Descriptive epidemiology of COVID-19 in Japan 2020: insights from a multihospital database.
coronavirus disease 2019
inpatient
medical resource utilization
outpatient
repurposed drug
Journal
Annals of clinical epidemiology
ISSN: 2434-4338
Titre abrégé: Ann Clin Epidemiol
Pays: Japan
ID NLM: 9918521386206676
Informations de publication
Date de publication:
2023
2023
Historique:
received:
04
03
2022
accepted:
17
08
2022
medline:
29
9
2022
pubmed:
29
9
2022
entrez:
20
3
2024
Statut:
epublish
Résumé
Epidemiological data are essential for developing strategies against the current coronavirus disease 2019 (COVID-19) pandemic. Data on COVID-19 epidemiology in Japan are limited owing to a focus on specific regions and patient groups, particularly in the early phase of the pandemic. We investigated COVID-19 epidemiology in Japan in 2020 using a large nationwide multihospital database containing insurance claim records and medical records. Inclusion criteria were inpatient and outpatient referrals for COVID-19 in 2020. We analyzed demographic data, comorbidities, drug use, severe COVID-19 risk, and clinical course of hospitalized patients (including death). We identified 11,868 COVID-19 cases from 56 institutions: 6,440 outpatients and 5,428 inpatients. Of the patients, 53.2% had comorbid conditions, the most common of which was tumor (22.1%), and 56.4% were classed as having a high risk of COVID-19. Pharmacological management patterns were generally consistent between the first and second half of 2020, except for glucocorticoid use. The use of unauthorized medications (hydroxychloroquine, ivermectin, and favipiravir) was infrequent. For hospitalized patients, the median length of stay was 10 days, and 2.4% of patients were admitted to intensive care units. Post-COVID-19 all-cause mortality, all-cause 30-day mortality, and in-hospital deaths were recorded for 7.9%, 5.4%, and 4.6% of patients, respectively. Patients with high-risk conditions had a lower survival probability. This descriptive study of COVID-19 in 2020 identified differences in care across outpatient and inpatient settings and changes in care delivery as the pandemic progressed. These findings could inform strategies for future infectious disease pandemics.
Sections du résumé
BACKGROUND
BACKGROUND
Epidemiological data are essential for developing strategies against the current coronavirus disease 2019 (COVID-19) pandemic. Data on COVID-19 epidemiology in Japan are limited owing to a focus on specific regions and patient groups, particularly in the early phase of the pandemic.
METHODS
METHODS
We investigated COVID-19 epidemiology in Japan in 2020 using a large nationwide multihospital database containing insurance claim records and medical records. Inclusion criteria were inpatient and outpatient referrals for COVID-19 in 2020. We analyzed demographic data, comorbidities, drug use, severe COVID-19 risk, and clinical course of hospitalized patients (including death).
RESULTS
RESULTS
We identified 11,868 COVID-19 cases from 56 institutions: 6,440 outpatients and 5,428 inpatients. Of the patients, 53.2% had comorbid conditions, the most common of which was tumor (22.1%), and 56.4% were classed as having a high risk of COVID-19. Pharmacological management patterns were generally consistent between the first and second half of 2020, except for glucocorticoid use. The use of unauthorized medications (hydroxychloroquine, ivermectin, and favipiravir) was infrequent. For hospitalized patients, the median length of stay was 10 days, and 2.4% of patients were admitted to intensive care units. Post-COVID-19 all-cause mortality, all-cause 30-day mortality, and in-hospital deaths were recorded for 7.9%, 5.4%, and 4.6% of patients, respectively. Patients with high-risk conditions had a lower survival probability.
CONCLUSIONS
CONCLUSIONS
This descriptive study of COVID-19 in 2020 identified differences in care across outpatient and inpatient settings and changes in care delivery as the pandemic progressed. These findings could inform strategies for future infectious disease pandemics.
Identifiants
pubmed: 38505379
doi: 10.37737/ace.23002
pmc: PMC10760473
doi:
Types de publication
Journal Article
Langues
eng
Pagination
5-12Informations de copyright
© 2023 Society for Clinical Epidemiology.
Déclaration de conflit d'intérêts
SI and TK are employees of Real World Data, Co., Ltd. KK received research funds from Eisai Co., Ltd., Kyowa Kirin Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Pfizer Inc., Stella Pharma Corporation, CMIC Co., Ltd., Suntory Beverage & Food Ltd., Mitsubishi Corporation, and Real World Data Co., Ltd.; consulting fees from LEBER Inc., JMDC Inc., Shin Nippon Biomedical Laboratories Ltd., Kaken Pharmaceutical Co., Ltd., and Advanced Medical Care Inc.; executive compensation from Cancer Intelligence Care Systems, Inc.; honorarium from Mitsubishi Chemical Holdings Corporation, Mitsubishi Corporation, Pharma Business Academy, and Toppan Inc.; and holds stock in Real World Data Co., Ltd. MT, NE, and TT have no competing interests relevant to this study.