ABSTRACT
BACKGROUND: The coronavirus infectious disease 2019 (COVID-19) has been shown to be more lethal in the elderly (>65 years), especially those with co-morbidities. This study examined the impact of the pandemic lockdown period on trends in elderly medical admissions and deaths. METHODOLOGY: This is a retrospective study of elderly medical admissions and deaths in the medical wards of a Nigerian hospital. Data for the months of March, April, May, June, and July of 2020 was compared to the same months before (2019) and after (2021). Analysis was done using STATA version 15.0. RESULTS: During the study period, two hundred and seventy-six elderly patients were admitted, with a mean age (±SD) of 73.4 ± 7.4 years. The most common diagnoses at admission were chronic kidney disease (CKD) (26.85%, n=74) and hypertensive heart disease (HHD) (21.7%, n=60). The highest admission was in 2021, with a total of 99 (35.9%). Overall, 60 mortalities were recorded, with a proportional mortality rate of 21.7%, which was highest in 2020 (25.0%) and lowest in 2021 (17.1%). There was no difference between the mortality rates of 2019 versus 2020 (P=0.82) and 2020 versus 2021(P=0.18). Sepsis (35.0%) and CKD (25.0%) were the major contributors in 2019. CONCLUSION: CKD and HHD were the most common diagnoses at admission, whereas sepsis, CKD, and CVD were the commonest causes of death. The Covid-19 pandemic did not significantly alter the elderly admission pattern in our setting.
CONTEXTE: Il a été démontré que la maladie infectieuse à coronavirus 2019 (COVID-19) est plus mortelle chez les personnes âgées (>65 ans), en particulier celles qui présentent des comorbidités. Cette étude a examiné l'impact de la période de verrouillage pandémique sur les tendances des admissions médicales et des décès de personnes âgées. MÉTHODOLOGIE: Il s'agit d'une étude rétrospective des admissions et des décès de personnes âgées dans les services médicaux d'un hôpital nigérian. Les données relatives aux personnes âgées pour les mois de mars, avril, mai, juin et juillet 2020 ont été comparées aux mêmes mois avant (2019) et après (2021). L'analyse a été réalisée à l'aide de STATA version 15.0. RÉSULTATS: Au cours de la période, deux cent soixante-seize patients âgés ont été admis, avec un âge moyen et un écart-type (ET) de 73,4 7,4 ans. Les diagnostics les plus fréquents à l'admission étaient l'insuffisance rénale chronique (IRC) (26,85 %, n=74) et la cardiopathie hypertensive (HHD) (21,7 %, n=60). Le nombre d'admissions le plus élevé a été enregistré en 2021, avec un total de 99 (35,9 %). Au total, 60 décès ont été enregistrés, avec un taux de mortalité proportionnel de 21,7 %, qui était le plus élevé en 2020 (25,0 %) et le plus faible en 2021 (17,1 %). Les preuves étaient insuffisantes pour montrer une différence entre les taux de mortalité de 2019 par rapport à 2020 (P=0,82) et de 2020 par rapport à 2021 (P=0,18). Le sepsis (35,0 %) et l'IRC (25,0 %) étaient les principaux facteurs de mortalité en 2019. CONCLUSION: L'IRC et l'HHD étaient les diagnostics les plus courants à l'admission, tandis que la septicémie, l'IRC et les MCV étaient les causes les plus fréquentes de décès. La pandémie de Covid-19 n'a pas modifié de manière significative le schéma d'admission des personnes âgées dans notre contexte. Mots clés: COVID-19, Personnes âgées, Mode d'admission, Mortalité.
Subject(s)
COVID-19 , Communicable Diseases , Sepsis , Humans , Aged , Aged, 80 and over , Retrospective Studies , Pandemics , Tertiary Care Centers , Nigeria/epidemiology , Cause of Death , COVID-19/epidemiology , Hospital Mortality , Communicable Disease ControlABSTRACT
Background: The coronavirus disease 2019 (COVID-19) outbreak caused a significant strain on healthcare resources and utilization worldwide. However, the impact of COVID-19 outbreak on patient hospitalization was barely known. This study aimed to determine the impact of the outbreak on the pattern of inpatient hospital admissions to help allocate health care resources during a pandemic. Methods: This retrospective study included patients who were hospitalized in a tertiary teaching hospital in Shanghai between 1 January and 30 April across the years 2017 to 2020. The number of hospitalizations during the study period from 2017 to 2020 were 30,605, 31,464, 32,812 and 24,163, respectively. Changes in patient volumes and the frequency of the International Classification of Diseases and Related Health Problem Tenth Edition (ICD-10) codes before and after the onset of the COVID-19 outbreak were analyzed and presented as absolute and relative differences with 95% confidence intervals between periods of different years. Results: Overall inpatient hospital admissions decreased by 26.35% between January and April 2020, compared to the same period in 2019. The average age of patients in 2020 was higher compared to those from 2017 to 2019. Conversely, the proportions of self-paying patients and non-local patients were significantly lower between January and April 2020 compared to the same period in the previous three years. The top five ICD-10 codes remained common before and during the pandemic. Admissions associated with antineoplastic radiation therapy, chemotherapy, and immunotherapy increased in frequency and proportion by 2020 (difference, 5.6%, 95% CI: 4.4% to 6.8%), and increased proportions were observed for liver and intrahepatic bile duct malignancies (2.18%, 95% CI: 1.15% to 3.21%), cerebral infarction (2.27%, 95% CI: 0.54% to 4.00%), and chronic kidney disease (3.56%, 95% CI: 1.79% to 5.33%). Conclusions: There was a significant reduction in the number of inpatients and a marked change in admission diagnoses during the COVID-19 outbreak. Our findings are useful for making informed decisions on hospital management and reallocation of available health care resources during a pandemic.