Maroussia Roelens1, Alexis Martin2,3, Brian Friker4, Filipe Maximiano Sousa4, Amaury Thiabaud1, Beatriz Vidondo4, Valentin Buchter5, Céline Gardiol5, Jasmin Vonlanthen5, Carlo Balmelli6, Manuel Battegay7, Christoph Berger8, Michael Buettcher9, Alexia Cusini10, Domenica Flury11, Ulrich Heininger12, Anita Niederer-Loher13, Thomas Riedel14, Peter W Schreiber15, Rami Sommerstein16,17, Nicolas Troillet18, Sarah Tschudin-Sutter7, Pauline Vetter19, Sara Bernhard-Stirnemann20, Natascia Corti21, Roman Gaudenz22, Jonas Marschall16, Yvonne Nussbaumer-Ochsner23, Laurence Senn24, Danielle Vuichard-Gysin25, Petra Zimmermann26,27, Franziska Zucol28, Anne Iten29, Olivia Keiser1. 1. Institute of Global Health, Faculty of Medicine, University of Geneva, Switzerland. 2. Swiss Tropical and Public Health Institute, Basel, Switzerland. 3. University of Basel, Switzerland. 4. Veterinary Public Health Institute, University of Bern, Switzerland. 5. Swiss Federal Office of Public Health, Bern, Switzerland. 6. Infection Control Programme, EOC Hospitals, Ticino, Switzerland. 7. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Switzerland. 8. Division of Infectious Diseases, and Children's Research Centre, University Children's Hospital Zurich, Switzerland. 9. Paediatric Infectious Diseases, Department of Paediatrics, Children's Hospital, Cantonal Hospital Lucerne, Switzerland. 10. Department of Infectious Diseases, Cantonal Hospital Graubuenden, Chur, Switzerland. 11. Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, Switzerland. 12. Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland. 13. Children's Hospital of Eastern Switzerland, St Gallen, Switzerland. 14. Department of Paediatrics, Cantonal Hospital Graubuenden, Chur, Switzerland. 15. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Switzerland. 16. Department of Infectious Diseases, Bern University Hospital (Inselspital), Bern, Switzerland. 17. Infectious Diseases and Hospital Hygiene Clinic St Anna, Department of Health Sciences and Medicine, University of Lucerne, Switzerland. 18. Service of Infectious Diseases, Central Institute, Valais Hospitals, Sion, Switzerland. 19. Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland. 20. Children's Hospital Aarau, Switzerland. 21. Unit of General Internal Medicine, Hirslanden Clinic, Zurich, Switzerland. 22. Internal Medicine and Infectiology, Cantonal Hospital Nidwalden, Stans, Switzerland. 23. Clinic for Internal Medicine, Cantonal Hospital, Hospitals Schaffhausen, Switzerland. 24. Service of Preventive Medicine, Lausanne University Hospital, CHUV, Lausanne, Switzerland. 25. Division of Infectious Diseases and Hospital Hygiene, Thurgau Hospital Group Münsterlingen and Frauenfeld, Switzerland. 26. Faculty of Science and Medicine, University of Fribourg, Switzerland. 27. Department of Paediatrics, Fribourg Hospital HFR, Fribourg, Switzerland. 28. Paediatric Infectious Diseases, Department of Paediatrics, Cantonal Hospital Winterthur, Switzerland. 29. Service of Prevention and Infection Control, Directorate of Medicine and Quality, University Hospital Geneva, HUG, Geneva, Switzerland.
Abstract
BACKGROUND: When the periods of time during and after the first wave of the ongoing SARS-CoV-2/COVID-19 pandemic in Europe are compared, the associated COVID-19 mortality seems to have decreased substantially. Various factors could explain this trend, including changes in demographic characteristics of infected persons and the improvement of case management. To date, no study has been performed to investigate the evolution of COVID-19 in-hospital mortality in Switzerland, while also accounting for risk factors. METHODS: We investigated the trends in COVID-19-related mortality (in-hospital and in-intermediate/intensive-care) over time in Switzerland, from February 2020 to June 2021, comparing in particular the first and the second wave. We used data from the COVID-19 Hospital-based Surveillance (CH-SUR) database. We performed survival analyses adjusting for well-known risk factors of COVID-19 mortality (age, sex and comorbidities) and accounting for competing risk. RESULTS: Our analysis included 16,984 patients recorded in CH-SUR, with 2201 reported deaths due to COVID-19 (13.0%). We found that overall in-hospital mortality was lower during the second wave of COVID-19 than in the first wave (hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.63- 0.78; p <0.001), a decrease apparently not explained by changes in demographic characteristics of patients. In contrast, mortality in intermediate and intensive care significantly increased in the second wave compared with the first wave (HR 1.25, 95% CI 1.05-1.49; p = 0.029), with significant changes in the course of hospitalisation between the first and the second wave. CONCLUSION: We found that, in Switzerland, COVID-19 mortality decreased among hospitalised persons, whereas it increased among patients admitted to intermediate or intensive care, when comparing the second wave to the first wave. We put our findings in perspective with changes over time in case management, treatment strategy, hospital burden and non-pharmaceutical interventions. Further analyses of the potential effect of virus variants and of vaccination on mortality would be crucial to have a complete overview of COVID-19 mortality trends throughout the different phases of the pandemic.
BACKGROUND: When the periods of time during and after the first wave of the ongoing SARS-CoV-2/COVID-19 pandemic in Europe are compared, the associated COVID-19 mortality seems to have decreased substantially. Various factors could explain this trend, including changes in demographic characteristics of infected persons and the improvement of case management. To date, no study has been performed to investigate the evolution of COVID-19 in-hospital mortality in Switzerland, while also accounting for risk factors. METHODS: We investigated the trends in COVID-19-related mortality (in-hospital and in-intermediate/intensive-care) over time in Switzerland, from February 2020 to June 2021, comparing in particular the first and the second wave. We used data from the COVID-19 Hospital-based Surveillance (CH-SUR) database. We performed survival analyses adjusting for well-known risk factors of COVID-19 mortality (age, sex and comorbidities) and accounting for competing risk. RESULTS: Our analysis included 16,984 patients recorded in CH-SUR, with 2201 reported deaths due to COVID-19 (13.0%). We found that overall in-hospital mortality was lower during the second wave of COVID-19 than in the first wave (hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.63- 0.78; p <0.001), a decrease apparently not explained by changes in demographic characteristics of patients. In contrast, mortality in intermediate and intensive care significantly increased in the second wave compared with the first wave (HR 1.25, 95% CI 1.05-1.49; p = 0.029), with significant changes in the course of hospitalisation between the first and the second wave. CONCLUSION: We found that, in Switzerland, COVID-19 mortality decreased among hospitalised persons, whereas it increased among patients admitted to intermediate or intensive care, when comparing the second wave to the first wave. We put our findings in perspective with changes over time in case management, treatment strategy, hospital burden and non-pharmaceutical interventions. Further analyses of the potential effect of virus variants and of vaccination on mortality would be crucial to have a complete overview of COVID-19 mortality trends throughout the different phases of the pandemic.
Authors: Maddalena Marconato; Irene A Abela; Anthony Hauser; Magdalena Schwarzmüller; Rheliana Katzensteiner; Dominique L Braun; Selina Epp; Annette Audigé; Jacqueline Weber; Peter Rusert; Eméry Schindler; Chloé Pasin; Emily West; Jürg Böni; Verena Kufner; Michael Huber; Maryam Zaheri; Stefan Schmutz; Beat M Frey; Roger D Kouyos; Huldrych F Günthard; Markus G Manz; Alexandra Trkola Journal: J Clin Invest Date: 2022-06-15 Impact factor: 19.456
Authors: Kayode Oshinubi; Sana S Buhamra; Noriah M Al-Kandari; Jules Waku; Mustapha Rachdi; Jacques Demongeot Journal: Healthcare (Basel) Date: 2022-03-04