Abstract
Objectives: To investigate the temporal trends of 30-day mortality and hospitalisation in US Veterans with COVID-19 and 30-day mortality in hospitalised veterans with COVID-19 and to decompose the contribution of changes in the underlying characteristics of affected populations to these temporal changes.
Design: Observational cohort study.
Setting: US Department of Veterans Affairs.
Participants: 49 238 US veterans with a positive COVID-19 test between 20 March 2020 and 19 September 2020; and 9428 US veterans hospitalised with a positive COVID-19 test during the same period.
Outcome measures: 30-day mortality rate and hospitalisation rate.
Results: Between 20 March 2020 and 19 September 2020 and in COVID-19 positive individuals, 30-day mortality rate dropped by 9.2% from 13.6% to 4.4%; hospitalisation rate dropped by 16.8% from 33.8% to 17.0%. In hospitalised COVID-19 individuals, 30-day mortality rate dropped by 12.7% from 23.5% to 10.8%. Among COVID-19 positive individuals, decomposition analyses suggested that changes in demographic, health and contextual characteristics, COVID-19 testing capacity, and hospital occupancy rates accounted for 40.2% and 33.3% of the decline in 30-day mortality and hospitalisation, respectively. Changes in the underlying characteristics of hospitalised COVID-19 individuals accounted for 29.9% of the decline in 30-day mortality.
Conclusion: Between March and September 2020, changes in demographic and health characteristics of people infected with COVID-19 contributed measurably to the substantial decline in 30-day mortality and hospitalisation.
Keywords: COVID-19; epidemiology; general medicine (see internal medicine).
【저자키워드】 COVID-19, Epidemiology, general medicine (see internal medicine), 【초록키워드】 hospital, Population, cohort study, Health, COVID-19 testing, Characteristics, hospitalisation, change, 30-Day mortality, Analysis, changes, individual, Department, positive individuals, positive COVID-19, veteran, hospitalised, 30-day mortality rate, occupancy rate, affected, accounted, changes in, suggested, contributed, individuals, dropped, infected with COVID-19, with COVID-19, 【제목키워드】 hospitalisation, COVID-19 mortality, Observational cohort study, Department, veteran, Temporal, Affair,