Temporal trends in hospitalizations and 30-day mortality in older patients during the COVID pandemic from March 2020 to July 2021

PLoS One. 2023 Sep 14;18(9):e0291237. doi: 10.1371/journal.pone.0291237. eCollection 2023.

Abstract

Background: A reduction in mortality risk of COVID-19 throughout the first wave of the pandemic has been reported, but less is known about later waves. This study aimed to describe changes in hospitalizations and mortality of patients receiving inpatient geriatric care for COVID-19 or other causes during the pandemic.

Methods: Patients 70 years and older hospitalized in geriatric hospitals in Stockholm for COVID-19 or other causes between March 2020-July 2021 were included. Data on the incidence of COVID-positive cases and 30-day mortality of the total ≥ 70-year-old population, in relation to weekly hospitalizations and mortality after hospital admissions were analyzed. Findings The total number of hospitalizations was 5,320 for COVID-19 and 32,243 for non-COVID-cases. In COVID-patients, the 30-day mortality rate was highest at the beginning of the first wave (29% in March-April 2020), reached 17% at the second wave peak (November-December) followed by 11-13% in the third wave (March-July 2021). The mortality in non-COVID geriatric patients showed a similar trend, but of lower magnitude (5-10%). During the incidence peaks, COVID-19 hospitalizations displaced non-COVID geriatric patients.

Interpretation: Hospital admissions and 30-day mortality after hospitalizations for COVID-19 increased in periods of high community transmission, albeit with decreasing mortality rates from wave 1 to 3, with a probable vaccination effect in wave 3. Thus, the healthcare system could not compensate for the high community spread of COVID-19 during the pandemic peaks, which also led to displacing care for non-COVID geriatric patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • COVID-19* / epidemiology
  • Hospitalization
  • Humans
  • Pandemics
  • Patients
  • Probability

Grants and funding

Sara Garcia-Ptacek has received funding from the Swedish Stroke Association, StratNeuro, the regional agreement on medical training and clinical research between the Stockholm County council and the Karolinska Institutet (ALF), Karolinska Institutet Research Foundations, and the Swedish Research Council (#2022-01425). Hong Xu has received funding from the Center for Innovative Medicine (CIMED, FoUI-963369), StratNeuro, the Swedish Research Council (#2022-01428) and Karolinska Institutet Research Foundations. Maria Eriksdotter from the Swedish research council grant (#2016-02317 and #2020-02014) and the regional agreement on medical training and clinical research between the Stockholm County council and the Karolinska Institutet (ALF), Dorota Religa by the Swedish Research Council (2020-06101).