的降幅最低。
讨论/结论：2020 年呼吸科住院人数的显著减少提出了一个合理的问题，即是否有一些患者可能在 COVID-19 大流行期间避免了就医，并表明在大流行期间迫切需要改造医疗保健系统，以便对 COVID-19 以外的呼吸疾病进行适当管理。
