Sakurai Ayana, Morioka Shinichiro, Tsuzuki Shinya, Matsunaga Nobuaki, Saito Sho, Arai Noritoshi, Yamamoto Natsuyo, Hara Tetsuo, Hojo Masayuki, Hiroi Yukio, Yamada Kazuhiko, Ohmagari Norio
Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan.
AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan.
GHM Open. 2024 Jul 31;4(1):23-31. doi: 10.35772/ghmo.2023.01025.
Despite the lower rate of severe illness associated with the omicron variant than the delta variant, more deaths have occurred among patients with mild-to-moderate COVID-19 in Japan since the omicron variant surge during the sixth wave. This study aimed to elucidate the background, clinical course, and causes of death in patients with COVID-19. We conducted a retrospective observational study on patients with COVID-19 admitted to the National Center for Global Health and Medicine who subsequently died during the delta (July-September 2021) and omicron variant outbreaks (December 2021-August 2022). Among the 20 patients who died during the delta variant epidemic, the main causes of death were pneumonia ( = 16, 80%), preadmission complications ( = 3, 15%), and complications occurring during hospitalization ( = 1, 5%). However, during the omicron variant epidemic, 7/24 patients (29%) died of pneumonia, 11 (46%) died of complications before admission, and 6 (25%) died of complications during admission. During the omicron variant outbreak, two-thirds of the COVID-19 deaths during hospitalization were not primarily caused by pneumonia, unlike the delta variant outbreak, during which pneumonia had a greater impact on mortality. As patient demographics and clinical pictures change, the establishment of medical infrastructure for patients with life-threatening comorbidities and careful monitoring of acute COVID-related complications are essential.
尽管与德尔塔变异株相比，奥密克戎变异株所致重症率较低，但自第六波疫情奥密克戎变异株激增以来，日本轻症至中症新冠肺炎患者的死亡人数有所增加。本研究旨在阐明新冠肺炎患者的背景、临床病程及死亡原因。我们对国立国际医疗研究中心收治的新冠肺炎患者进行了一项回顾性观察研究，这些患者在德尔塔变异株（2021年7月至9月）和奥密克戎变异株疫情（2021年12月至2022年8月）期间死亡。在德尔塔变异株流行期间死亡的20例患者中，主要死亡原因是肺炎（n = 16，80%）、入院前并发症（n = 3，15%）和住院期间出现的并发症（n = 1，5%）。然而，在奥密克戎变异株流行期间，24例患者中有7例（29%）死于肺炎，11例（46%）死于入院前并发症，6例（25%）死于住院期间并发症。在奥密克戎变异株疫情期间，住院期间新冠肺炎死亡患者中有三分之二并非主要由肺炎导致，这与德尔塔变异株疫情不同，在德尔塔变异株疫情期间肺炎对死亡率的影响更大。随着患者人口统计学特征和临床表现的变化，为患有危及生命的合并症的患者建立医疗基础设施以及仔细监测急性新冠相关并发症至关重要。
