Demographic characteristics, acute care resource use and mortality by age and sex in patients with COVID-19 in Ontario, Canada: a descriptive analysis.
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
COVID-19
/ epidemiology
Child
Child, Preschool
Critical Care
/ statistics & numerical data
Facilities and Services Utilization
Female
Hospitalization
/ statistics & numerical data
Humans
Infant
Infant, Newborn
Male
Middle Aged
Ontario
Respiration, Artificial
/ statistics & numerical data
Sex Factors
Survival Rate
Young Adult
Journal
CMAJ open
ISSN: 2291-0026
Titre abrégé: CMAJ Open
Pays: Canada
ID NLM: 101620603
Informations de publication
Date de publication:
Historique:
entrez:
24
3
2021
pubmed:
25
3
2021
medline:
2
4
2021
Statut:
epublish
Résumé
Understanding resource use for coronavirus disease 2019 (COVID-19) is critical. We conducted a descriptive analysis using public health data to describe age- and sex-specific acute care use, length of stay (LOS) and mortality associated with COVID-19. We conducted a descriptive analysis using Ontario's Case and Contact Management Plus database of individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Ontario from Mar. 1 to Sept. 30, 2020, to determine age- and sex-specific hospital admissions, intensive care unit (ICU) admissions, use of invasive mechanical ventilation, LOS and mortality. We stratified analyses by month of infection to study temporal trends and conducted subgroup analyses by long-term care residency. During the observation period, 56 476 individuals testing positive for SARS-CoV-2 were reported; 41 049 (72.7%) of these were younger than 60 years, and 29 196 (51.7%) were female. Proportion of cases shifted from older populations (> 60 yr) to younger populations (10-39 yr) over time. Overall, 5383 (9.5%) of individuals were admitted to hospital; of these, 1183 (22.0%) were admitted to the ICU, and 712 (60.2%) of these received invasive mechanical ventilation. Mean LOS for individuals in the ward, ICU without invasive mechanical ventilation and ICU with invasive mechanical ventilation was 12.8 (standard deviation [SD] 15.4), 8.5 (SD 7.8) and 20.5 (SD 18.1) days, respectively. Among patients receiving care in the ward, ICU without invasive mechanical ventilation and ICU with invasive mechanical ventilation, 911/3834 (23.8%), 124/418 (29.7%) and 287/635 (45.2%) died, respectively. All outcomes varied by age and decreased over time, overall and within age groups. This descriptive study shows use of acute care and mortality varying by age and decreasing between March and September 2020 in Ontario. Improvements in clinical practice and changing risk distributions among those infected may contribute to fewer severe outcomes.
Sections du résumé
BACKGROUND
Understanding resource use for coronavirus disease 2019 (COVID-19) is critical. We conducted a descriptive analysis using public health data to describe age- and sex-specific acute care use, length of stay (LOS) and mortality associated with COVID-19.
METHODS
We conducted a descriptive analysis using Ontario's Case and Contact Management Plus database of individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Ontario from Mar. 1 to Sept. 30, 2020, to determine age- and sex-specific hospital admissions, intensive care unit (ICU) admissions, use of invasive mechanical ventilation, LOS and mortality. We stratified analyses by month of infection to study temporal trends and conducted subgroup analyses by long-term care residency.
RESULTS
During the observation period, 56 476 individuals testing positive for SARS-CoV-2 were reported; 41 049 (72.7%) of these were younger than 60 years, and 29 196 (51.7%) were female. Proportion of cases shifted from older populations (> 60 yr) to younger populations (10-39 yr) over time. Overall, 5383 (9.5%) of individuals were admitted to hospital; of these, 1183 (22.0%) were admitted to the ICU, and 712 (60.2%) of these received invasive mechanical ventilation. Mean LOS for individuals in the ward, ICU without invasive mechanical ventilation and ICU with invasive mechanical ventilation was 12.8 (standard deviation [SD] 15.4), 8.5 (SD 7.8) and 20.5 (SD 18.1) days, respectively. Among patients receiving care in the ward, ICU without invasive mechanical ventilation and ICU with invasive mechanical ventilation, 911/3834 (23.8%), 124/418 (29.7%) and 287/635 (45.2%) died, respectively. All outcomes varied by age and decreased over time, overall and within age groups.
INTERPRETATION
This descriptive study shows use of acute care and mortality varying by age and decreasing between March and September 2020 in Ontario. Improvements in clinical practice and changing risk distributions among those infected may contribute to fewer severe outcomes.
Identifiants
pubmed: 33757964
pii: 9/1/E271
doi: 10.9778/cmajo.20200323
pmc: PMC8096409
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
E271-E279Informations de copyright
© 2021 Joule Inc. or its licensors.
Déclaration de conflit d'intérêts
Competing interests: Kali Barrett has received personal fees from Xenios AG, outside of the submitted work. No other competing interests were declared.
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