Changes in the characteristics and outcomes of COVID-19 patients from the early pandemic to the delta variant epidemic: a nationwide population-based study
The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed because of virus mutations, vaccine dissemination, treatment development and policies, among other factors. These factors have a dynamic and complex effect on the characteristics and outcomes of patients. Therefore, there is a...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Emerging Microbes and Infections |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/22221751.2022.2155250 |
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| author | Koichi Miyashita Hironao Hozumi Kazuki Furuhashi Eiji Nakatani Yusuke Inoue Hideki Yasui Masato Karayama Yuzo Suzuki Tomoyuki Fujisawa Noriyuki Enomoto Naoki Inui Toshiyuki Ojima Takafumi Suda |
| author_facet | Koichi Miyashita Hironao Hozumi Kazuki Furuhashi Eiji Nakatani Yusuke Inoue Hideki Yasui Masato Karayama Yuzo Suzuki Tomoyuki Fujisawa Noriyuki Enomoto Naoki Inui Toshiyuki Ojima Takafumi Suda |
| author_sort | Koichi Miyashita |
| collection | DOAJ |
| description | The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed because of virus mutations, vaccine dissemination, treatment development and policies, among other factors. These factors have a dynamic and complex effect on the characteristics and outcomes of patients. Therefore, there is an urgent need to understand those changes and update the evidence. We used a large-scale real-world data set of 937,758 patients with COVID-19 from a nationwide claims database that included outpatients and inpatients in Japan to investigate the changes in their characteristics, outcomes and risk factors for severity/mortality from the early pandemic to the delta variant-predominant waves. The severity of COVID-19 was defined according to the modified World Health Organization clinical-progression ordinal scale. With changing waves, mean patient age decreased, and proportion of patients with comorbidities decreased. The incidences of “severe COVID-19 or death (i.e. ≥severe COVID-19)” and “death” markedly declined (5.0% and 2.9%, wild-type-predominant; 4.6% and 2.2%, alpha variant-predominant and 1.4% and 0.4%, delta variant-predominant waves, respectively). Across the wave shift, risk factors for ≥ severe COVID-19 and death, including older age, male, malignancy, congestive heart failure and chronic obstructive pulmonary disease, were largely consistent. The significance of some factors, such as liver disease, varied as per the wave. This study, one of the largest population-based studies on COVID-19, showed that patient characteristics and outcomes changed during the waves. Risk factors for severity/mortality were similar across all waves, but some factors were inconsistent. These data suggest that the clinical status of COVID-19 will change further with the coming epidemic wave. |
| format | Article |
| id | doaj-art-f33e820f9b1a46c39e5eaeebd5ef9da5 |
| institution | OA Journals |
| issn | 2222-1751 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Emerging Microbes and Infections |
| spelling | doaj-art-f33e820f9b1a46c39e5eaeebd5ef9da52025-08-20T01:49:50ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512023-12-0112110.1080/22221751.2022.2155250Changes in the characteristics and outcomes of COVID-19 patients from the early pandemic to the delta variant epidemic: a nationwide population-based studyKoichi Miyashita0Hironao Hozumi1Kazuki Furuhashi2Eiji Nakatani3Yusuke Inoue4Hideki Yasui5Masato Karayama6Yuzo Suzuki7Tomoyuki Fujisawa8Noriyuki Enomoto9Naoki Inui10Toshiyuki Ojima11Takafumi Suda12Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, JapanSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanDepartment of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, JapanDepartment of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, JapanThe coronavirus disease 2019 (COVID-19) pandemic has dramatically changed because of virus mutations, vaccine dissemination, treatment development and policies, among other factors. These factors have a dynamic and complex effect on the characteristics and outcomes of patients. Therefore, there is an urgent need to understand those changes and update the evidence. We used a large-scale real-world data set of 937,758 patients with COVID-19 from a nationwide claims database that included outpatients and inpatients in Japan to investigate the changes in their characteristics, outcomes and risk factors for severity/mortality from the early pandemic to the delta variant-predominant waves. The severity of COVID-19 was defined according to the modified World Health Organization clinical-progression ordinal scale. With changing waves, mean patient age decreased, and proportion of patients with comorbidities decreased. The incidences of “severe COVID-19 or death (i.e. ≥severe COVID-19)” and “death” markedly declined (5.0% and 2.9%, wild-type-predominant; 4.6% and 2.2%, alpha variant-predominant and 1.4% and 0.4%, delta variant-predominant waves, respectively). Across the wave shift, risk factors for ≥ severe COVID-19 and death, including older age, male, malignancy, congestive heart failure and chronic obstructive pulmonary disease, were largely consistent. The significance of some factors, such as liver disease, varied as per the wave. This study, one of the largest population-based studies on COVID-19, showed that patient characteristics and outcomes changed during the waves. Risk factors for severity/mortality were similar across all waves, but some factors were inconsistent. These data suggest that the clinical status of COVID-19 will change further with the coming epidemic wave.https://www.tandfonline.com/doi/10.1080/22221751.2022.2155250COVID-19epidemiologyrisk factorsnational database of health insurance claims and specific health checkups of JapanNDB |
| spellingShingle | Koichi Miyashita Hironao Hozumi Kazuki Furuhashi Eiji Nakatani Yusuke Inoue Hideki Yasui Masato Karayama Yuzo Suzuki Tomoyuki Fujisawa Noriyuki Enomoto Naoki Inui Toshiyuki Ojima Takafumi Suda Changes in the characteristics and outcomes of COVID-19 patients from the early pandemic to the delta variant epidemic: a nationwide population-based study Emerging Microbes and Infections COVID-19 epidemiology risk factors national database of health insurance claims and specific health checkups of Japan NDB |
| title | Changes in the characteristics and outcomes of COVID-19 patients from the early pandemic to the delta variant epidemic: a nationwide population-based study |
| title_full | Changes in the characteristics and outcomes of COVID-19 patients from the early pandemic to the delta variant epidemic: a nationwide population-based study |
| title_fullStr | Changes in the characteristics and outcomes of COVID-19 patients from the early pandemic to the delta variant epidemic: a nationwide population-based study |
| title_full_unstemmed | Changes in the characteristics and outcomes of COVID-19 patients from the early pandemic to the delta variant epidemic: a nationwide population-based study |
| title_short | Changes in the characteristics and outcomes of COVID-19 patients from the early pandemic to the delta variant epidemic: a nationwide population-based study |
| title_sort | changes in the characteristics and outcomes of covid 19 patients from the early pandemic to the delta variant epidemic a nationwide population based study |
| topic | COVID-19 epidemiology risk factors national database of health insurance claims and specific health checkups of Japan NDB |
| url | https://www.tandfonline.com/doi/10.1080/22221751.2022.2155250 |
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