Trends and risk factors of in-hospital mortality of patients with COVID-19 in Germany: results of a large nationwide inpatient sample

Unselected data of nationwide studies of hospitalized patients with COVID-19 are still sparse, but these data are of outstanding interest to avoid exceeding hospital capacities and overloading national healthcare systems. Thus, we sought to analyze seasonal/regional trends, predictors of in-hospital...

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Main Authors: Hobohm, Lukas (Author) , Sagoschen, Ingo (Author) , Barco, Stefano (Author) , Schmidtmann, Irene Maria (Author) , Espinola-Klein, Christine (Author) , Konstantinides, Stavros (Author) , Münzel, Thomas (Author) , Keller, Karsten (Author)
Format: Article (Journal)
Language:English
Published: 28 January 2022
In: Viruses
Year: 2022, Volume: 14, Issue: 2, Pages: 1-12$
ISSN:1999-4915
DOI:10.3390/v14020275
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/v14020275
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/1999-4915/14/2/275
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Author Notes:Lukas Hobohm, Ingo Sagoschen, Stefano Barco, Irene Schmidtmann, Christine Espinola-Klein, Stavros Konstantinides, Thomas Münzel and Karsten Keller
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Summary:Unselected data of nationwide studies of hospitalized patients with COVID-19 are still sparse, but these data are of outstanding interest to avoid exceeding hospital capacities and overloading national healthcare systems. Thus, we sought to analyze seasonal/regional trends, predictors of in-hospital case-fatality, and mechanical ventilation (MV) in patients with COVID-19 in Germany. We used the German nationwide inpatient samples to analyze all hospitalized patients with a confirmed COVID-19 diagnosis in Germany between 1 January and 31 December in 2020. We analyzed data of 176,137 hospitalizations of patients with confirmed COVID-19-infection. Among those, 31,607 (17.9%) died, whereby in-hospital case-fatality grew exponentially with age. Overall, age ≥ 70 years (OR 5.91, 95%CI 5.70-6.13, p < 0.001), pneumonia (OR 4.58, 95%CI 4.42-4.74, p < 0.001) and acute respiratory distress syndrome (OR 8.51, 95%CI 8.12-8.92, p < 0.001) were strong predictors of in-hospital death. Most COVID-19 patients were treated in hospitals in urban areas (n = 92,971) associated with the lowest case-fatality (17.5%), as compared to hospitals in suburban (18.3%) or rural areas (18.8%). MV demand was highest in November/December 2020 (32.3%, 20.3%) in patients between the 6th and 8th age decade. In the first age decade, 78 of 1861 children (4.2%) with COVID-19-infection were treated with MV, and five of them died (0.3%). The results of our study indicate seasonal and regional variations concerning the number of COVID-19 patients, necessity of MV, and case fatality in Germany. These findings may help to ensure the flexible allocation of intensive care (human) resources, which is essential for managing enormous societal challenges worldwide to avoid overloaded regional healthcare systems.
Item Description:Gesehen am 14.04.2022
Physical Description:Online Resource
ISSN:1999-4915
DOI:10.3390/v14020275