Leiner Johannes, Hohenstein Sven, Pellissier Vincent, König Sebastian, Winklmair Claudia, Nachtigall Irit, Bollmann Andreas, Kuhlen Ralf
Heart Centre Leipzig at University of Leipzig, Department of Electrophysiology, Leipzig, Germany.
Real World Evidence and Health Technology Assessment at Helios Health Institute, Berlin, Germany.
Infect Drug Resist. 2023 May 8;16:2775-2781. doi: 10.2147/IDR.S402313. eCollection 2023.
Reliable surveillance systems to monitor trends of COVID-19 case numbers and the associated healthcare burden play a central role in efficient pandemic management. In Germany, the federal government agency Robert-Koch-Institute uses an ICD-code-based inpatient surveillance system, ICOSARI, to assess temporal trends of severe acute respiratory infection (SARI) and COVID-19 hospitalization numbers. In a similar approach, we present a large-scale analysis covering four pandemic waves derived from the Initiative of Quality Medicine (IQM), a German-wide network of acute care hospitals.
Routine data from 421 hospitals for the years 2019-2021 with a "pre-pandemic" period (01-01-2019 to 03-03-2020) and a "pandemic" period (04-03-2020 to 31-12-2021) was analysed. SARI cases were defined by ICD-codes J09-J22 and COVID-19 by ICD-codes U07.1 and U07.2. The following outcomes were analysed: intensive care treatment, mechanical ventilation, in-hospital mortality.
Over 1.1 million cases of SARI and COVID-19 were identified. Patients with COVID-19 and additional codes for SARI were at higher risk for adverse outcomes when compared to non-COVID SARI and COVID-19 without any coding for SARI. During the pandemic period, non-COVID SARI cases were associated with 28%, 23% and 27% higher odds for intensive care treatment, mechanical ventilation and in-hospital mortality, respectively, compared to pre-pandemic SARI.
The nationwide IQM network could serve as an excellent data source to enhance COVID-19 and SARI surveillance in view of the ongoing pandemic. Future developments of COVID-19/SARI case numbers and associated outcomes should be closely monitored to identify specific trends, especially considering novel virus variants.
可靠的监测系统对于监控新冠病毒疾病（COVID-19）病例数趋势及相关医疗负担在有效的疫情管理中起着核心作用。在德国，联邦政府机构罗伯特·科赫研究所使用基于国际疾病分类代码（ICD-code）的住院监测系统ICOSARI来评估严重急性呼吸道感染（SARI）和COVID-19住院人数的时间趋势。采用类似方法，我们呈现了一项大规模分析，该分析涵盖了来自德国急性护理医院网络“优质医学倡议”（IQM）的四个疫情波次。
分析了421家医院在2019 - 2021年期间的常规数据，分为“疫情前”时期（2019年1月1日至2020年3月3日）和“疫情”时期（2020年4月3日至2021年12月31日）。SARI病例由ICD编码J09 - J22定义，COVID-19由ICD编码U07.1和U07.2定义。分析了以下结果：重症监护治疗、机械通气、院内死亡率。
共识别出超过110万例SARI和COVID-19病例。与非COVID SARI以及无SARI编码的COVID-19患者相比，患有COVID-19且有SARI附加编码的患者出现不良结局的风险更高。在疫情期间，与疫情前的SARI相比，非COVID SARI病例接受重症监护治疗、机械通气和院内死亡的几率分别高出28%、23%和27%。
鉴于当前的疫情，全国性的IQM网络可作为加强COVID-19和SARI监测的优质数据源。应密切监测COVID-19/SARI病例数及相关结局的未来发展，以识别特定趋势，尤其是考虑到新型病毒变种。
