Los Angeles County + University of Southern California (LAC + USC) Medical Center, Los Angeles, California, USA.
Vizient, Inc., Irving, Texas, USA.
J Med Virol. 2022 Jan;94(1):318-326. doi: 10.1002/jmv.27332. Epub 2021 Sep 18.
When hospitals first encountered coronavirus disease 2019 (COVID-19), there was a dearth of therapeutic options and nearly 1 in 3 patients died from the disease. By the summer of 2020, as deaths from the disease declined nationally, multiple single-center studies began to report declining mortality of patients with COVID-19. To evaluate the effect of COVID-19 on hospital-based mortality, we searched the Vizient Clinical Data Base for outcomes data from approximately 600 participating hospitals, including 130 academic medical centers, from January 2017 through December 2020. More than 32 million hospital admissions were included in the analysis. After an initial spike, mortality from COVID-19 declined in all regions of the country to under 10% by June 2020 and remained constant for the remainder of the year. Despite this, inpatient, all-cause mortality has increased since the beginning of the pandemic, even those without respiratory failure. Inpatient mortality has particularly increased in elderly patients and in those requiring intubation for respiratory failure. Since June 2020, COVID-19 kills one in every 10 patients admitted to the hospital with this diagnosis. The addition of this new disease has raised overall hospital mortality especially those who require intubation for respiratory failure.
当医院首次遇到 2019 年冠状病毒病(COVID-19)时,治疗选择非常有限,近三分之一的患者死于该疾病。到 2020 年夏天,随着全国因该病死亡的人数下降,多项单中心研究开始报告 COVID-19 患者的死亡率下降。为了评估 COVID-19 对医院死亡率的影响,我们在 Vizient 临床数据库中搜索了约 600 家参与医院的结果数据,包括 130 家学术医疗中心,时间范围为 2017 年 1 月至 2020 年 12 月。该分析共纳入超过 3200 万例住院患者。在最初的激增之后,到 2020 年 6 月,全国所有地区 COVID-19 的死亡率均降至 10%以下,并在该年剩余时间内保持不变。尽管如此,自大流行开始以来,包括无呼吸衰竭的患者在内,住院患者的全因死亡率一直在增加。住院患者的死亡率在老年患者和因呼吸衰竭需要插管的患者中尤其增加。自 2020 年 6 月以来,COVID-19 使每 10 名因该诊断住院的患者中就有 1 人死亡。这种新疾病的出现,尤其是那些因呼吸衰竭需要插管的患者,导致了整体医院死亡率的上升。