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Trends and Risk Factors of In-Hospital Mortality of Patients with COVID-19 in Germany: Results of a Large Nationwide Inpatient Sample.
Hobohm, Lukas; Sagoschen, Ingo; Barco, Stefano; Schmidtmann, Irene; Espinola-Klein, Christine; Konstantinides, Stavros; Münzel, Thomas; Keller, Karsten.
  • Hobohm L; Department of Cardiology, University Medical Center Mainz (Johannes Gutenberg-University Mainz), 55131 Mainz, Germany.
  • Sagoschen I; Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), 55131 Mainz, Germany.
  • Barco S; Department of Cardiology, University Medical Center Mainz (Johannes Gutenberg-University Mainz), 55131 Mainz, Germany.
  • Schmidtmann I; Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), 55131 Mainz, Germany.
  • Espinola-Klein C; Department of Angiology, University Hospital Zurich, 8091 Zurich, Switzerland.
  • Konstantinides S; Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz (Johannes Gutenberg-University Mainz), 55131 Mainz, Germany.
  • Münzel T; Department of Cardiology, University Medical Center Mainz (Johannes Gutenberg-University Mainz), 55131 Mainz, Germany.
  • Keller K; Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), 55131 Mainz, Germany.
Viruses ; 14(2)2022 01 28.
Article in English | MEDLINE | ID: covidwho-1667344
ABSTRACT
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hospital Mortality / COVID-19 / Hospitalization / Inpatients Type of study: Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Year: 2022 Document Type: Article Affiliation country: V14020275

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hospital Mortality / COVID-19 / Hospitalization / Inpatients Type of study: Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Year: 2022 Document Type: Article Affiliation country: V14020275