Hospital mortality rates between 2015 and 2022: a comparison between the pre-pandemic and pandemic period shows that COVID-19 is a critical health problem

Introduction: COVID-19 caused 6.2 million deaths in the world. The present study aims to evaluate hospital mortality rates from 2015 to 2022, to compare the pre and during the pandemic period.Methods: The study was carried out in a private hospital in southern Brazil. 174,013 hospital discharges between January 2015 and March 2022 were analyzed. Pearson's chi-squared test was performed to evaluate the mortality rate by year. Differences between mortality rates before and during the pandemic was tested with Student's t-test. P-values < 0.05 for all tests were considered significant.Results: Mortality rates were 2.29% in 2015; 2.37% in 2016; 2.25% in 2017; 2.31% in 2018; 2.46% in 2019; 3.45% in 2020; 3.58% in 2021 and 2.77% in 2022 (p< 0.01). The mortality for 2020 and 2021 was higher than in the other years (3.50% ± 0.14 vs 2.34% ± 0.05; p < 0.01).Conclusion: The mortality rates were significantly higher in the years 2020 and 2021, demonstrating that COVID-19 is a critical health problem.

COVID-19: hypernatremia is a significant predictor of mortality

Introduction: Coronavirus disease 2019 (COVID-19) pandemic spread rapidly, creating a worrisome scenario worldwide. In hospitalized patients, dysnatremia (hyponatremia and/or hypernatremia) is the most common electrolyte disturbance, reported in 30­40% of cases and associated with a poor prognosis. This study aimed to evaluate the association between dysnatremia and mortality in hospitalized patients infected with SARS-COV-2. Methods: Retrospective longitudinal study that analyzed data from hospital records of 1,000 patients with COVID-19 (median age, 62.5 years; 57.1% men), including 109 (10.9%) deaths. Kaplan-Meier survival curves and Cox proportional hazard models with Hazard Ratio (HR) with 95% confidence intervals (95%CI) were applied to confirm the association between dysnatremia (hyponatremia and/or hypernatremia) and death. Results: Hypernatremia was detected in 83 (76.1%) of the patients who died, with a cumulative reduction in survival (p < 0.01) and a 2.42-fold increased mortality risk (95%CI: 1.45­2.91). In the multivariable analysis, hypernatremia was the main factor associated with increased mortality (HR: 1.50; 95%CI: 1.23­1.81). Long length of stay (LOS) (HR: 1.54; 95%CI: 1.21­1.78), old age (HR: 1.63; 95%CI: 1.28­1.88), and chronic kidney disease (HR: 1.77; 95%CI: 1.21­3.30) were also associated with death. Conclusion: Hypernatremia during hospitalization is an important risk factor for poor prognosis and an increased mortality risk. LOS, old age, and chronic kidney disease could also be used for risk stratification in patients with COVID-19.