gms | German Medical Science

Background and (inter-)national state of the art: The SARS-CoV-2 pandemic put an unprecedented burden on healthcare systems, particularly on hospitals and intensive care units (ICU). Until now, there are only few studies available describing the characteristics and outcomes for COVID-19 patients admitted to hospitals in Germany.

Research question and aim: Our aim was to collect and analyse hospital data with respect to characteristics and outcomes of COVID-19 patients in Munich.

Methods: We combined secondary data from 28 hospitals in Munich which were originally collected based on § 21 KHEntgG (hospital remuneration act) and considering the BayDSG (Bavarian data protection act). Our analyses included data from all patients with a confirmed COVID-19 infection who were discharged or transferred from hospital as well as patients who died in hospital between 01.01.2020 an 31.12.2020. We conducted descriptive analyses and estimated mortality risk with respect to different patient characteristics by calculating odds ratios (OR) and their 95% confidence intervals (95%CI).

Results: We analysed data from 5,436 patients, of which 1,107 (20.4%) were treated on ICU, 588 (10.8%) were ventilated, and 666 (12.3%) died in hospital. The mean age at hospitalization was 64.6 (standard deviation (SD) 20.5) years, and 2,426 (44.6%) of the patients were female. The mean length of stay was 12.9 (SD 16.7) days in the hospital for all patients, 23.9 (23.4) days on ICU and 28.9 (SD 27.4) days for ventilated patients on ICU. The mortality risk for patients older than 60 years of age was ten times higher compared to patients aged 60 years or younger (OR 10.0; 95%CI 7.4-13.8), while there was no significant difference in mortality risk between men and women (OR 1.11; 95%CI 0.94-1.32). ICU admission was associated with a 70 % increased mortality risk (OR 1.7; 95%CI 1.3-2.2), and ventilation with a 3.7 times increased risk (OR 3.7; 95%CI 2.7-5.0). Patients who were hospitalized with COVID-19 during the second infection wave (July–December) had an 80% increased risk compared to patients admitted to hospital during the first infection wave (OR 1.8; 95%CI 1.5-2.1).

Discussion: This study allows for a comprehensive view on characteristics and outcomes of COVID-19 patients in Munich clinics. We were able to quantify and understand the characteristics of patients admitted to hospital with a COVID-19 infection in 2020 and their risk factors for dying in the clinic.

Practical implications: These data confirm that increased age is the most dominant risk factor for COVID-19 mortality. Our data suggest a difference in mortality risk between the two infection waves, although we cannot preclude that this might partly reflect different decision regimes regarding hospitalization of COVID-19 patients over time. Data collection is still ongoing, and analyses of the hospital data from 2021 will give further insights, also with respect to the potential impact of further infection waves.

Appeal for practice (science and/or care) in one sentence: Mortality risk of hospitalized COVID-19 patients depends on age, ICU admission, ventilation and possibly on the time of infection.