Kondo Kyoko, Suita Asae, Ohfuji Satoko, Mukai Emiko, Kase Tetsuo, Fukushima Wakaba
Management Bureau, Osaka Metropolitan University Hospital, Osaka, Japan.
Research Support Platform, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
JMA J. 2024 Jul 16;7(3):364-374. doi: 10.31662/jmaj.2023-0179. Epub 2024 Jun 17.
Elucidating the epidemiological picture in the early phase of a pandemic is crucial to strengthening preparedness and public health responses to future emerging infectious diseases. Using data from the "Osaka Prefectural Novel Coronavirus Response Status Management System," we evaluated factors associated with mortality among patients with novel coronavirus disease 2019 (COVID-19) in Osaka Prefecture, Japan.
The study periods were from January 29 to June 13, 2020 (first surge), from June 14 to October 9, 2020 (second surge), and from October 10 to December 24, 2020 (up to the middle of the third surge). The odds ratios (ORs) and 95% confidence intervals (95% CIs) for mortality were calculated using logistic regression models.
Of the 14,864 patients with COVID-19 (8,207 men, 6,657 women) registered, 297 (2%) died. The ORs for mortality were significantly higher in men (OR = 2.00, 95% CI = 1.54-2.60) than in women, in 70- to 79-year-olds (OR = 25.4, 95% CI = 16.8-38.2) and ≥80-year-olds (OR = 78.1, 95% CI = 53.3-114) than in 0- to 69-year-olds ( for trend < 0.001), and in those with underlying diseases (OR = 1.74, 95% CI = 1.34-2.27) than in those without. The ORs for the second surge (OR = 0.42, 95% CI = 0.31-0.57) and third surge (OR = 0.41, 95% CI = 0.29-0.58) decreased compared with the first surge. Detailed evaluation of underlying diseases by time period showed that "Diseases of the blood and blood-forming organs and certain disorders involving immune mechanisms," "Endocrine, nutritional, and metabolic diseases," "Diseases of the genitourinary system," and "Diseases of the respiratory system" were associated with increased risk of mortality.
Among those affected early in the COVID-19 epidemic, male sex, older age, first-surge infection, and underlying medical conditions were significantly associated with mortality. Our findings are expected to provide a useful reference for future countermeasures in the early stages of pandemics involving unknown emerging infectious diseases.
阐明大流行早期的流行病学情况对于加强对未来新发传染病的防范和公共卫生应对至关重要。我们利用“大阪府新型冠状病毒应对状况管理系统”的数据，评估了日本大阪府2019年冠状病毒病（COVID-19）患者死亡的相关因素。
研究时间段为2020年1月29日至6月13日（第一波高峰）、2020年6月14日至10月9日（第二波高峰）以及2020年10月10日至12月24日（直至第三波高峰中期）。使用逻辑回归模型计算死亡率的比值比（OR）和95%置信区间（95%CI）。
在登记的14864例COVID-19患者中（男性8207例，女性6657例），297例（2%）死亡。男性的死亡率OR（OR = 2.00，95%CI = 1.54 - 2.60）显著高于女性，70至79岁人群（OR = 25.4，95%CI = 16.8 - 38.2）和80岁及以上人群（OR = 78.1，95%CI = 53.3 - 114）的死亡率OR高于0至69岁人群（趋势P < 0.001），有基础疾病者的死亡率OR（OR = 1.74，95%CI = 1.34 - 2.27）高于无基础疾病者。与第一波高峰相比，第二波高峰（OR = 0.42，95%CI = 0.31 - 0.57）和第三波高峰（OR = 0.41，95%CI = 0.29 - 0.58）的死亡率OR有所下降。按时间段对基础疾病进行详细评估显示，“血液及造血器官疾病和某些涉及免疫机制的疾病”“内分泌、营养和代谢疾病”“泌尿生殖系统疾病”以及“呼吸系统疾病”与死亡风险增加相关。
在COVID-19疫情早期受影响的人群中，男性、高龄、第一波高峰感染以及基础疾病与死亡率显著相关。我们的研究结果有望为未来涉及未知新发传染病的大流行早期应对措施提供有用参考。
