Trends in COVID‐19 Risk‐Adjusted Mortality Rates
Tóm tắt
Early reports showed high mortality from coronavirus disease 2019 (COVID‐19). Mortality rates have recently been lower, raising hope that treatments have improved. However, patients are also now younger, with fewer comorbidities. We explored whether hospital mortality was associated with changing demographics at a 3‐hospital academic health system in New York. We examined in‐hospital mortality or discharge to hospice from March through August 2020, adjusted for demographic and clinical factors, including comorbidities, admission vital signs, and laboratory results. Among 5,121 hospitalizations, adjusted mortality dropped from 25.6% (95% CI, 23.2‐28.1) in March to 7.6% (95% CI, 2.5‐17.8) in August. The standardized mortality ratio dropped from 1.26 (95% CI, 1.15‐1.39) in March to 0.38 (95% CI, 0.12‐0.88) in August, at which time the average probability of death (average marginal effect) was 18.2 percentage points lower than in March. Data from one health system suggest that mortality from COVID‐19 is decreasing even after accounting for patient characteristics.
Từ khóa
Tài liệu tham khảo
CDC COVID Data Tracker.2020.Centers for Disease Control and Prevention. Accessed October 14 2020.https://covid.cdc.gov/covid‐data‐tracker/#trends_dailytrendscases
margins: Marginal Effects for Model Objects [computer program].Version R package version 0.3.232018. Accessed October 1 2020.https://rdrr.io/cran/margins/
Greene WH, 2012, Econometric Analysis
DoidgeJC MounceyPR ThomasK et al.Trends in intensive care for patients with COVID‐19 in England Wales and Northern Ireland. Preprints2020. Preprint posted online August 11 2020.https://doi.org/10.20944/preprints202008.0267.v1
Recovery Collaborative Group HorbyP LimWS et al.Dexamethasone in hospitalized patients with Covid‐19 ‐ preliminary report.N Engl J Med.2020. Online first July 17 2020.https://doi.org/10.1056/NEJMoa2021436
BeigelJH TomashekKM DoddLE et al.Remdesivir for the treatment of Covid‐19 – final report.N Enl J Med.2020. Online first October 8 2020.https://doi.org/10.1056/NEJMoa2007764