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In-hospital mortality in COVID-19 vs. pre-COVID-19 era in the Split-Dalmatia County, Croatia

Abstract Background The COVID-19 pandemic marked 2020 with numerous consequences for the health of the population. Therefore, this study aimed to explore whether the COVID-19 pandemic affected in-hospital mortality. Methods We employed a cross-sectional comparative study using two different time periods, pre-COVID-19 (2019 year) and COVID-19 era (2020 year) to explore possibilities of COVID-19 influences in-hospital mortality in Split-Dalmatia County, Croatia. The research used data from the national information system on hospitalizations from the Clinical Hospital Center Split, University Hospital Split. The indicators were statistically analyzed. The z-score test for two population proportions is used. Results In 2020, there was a significantly higher in-hospital mortality compared to 2019 (z = 9.0827; p < 0.00001), which was supported by a significant increase in mortality from respiratory diseases according to the comparison of disease categories of International Statistical Classification of Diseases and Related Health Problems (ICD-10) (z = 9.0427; p < 0.00001). Within hospital departments, significantly higher mortality was in the Intensive Care Unit (z = 5.2763; p < 0.00001) and the Infectious Diseases Department (z = 9.6982; p < 0.00001). Among deaths in 2020 with confirmed COVID-19, there were significantly more positive among deaths from respiratory diseases (z=-17.4462; p < 0.00001). There was no difference in mortality rates between 2020 and 2019 by age. Conclusions The results of the study indicate that COVID-19 has a contribution to hospital mortality. Given that the pandemic has not yet completed additional research, it will be necessary to obtain a more complete picture of the impact of COVID-19 on hospital mortality in Split-Dalmatia County, as well as in other regions and countries. Key messages The results of the study indicate that COVID-19 has a contribution to hospital mortality. Given that the pandemic has not yet completed additional research, it will be necessary to obtain a more complete picture of the impact of COVID-19 on hospital mortality.


Background:
The indirect effects of COVID-19 pandemic are yet undefined, but behavioral and lifestyle consequences of the containment measures may cause weight changes, with different concerns across demographic groups. Our aim was to determine weight changes based on the data collected from same individuals before (2017) and during (2020) the COVID-19 pandemic. Methods: Participants aged 25+ years, from the nationally representative FinHealth 2017 Study and its follow-up survey in autumn 2020, with information on self-reported weight in both years were included (n = 4770). Weight maintenance was defined as < AE 5% change in body weight for each individual (i.e. weight loss = !5% loss; weight gain = !5% gain). Prevalence was estimated using inverse probability weights, acknowledging sampling design and non-response.

Conclusions:
The weight loss among 70+ year olds seems worrying, but might be age related. Moreover, younger women and men with low education gained weight, groups known to be vulnerable for weight gain. Further analyses are required to evaluate whether containment measures related to COVID-19 pandemic have caused additional change compared to ageing and time related change. Key messages: Few weight changes were observed in the Finnish adult population. As weight gain/loss may take longer time to develop, further studies are needed to address the long term effects of COVID-19 pandemic.
To avoid increasing health inequity after pandemic, public health promotion should stress obesity prevention among young women plus men with low education. Weight loss is a concern among the elderly.

Background:
The COVID-19 pandemic marked 2020 with numerous consequences for the health of the population. Therefore, this study aimed to explore whether the COVID-19 pandemic affected in-hospital mortality.

Methods:
We employed a cross-sectional comparative study using two different time periods, pre-COVID-19 (2019 year) and COVID-19 era (2020 year) to explore possibilities of COVID-19 influences in-hospital mortality in Split-Dalmatia County, Croatia. The research used data from the national information system on hospitalizations from the Clinical Hospital Center Split, University Hospital Split. The indicators were statistically analyzed. The z-score test for two population proportions is used.

Results:
In 2020, there was a significantly higher in-hospital mortality compared to 2019 (z = 9.0827; p < 0.00001), which was supported by a significant increase in mortality from respiratory diseases according to the comparison of disease categories of International Statistical Classification of Diseases and Related Health Problems (ICD-10) (z = 9.0427; p < 0.00001). Within hospital departments, significantly higher mortality was in the Intensive Care Unit (z = 5.2763; p < 0.00001) and the Infectious Diseases Department (z = 9.6982; p < 0.00001). Among deaths in 2020 with confirmed COVID-19, there were significantly more positive among deaths from respiratory diseases (z=-17.4462; p < 0.00001). There was no difference in mortality rates between 2020 and 2019 by age.

Conclusions:
The results of the study indicate that COVID-19 has a contribution to hospital mortality. Given that the pandemic has not yet completed additional research, it will be necessary to obtain a more complete picture of the impact of COVID-19 on hospital mortality in Split-Dalmatia County, as well as in other regions and countries.

Key messages:
The results of the study indicate that COVID-19 has a contribution to hospital mortality. Given that the pandemic has not yet completed additional research, it will be necessary to obtain a more complete picture of the impact of COVID-19 on hospital mortality.