Bowen Anthony, Zucker Jason, Shen Yanhan, Huang Simian, Yan Qiheng, Annavajhala Medini K, Uhlemann Anne-Catrin, Kuhn Louise, Sobieszczyk Magdalena, Castor Delivette
Columbia University Irving Medical Center, New York, New York, USA.
medRxiv. 2022 Mar 30:2022.03.29.22273044. doi: 10.1101/2022.03.29.22273044.
Many regions have experienced successive epidemic waves of COVID-19 since the emergence of SARS-CoV-2 with heterogeneous differences in mortality. Elucidating factors differentially associated with mortality between epidemic waves may inform clinical and public health strategies. We examined clinical and demographic data among patients admitted with COVID-19 during the first (March-June 2020) and second (December 2020-March 2021) epidemic waves at an academic medical center in New York City. Hospitalized patients (N=4631) had lower mortality during the second wave (14%) than the first (23%). Patients in the second wave had a lower 30-day mortality (Hazard Ratio (HR) 0.52, 95% CI 0.44, 0.61) than those in the first wave. The mortality decrease persisted after adjusting for confounders except for the volume of COVID-19 admissions (HR 0.88, 95% CI 0.70, 1.11), a measure of health system strain. Several demographic and clinical patient factors were associated with an increased risk of mortality independent of wave.
Using clinical and demographic data from COVID-19 hospitalizations at a tertiary New York City medical center, we show that a reduction in mortality during the second epidemic wave was associated with decreased strain on healthcare resources.
自严重急性呼吸综合征冠状病毒2（SARS-CoV-2）出现以来，许多地区经历了新冠病毒病（COVID-19）的连续疫情波，死亡率存在异质性差异。阐明不同疫情波之间与死亡率差异相关的因素可能为临床和公共卫生策略提供信息。我们研究了纽约市一家学术医疗中心在第一波（2020年3月至6月）和第二波（2020年12月至2021年3月）疫情期间因COVID-19入院患者的临床和人口统计学数据。住院患者（N = 4631）在第二波疫情期间的死亡率（14%）低于第一波（23%）。第二波疫情中的患者30天死亡率低于第一波（风险比（HR）0.52，95%置信区间0.44，0.61）。在调整混杂因素后，除了COVID-19入院量（HR 0.88，95%置信区间0.70，1.11）这一衡量卫生系统压力的指标外，死亡率下降仍然存在。一些人口统计学和临床患者因素与独立于疫情波的死亡风险增加相关。
利用纽约市一家三级医疗中心COVID-19住院患者的临床和人口统计学数据，我们表明第二波疫情期间死亡率的降低与医疗资源压力的减轻有关。
