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In-Hospital SARS-CoV-2 Mortality Declined Throughout Pandemic

FRIDAY, April 9, 2021 -- In-hospital mortality for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients of all ages has declined throughout the pandemic period, according to a study published online April 8 in JAMA Network Open.

Lyn Finelli, Dr.P.H., from Merck and Co in Kenilworth, New Jersey, and colleagues assessed changes over time for in-hospital mortality in patients with SARS-CoV-2-positive tests from March 1 to Nov. 21, 2020. The analysis included 503,409 patients who were hospitalized for at least one day at 209 U.S. acute care hospitals (of variable size and in a mix of urban and rural areas), 8.5 percent of whom had a SARS-CoV-2-positive test.

The researchers found that hospital admissions among patients with SARS-CoV-2-positive tests were highest in the group aged 65 years and older (46.8 percent), followed by those aged 50 to 64 years (27.2 percent) and 18 to 49 years (24.9 percent). Increasing age was associated with higher in-hospital mortality rates regardless of SARS-CoV-2 positivity (SARS-CoV-2-negative: in-hospital mortality range, 0.4 percent for <18 years to 4.5 percent for >75 years; SARS-CoV-2-positive: 0.2 percent for <18 years to 20.9 percent for >75 years). Among SARS-CoV-2-negative patients, in-hospital mortality rates were similar for male and female patients (3.0 and 2.2 percent, respectively); however, among SARS-CoV-2-positive patients, mortality was higher for male patients (12.5 versus 9.6 percent). Overall, in-hospital mortality increased from March to April (10.6 to 19.7 percent), but then decreased significantly in November (9.3 percent). Over time, significant decreases in in-hospital mortality were observed in the oldest age groups.

"Reductions in mortality rates did not appear to be associated with the age distribution of hospitalized patients with SARS-CoV-2-positive tests and were likely because of new therapies and improvements in the clinical management of patients with SARS-CoV-2 infection," the authors write.

The authors disclosed financial ties to pharmaceutical companies.

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