Bürke Carla, Baty Florent, Rassouli Frank, Brutsche Martin H, Albrich Werner C
Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital St. Gallen, University Teaching and Research Hospital, Rorschacherstrasse 95, St. Gallen, CH-9007, Switzerland.
Lung Center, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Pneumonia (Nathan). 2024 Oct 25;16(1):24. doi: 10.1186/s41479-024-00150-y.
Protective measures applied during the Covid-19 pandemic had a marked impact on the incidence of pneumonia. However, systematic data are lacking for hospitalizations for pneumonia and acute exacerbations of chronic obstructive lung diseases (AECOPD) not caused by SARS-CoV-2 in Switzerland. We aimed to compare the incidences of hospitalization for these entities between 2020/2021 and prepandemic years.
This retrospective study examined all nationwide hospitalizations for non-Covid-19-pneumonia and AECOPD listed as primary diagnoses based on ICD-10 codes between 2015 and 2021 in a publicly available hospitalization database of the Swiss Federal Statistical Office. Hospitalizations for acute coronary syndrome (ACS) and stroke were used as controls. Changes of monthly incidences of hospitalizations, length of stay (LOS) and mortality were compared between 2020/2021 and the average of 2015-2019.
The incidences of hospitalizations for AECOPD and for pneumonia showed seasonal variations from 2015 to 2019 followed by significant and almost identical decreases in 2020/2021 (incidence rate ratio [IRR] 0.59, 95% CI: 0.45-0.77, p < 0.001, and IRR: 0.62, 95% CI: 0.52-0.74, p < 0.001, respectively). Hospital-mortality was slightly higher in 2020/2021 for AECOPD (2015-2019: 3.8%; 2020/2021: 4.2%, odds ratio [OR] 1.24, 95% CI: 1.07-1.44, p = 0.004) and for pneumonia (2015-2019: 4.5%, 2020/2021: 4.6%, odds ratio [OR] 1.17, 95% CI: 1.07-1.28, p < 0.001). Median LOS slightly decreased for AECOPD (2015-2019: 8 [IQR: 5-14] days; 2020/2021: 7 [IQR: 4-13] days, Wilcoxon test: p < 0.001) but slightly increased for pneumonia (2015-2019: 7 [IQR: 4-11] days; 2020/2021: 7 [IQR: 4-13] days, Wilcoxon test: p < 0.001). Throughout 2020/2021, there were no significant fluctuations observed in the incidences of ACS and stroke. (IRR: 0.98, 95% CI: 0.83-1.16, p = 0.810, IRR: 0.96, 95% CI: 0.81-1.14, p = 0.636, respectively).
The first two years of the Covid-19 pandemic showed a marked decrease in incidences in AECOPD and non-Covid-19 pneumonia hospitalizations in Switzerland. It is likely that this effect is associated with the society-based, at first vigorous, social distancing measures.
新冠疫情期间采取的防护措施对肺炎发病率产生了显著影响。然而，瑞士缺乏关于非新冠病毒导致的肺炎和慢性阻塞性肺疾病急性加重（AECOPD）住院治疗的系统性数据。我们旨在比较2020/2021年与疫情前几年这些疾病的住院发病率。
这项回顾性研究在瑞士联邦统计局公开的住院数据库中，检查了2015年至2021年期间所有列为主要诊断的非新冠肺炎和AECOPD的全国性住院病例。急性冠状动脉综合征（ACS）和中风的住院病例用作对照。比较了2020/2021年与2015 - 2019年平均值之间住院月发病率、住院时间（LOS）和死亡率的变化。
2015年至2019年期间，AECOPD和肺炎的住院发病率呈现季节性变化，随后在2020/2021年显著且几乎相同地下降（发病率比[IRR]分别为0.59，95%置信区间：0.45 - 0.77，p < 0.001，以及IRR：0.62，95%置信区间：0.52 - 0.74，p < 0.001）。2020/2021年，AECOPD的医院死亡率略高（2015 - 2019年：3.8%；2020/2021年：4.2%，优势比[OR]为1.24，95%置信区间：1.07 - 1.44，p = 0.004），肺炎的医院死亡率也略高（2015 - 2019年：4.5%，2020/2021年：4.6%，优势比[OR]为1.17，95%置信区间：1.07 - 1.28，p < 0.001）。AECOPD的中位住院时间略有下降（2015 - 2019年：8[四分位间距：5 - 14]天；2020/2021年：7[四分位间距：4 - 13]天，Wilcoxon检验：p < 0.001），而肺炎的中位住院时间略有增加（2015 - 2019年：7[四分位间距：4 - 11]天；2020/2021年：7[四分位间距：4 - 13]天，Wilcoxon检验：p < 0.001）。在整个2020/2021年期间，未观察到ACS和中风发病率的显著波动（IRR分别为0.98，95%置信区间：0.83 - 1.16，p = 0.810，以及IRR：0.96，95%置信区间：0.81 - 1.14，p =
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