Pfizer Biopharma Group, Pfizer Oy, Helsinki, Finland.
NHG Finland, Nordic Healthcare Group, Helsinki, Finland.
PLoS One. 2023 May 23;18(5):e0286142. doi: 10.1371/journal.pone.0286142. eCollection 2023.
Ever since COVID-19 was announced as a global pandemic in March 2020, healthcare systems around the world have struggled with the burden of the disease. Vaccinations and other preventive measures have decreased this burden, but severe forms of COVID-19 leading to hospitalizations and even deaths still effect certain risk groups, such as the elderly and patients with multiple comorbidities. The objective of this retrospective observational study was to identify which risk groups are at the highest risk for a severe COVID-19 infection in Finland using national registry data ranging from January 2021 to June 2022. The data was analysed in three time periods, enabling comparisons in high-risk groups between epidemiological waves caused by different variants of SARS-CoV-2. The summary level data were stratified according to predefined groups based on two criteria: age (≥18 years, 18-59 years, and ≥60 years) and risk group. The results include analysis of infection hospitalisation rate (IHR), case fatality rate (CFR) and average length of stay (LOS) in both primary and specialty care for each risk group and age group. Our results confirm that despite the decrease in COVID-19 hospitalisations and deaths observed during the study period, a significant proportion of patients are still hospitalised, and deaths occur especially in the 60+ population. Also, even though the average length of stay of hospitalised COVID-19 patients has decreased, it is still long compared to specialty care hospitalisations in general. Old age is a significant risk factor for severe COVID-19 in all patient groups and certain risk factors such as chronic kidney disease clearly increase the risk for severe COVID-19 outcomes. Early treatment should be considered with a low threshold for risk group patients and for elderly patients in order to avoid severe disease courses, and to ease the burden on hospitals where resources are currently very strained.
自 2020 年 3 月 COVID-19 宣布为全球大流行以来，全球各地的医疗体系一直在努力应对疾病带来的负担。疫苗接种和其他预防措施减轻了这种负担，但导致住院甚至死亡的 COVID-19 严重形式仍会影响某些风险群体，如老年人和患有多种合并症的患者。本回顾性观察研究的目的是使用从 2021 年 1 月至 2022 年 6 月的全国登记数据，确定在芬兰哪些风险群体因 SARS-CoV-2 的不同变体而引发的流行波中，感染 COVID-19 的风险最高。在三个时间段内分析了数据，使得可以在不同的 SARS-CoV-2 变体引起的流行病学波之间对高风险群体进行比较。汇总水平数据根据两个标准按预定义的组进行分层：年龄（≥18 岁、18-59 岁和≥60 岁）和风险组。结果包括对每个风险组和年龄组的初级和专科护理中的感染住院率（IHR）、病死率（CFR）和平均住院时间（LOS）进行分析。我们的研究结果证实，尽管在研究期间观察到 COVID-19 住院和死亡人数有所下降，但仍有相当一部分患者需要住院治疗，尤其是 60 岁以上人群。此外，尽管住院 COVID-19 患者的平均住院时间有所缩短，但与一般专科护理住院相比，仍较长。所有患者群体中，年龄较大是感染 COVID-19 后出现严重症状的重要危险因素，而某些危险因素，如慢性肾脏病，显然会增加感染 COVID-19 后出现严重后果的风险。应考虑对风险群体患者和老年患者进行早期治疗，以避免严重的疾病过程，并减轻目前资源非常紧张的医院的负担。
