Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort study
Background The COVID-19 pandemic could impact frequency and mortality of non-COVID-19 community-acquired pneumonia (CAP). Changes in frequency, patient mix, treatment and organ dysfunction could cascade together to increase mortality of CAP during compared with pre-COVID-19.Methods Hospitalised CAP...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-07-01
|
| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/10/1/e001810.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850033601759936512 |
|---|---|
| author | Keith R Walley Andre Kalil Terry Lee Kelly A Cawcutt John H Boyd James A Russell |
| author_facet | Keith R Walley Andre Kalil Terry Lee Kelly A Cawcutt John H Boyd James A Russell |
| author_sort | Keith R Walley |
| collection | DOAJ |
| description | Background The COVID-19 pandemic could impact frequency and mortality of non-COVID-19 community-acquired pneumonia (CAP). Changes in frequency, patient mix, treatment and organ dysfunction could cascade together to increase mortality of CAP during compared with pre-COVID-19.Methods Hospitalised CAP patients at St. Paul’s Hospital, Vancouver, Canada pre-COVID-19 (fiscal years 2018/2019 and 2019/2020) and during COVID-19 pandemic (2020/2021 and 2021/2022) were evaluated.Results In 5219 CAP patients, there was no significant difference prepandemic versus during pandemic in mean age, gender and Charlson Comorbidity Score. However, hospital mortality increased significantly from pre-COVID-19 versus during COVID-19 (7.5% vs 12.1% respectively, (95% CI for difference: 3.0% to 6.3%), p<0.001), a 61% relative increase, coincident with increases in ICU admission (18.3% vs 25.5%, respectively, (95% CI for difference: 5.0% to 9.5%) p<0.001, 39% relative increase) and ventilation (12.7% vs 17.5%, respectively, (95% CI for difference: 2.8% to 6.7%) p<0.001, 38% relative increase). Results remained the same after regression adjustment for age, sex and Charlson score. CAP hospital admissions decreased 27% from pre-COVID-19 (n=1349 and 1433, 2018/2019 and 2019/2020, respectively) versus the first COVID-19 pandemic year (n=1047 in 2020/2021) then rose to prepandemic number (n=1390 in 2021/2022). During prepandemic years, CAP admissions peaked in winter; during COVID-19, the CAP admissions peaked every 6 months.Conclusions and relevance This is the first study to show that the COVID-19 pandemic was associated with increases in hospital mortality, ICU admission and invasive mechanical ventilation rates of non-COVID-19 CAP and a transient, 1-year frequency decrease. There was no winter seasonality of CAP during the COVID-19 pandemic era. These novel findings could be used to guide future pandemic planning for CAP hospital care. |
| format | Article |
| id | doaj-art-2d2645dd68ca405e807ecffe54081e01 |
| institution | DOAJ |
| issn | 2052-4439 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj-art-2d2645dd68ca405e807ecffe54081e012025-08-20T02:58:08ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392023-07-0110110.1136/bmjresp-2023-001810Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort studyKeith R Walley0Andre Kalil1Terry Lee2Kelly A Cawcutt3John H Boyd4James A Russell5Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USACentre for Health Evaluation and Outcome Sciences, The University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USADivision of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, CanadaDivision of Critical Care Medicine, The University of British Columbia, Vancouver, British Columbia, CanadaBackground The COVID-19 pandemic could impact frequency and mortality of non-COVID-19 community-acquired pneumonia (CAP). Changes in frequency, patient mix, treatment and organ dysfunction could cascade together to increase mortality of CAP during compared with pre-COVID-19.Methods Hospitalised CAP patients at St. Paul’s Hospital, Vancouver, Canada pre-COVID-19 (fiscal years 2018/2019 and 2019/2020) and during COVID-19 pandemic (2020/2021 and 2021/2022) were evaluated.Results In 5219 CAP patients, there was no significant difference prepandemic versus during pandemic in mean age, gender and Charlson Comorbidity Score. However, hospital mortality increased significantly from pre-COVID-19 versus during COVID-19 (7.5% vs 12.1% respectively, (95% CI for difference: 3.0% to 6.3%), p<0.001), a 61% relative increase, coincident with increases in ICU admission (18.3% vs 25.5%, respectively, (95% CI for difference: 5.0% to 9.5%) p<0.001, 39% relative increase) and ventilation (12.7% vs 17.5%, respectively, (95% CI for difference: 2.8% to 6.7%) p<0.001, 38% relative increase). Results remained the same after regression adjustment for age, sex and Charlson score. CAP hospital admissions decreased 27% from pre-COVID-19 (n=1349 and 1433, 2018/2019 and 2019/2020, respectively) versus the first COVID-19 pandemic year (n=1047 in 2020/2021) then rose to prepandemic number (n=1390 in 2021/2022). During prepandemic years, CAP admissions peaked in winter; during COVID-19, the CAP admissions peaked every 6 months.Conclusions and relevance This is the first study to show that the COVID-19 pandemic was associated with increases in hospital mortality, ICU admission and invasive mechanical ventilation rates of non-COVID-19 CAP and a transient, 1-year frequency decrease. There was no winter seasonality of CAP during the COVID-19 pandemic era. These novel findings could be used to guide future pandemic planning for CAP hospital care.https://bmjopenrespres.bmj.com/content/10/1/e001810.full |
| spellingShingle | Keith R Walley Andre Kalil Terry Lee Kelly A Cawcutt John H Boyd James A Russell Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort study BMJ Open Respiratory Research |
| title | Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort study |
| title_full | Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort study |
| title_fullStr | Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort study |
| title_full_unstemmed | Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort study |
| title_short | Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort study |
| title_sort | impact of the covid 19 pandemic on non covid 19 community acquired pneumonia a retrospective cohort study |
| url | https://bmjopenrespres.bmj.com/content/10/1/e001810.full |
| work_keys_str_mv | AT keithrwalley impactofthecovid19pandemiconnoncovid19communityacquiredpneumoniaaretrospectivecohortstudy AT andrekalil impactofthecovid19pandemiconnoncovid19communityacquiredpneumoniaaretrospectivecohortstudy AT terrylee impactofthecovid19pandemiconnoncovid19communityacquiredpneumoniaaretrospectivecohortstudy AT kellyacawcutt impactofthecovid19pandemiconnoncovid19communityacquiredpneumoniaaretrospectivecohortstudy AT johnhboyd impactofthecovid19pandemiconnoncovid19communityacquiredpneumoniaaretrospectivecohortstudy AT jamesarussell impactofthecovid19pandemiconnoncovid19communityacquiredpneumoniaaretrospectivecohortstudy |