Suzuki Toshiki, Taniguchi Yuta, Komiyama Jun, Kuno Toshiki, Adomi Motohiko, Abe Toshikazu, Inokuchi Ryota, Miyawaki Atsushi, Imai Shinobu, Saito Makoto, Ohbe Hiroyuki, Aso Shotaro, Kamio Tadashi, Tamiya Nanako, Iwagami Masao
School of Medicine, University of Tsukuba, Tsukuba, Japan.
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
Heliyon. 2023 Aug 25;9(9):e19490. doi: 10.1016/j.heliyon.2023.e19490. eCollection 2023 Sep.
We aimed to describe patient characteristics, healthcare utilization, and in-hospital mortality among patients with COVID-19 in Japan across waves.
Using a large-scale hospital-based database, we identified patients hospitalized for COVID-19 in the first (January-June 2020), second (June-October 2020), third (October 2020-February 2021), fourth (March-June 2021), and fifth (June-December 2021) waves. We summarized patient characteristics, healthcare utilization, and in-hospital mortality during each wave and performed multivariable logistic regression analyses for in-hospital mortality.
From the first to fifth waves, the number of patients (mean age ± standard deviation, years) was 2958 (61.2 ± 22.8), 7981 (55.6 ± 25.3), 18,788 (63.6 ± 22.9), 17,729 (60.6 ± 22.6), and 23,656 (51.2 ± 22.3), respectively. There were 190 (6.4%), 363 (4.5%), 1261 (6.7%), 1081 (6.1%), and 762 (3.2%) in-hospital deaths, respectively. The adjusted odds ratios for in-hospital deaths (95% confidence interval) were 0.78 (0.65-0.95), 0.94 (0.79-1.12), 0.99 (0.84-1.18), 0.77 (0.65-0.92), in the second to fifth waves, respectively, compared with the first wave.
In-hospital COVID-19 mortality improved from the first to the second wave; however, during the third and fourth waves, mortality was as serious as in the first wave. Although in-hospital mortality during the fifth wave improved, careful monitoring is needed for upcoming waves, considering changing patient and viral characteristics.
我们旨在描述日本各波次新冠病毒病（COVID-19）患者的特征、医疗服务利用情况及院内死亡率。
利用一个大型的基于医院的数据库，我们确定了在第一波（2020年1月至6月）、第二波（2020年6月至10月）、第三波（2020年10月至2021年2月）、第四波（2021年3月至6月）和第五波（2021年6月至12月）因COVID-19住院的患者。我们总结了每一波次的患者特征、医疗服务利用情况及院内死亡率，并对院内死亡率进行了多变量逻辑回归分析。
从第一波到第五波，患者数量（平均年龄±标准差，岁）分别为2958例（61.2±22.8）、7981例（55.6±25.3）、18788例（63.6±22.9）、17729例（60.6±22.6）和23656例（51.2±22.3）。院内死亡人数分别为190例（6.4%）、363例（4.5%）、1261例（6.7%）、1081例（6.1%）和762例（3.2%）。与第一波相比，第二波至第五波院内死亡的调整比值比（95%置信区间）分别为0.78（0.65-0.95）、0.94（0.79-1.12）、0.99（0.84-1.18）、0.77（0.65-0.92）。
COVID-19的院内死亡率从第一波到第二波有所改善；然而，在第三波和第四波期间，死亡率与第一波一样严重。尽管第五波期间的院内死亡率有所改善，但考虑到患者和病毒特征的变化，对未来波次仍需进行密切监测。
