Abstract
AbstractWidespread vaccination campaigns have changed the landscape for COVID-19, vastly altering symptoms and reducing morbidity and mortality. We estimate trends in mortality by month of admission and vaccination status among those hospitalised with COVID-19 in England between March 2020 to September 2021, controlling for demographic factors and hospital load. Among 259,727 hospitalised COVID-19 cases, 51,948 (20.0%) experienced mortality in hospital. Hospitalised fatality risk ranged from 40.3% (95% confidence interval 39.4–41.3%) in March 2020 to 8.1% (7.2–9.0%) in June 2021. Older individuals and those with multiple co-morbidities were more likely to die or else experienced longer stays prior to discharge. Compared to unvaccinated people, the hazard of hospitalised mortality was 0.71 (0.67–0.77) with a first vaccine dose, and 0.56 (0.52–0.61) with a second vaccine dose. Compared to hospital load at 0–20% of the busiest week, the hazard of hospitalised mortality during periods of peak load (90–100%), was 1.23 (1.12–1.34). The prognosis for people hospitalised with COVID-19 in England has varied substantially throughout the pandemic and according to case-mix, vaccination, and hospital load. Our estimates provide an indication for demands on hospital resources, and the relationship between hospital burden and outcomes.
Publisher
Springer Science and Business Media LLC
Subject
General Physics and Astronomy,General Biochemistry, Genetics and Molecular Biology,General Chemistry,Multidisciplinary
Reference32 articles.
1. Ferrando-Vivas, P. et al. Prognostic Factors for 30-Day Mortality in Critically Ill Patients With Coronavirus Disease 2019: An Observational Cohort Study. Crit. Care Med. 49, 102–111 (2021).
2. Kirwan, P. D. et al. Trends in risks of severe events and lengths of stay for COVID-19 hospitalisations in England over the pre-vaccination era: results from the Public Health England SARI-Watch surveillance scheme. arXiv [stat.AP]. http://arxiv.org/abs/2103.04867 (2021).
3. Navaratnam, A. V., Gray, W. K., Day, J., Wendon, J. & Briggs, T. W. R. Patient factors and temporal trends associated with COVID-19 in-hospital mortality in England: an observational study using administrative data. Lancet Respir Med. https://doi.org/10.1016/S2213-2600(20)30579-8 (2021).
4. Agrawal, U. et al. Association between multimorbidity and mortality in a cohort of patients admitted to hospital with COVID-19 in Scotland. J. R. Soc. Med. 115, 22–30 (2022).
5. Lopez Bernal, J. et al. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study. BMJ 373, n1088 (2021).
Cited by
15 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献