Currently submitted to: JMIRx Med
Date Submitted: Oct 9, 2022
Open Peer Review Period: Oct 9, 2022 - Dec 4, 2022
Date Accepted: Mar 26, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Healthcare system overstretch and in-hospital mortality of intubated COVID-19 patients in Greece: an updated analysis, September 2020 to April 2022
ABSTRACT
Background:
Our previous analysis showed how in-hospital mortality of intubated COVID-19 patients in Greece is adversely affected by patient load and regional disparities.
Objective:
We aimed to update this analysis to include the large “delta” and “omicron” waves that affected Greece during 2021-2022, while also considering the effect of vaccination.
Methods:
Anonymized surveillance data were analyzed from all COVID-19 patients in Greece intubated between 1 September 2020 and 4 April 2022, and followed up until 17 May 2022. Poisson regression was used to estimate the hazard of dying as a function of fixed and time-varying covariates.
Results:
Mortality was significantly higher above 400 patients, with an adjusted Hazard Ratio of 1.22, 95% CI: 1.09-1.38), rising progressively up to 1.48 (95% CI: 1.31-1.69) for 800+ patients. Hospitalization away from Attica region was also independently associated with increased mortality, as was hospitalization after 1 September 2021 (HR=1.21, 95% CI: 1.09-1.36). Vaccination did not affect the mortality of these already severely ill patients.
Conclusions:
Our results confirm that in-hospital mortality of severely ill COVID-19 patients is adversely affected by high patient load and regional disparities, and point to a further significant deterioration after 1 September especially away from Attica and Thessaloniki. This highlights the need for urgent strengthening of healthcare services in Greece, ensuring equitable and high-quality care for all.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.