Tshabalala Khanyisile M, Fabris-Rotelli Inger, Basu Debashis, Myburgh Magriet, Abdullah Fareed
Department of Public Health Medicine, School of Health Sciences, Steve Biko Academic Hospital, Tshwane, South Africa.
Department of Public Health Medicine, Faculty of Health Sciences, University of Pretoria, Tshwane, South Africa.
S Afr J Infect Dis. 2025 Mar 6;40(1):679. doi: 10.4102/sajid.v40i1.679. eCollection 2025.
Before coronavirus disease 2019 (COVID-19), global health was improving, with declining mortality trends. The pandemic disrupted this progress, increasing mortality in South Africa between April 2020 and March 2022. Pre-pandemic data establishes a baseline for assessing COVID-19's impact on all-cause mortality.
This study examines changes in hospital-based mortality trends in a Gauteng hospital complex from April 2018 to March 2022, addressing the scarcity of such studies during the COVID-19 era.
A retrospective review of 7815 deaths from April 2018 to March 2022 was conducted. Chi-squared tests were used to analyse deaths by age group and gender, with correlations reported.
Mortality rates rose from 3.2% in 2018-2019, peaked at 5.1% in 2020-2021, and declined to 4.2% in 2021-2022. Patients aged 15 years-64 years had the highest death rates, with an increase among those over 65. Male deaths exceeded female deaths, with the smallest difference observed in 2020-2021. Leading causes of death included diseases of the circulatory and respiratory systems, neoplasms, digestive system diseases, and infectious and parasitic diseases.
The study highlights COVID-19's impact on mortality, showing variations by year, age, gender, and disease.
Excess non-COVID-19 deaths likely stemmed from disrupted healthcare services. These findings underscore the need for ongoing monitoring of hospital mortality to identify pandemic-related service disruptions and guide interventions to strengthen healthcare services, improve access to care, and enhance referral systems during unexpected disasters.
在2019冠状病毒病（COVID-19）之前，全球健康状况一直在改善，死亡率呈下降趋势。这场大流行扰乱了这一进程，在2020年4月至2022年3月期间，南非的死亡率有所上升。疫情前的数据为评估COVID-19对全因死亡率的影响奠定了基线。
本研究调查了2018年4月至2022年3月期间豪登省一家医院联合体基于医院的死亡率趋势变化，以解决COVID-19时代此类研究的稀缺问题。
对2018年4月至2022年3月期间的7815例死亡病例进行了回顾性研究。采用卡方检验分析按年龄组和性别的死亡情况，并报告相关性。
死亡率从2018 - 2019年的3.2%上升，在2020 - 2021年达到5.1%的峰值，然后在2021 - 2022年降至4.2%。15岁至64岁的患者死亡率最高，65岁以上人群的死亡率有所上升。男性死亡人数超过女性死亡人数，在2020 - 2021年观察到的差异最小。主要死因包括循环系统和呼吸系统疾病、肿瘤、消化系统疾病以及传染病和寄生虫病。
该研究突出了COVID-19对死亡率的影响，显示出按年份、年龄、性别和疾病的差异。
非COVID-19导致的额外死亡可能源于医疗服务中断。这些发现强调了持续监测医院死亡率的必要性，以识别与大流行相关的服务中断情况，并指导干预措施，以加强医疗服务、改善就医机会并在意外灾难期间加强转诊系统。
