Evolution of COVID-19 mortality over time: results from the Swiss hospital surveillance system (CH-SUR).

Details

Serval ID
serval:BIB_47ED0E597A46
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Evolution of COVID-19 mortality over time: results from the Swiss hospital surveillance system (CH-SUR).
Journal
Swiss medical weekly
Author(s)
Roelens M., Martin A., Friker B., Sousa F.M., Thiabaud A., Vidondo B., Buchter V., Gardiol C., Vonlanthen J., Balmelli C., Battegay M., Berger C., Buettcher M., Cusini A., Flury D., Heininger U., Niederer-Loher A., Riedel T., Schreiber P.W., Sommerstein R., Troillet N., Tschudin-Sutter S., Vetter P., Bernhard-Stirnemann S., Corti N., Gaudenz R., Marschall J., Nussbaumer-Ochsner Y., Senn L., Vuichard-Gysin D., Zimmermann P., Zucol F., Iten A., Keiser O.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
22/11/2021
Peer-reviewed
Oui
Volume
151
Pages
w30105
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
When the periods of time during and after the first wave of the ongoing SARS-CoV-2/COVID-19 pandemic in Europe are compared, the associated COVID-19 mortality seems to have decreased substantially. Various factors could explain this trend, including changes in demographic characteristics of infected persons and the improvement of case management. To date, no study has been performed to investigate the evolution of COVID-19 in-hospital mortality in Switzerland, while also accounting for risk factors.
We investigated the trends in COVID-19-related mortality (in-hospital and in-intermediate/intensive-care) over time in Switzerland, from February 2020 to June 2021, comparing in particular the first and the second wave. We used data from the COVID-19 Hospital-based Surveillance (CH-SUR) database. We performed survival analyses adjusting for well-known risk factors of COVID-19 mortality (age, sex and comorbidities) and accounting for competing risk.
Our analysis included 16,984 patients recorded in CH-SUR, with 2201 reported deaths due to COVID-19 (13.0%). We found that overall in-hospital mortality was lower during the second wave of COVID-19 than in the first wave (hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.63- 0.78; p <0.001), a decrease apparently not explained by changes in demographic characteristics of patients. In contrast, mortality in intermediate and intensive care significantly increased in the second wave compared with the first wave (HR 1.25, 95% CI 1.05-1.49; p = 0.029), with significant changes in the course of hospitalisation between the first and the second wave.
We found that, in Switzerland, COVID-19 mortality decreased among hospitalised persons, whereas it increased among patients admitted to intermediate or intensive care, when comparing the second wave to the first wave. We put our findings in perspective with changes over time in case management, treatment strategy, hospital burden and non-pharmaceutical interventions. Further analyses of the potential effect of virus variants and of vaccination on mortality would be crucial to have a complete overview of COVID-19 mortality trends throughout the different phases of the pandemic.
Keywords
COVID-19, Hospital Mortality, Hospitals, Humans, Pandemics, SARS-CoV-2, Switzerland/epidemiology
Pubmed
Open Access
Yes
Create date
03/12/2021 10:33
Last modification date
30/12/2021 6:35
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