Real-time analysis of hospital length of stay in a mixed SARS-CoV-2 Omicron and Delta epidemic in New South Wales, Australia

Tobin, Ruarai; Wood, James G.; Jayasundara, Duleepa; Sara, Grant; Walker, Camelia R.; Martin, Geneviève; McCaw, James M.; Shearer, Freya M; Price, David

doi:10.1186/s12879-022-07971-6

Cited by 12 publications

(4 citation statements)

References 25 publications

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“…However, there were statistically significantly fewer hazards of death in Omicron than Delta in the study of Nyberg et al [14]. While we found faster ward-to-ICU transfer in omicron than delta, we did not evaluate the effects of other variables on this, but Tobin et al [18] showed that age was significantly affecting the time of ward-to-ICU transfer. Yet, we found that the hazard ratio for the age was 1.056 (95% CI 1.018-1.097, p =0.004), showing a 5.6% increase in death risk with a 1-year increase in age.…”

Section: Resultscontrasting

confidence: 59%

Untitled

2023

J. Med. Chem. Sci.

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Objective: COVID-19 has presented numerous epidemiological and clinical pictures from its beginning and much effort has been paid to detect the behavior of disease and its new types. Therefore, in this study, we aimed to compare the in-hospital survival time of Delta and Omicron variant patients admitted to the intensive care unit. Methods: This was a secondary data analysis of the QCOVICU data registry of 200 COVID-19 patients admitted to the ICU of Shahid Beheshti-Amir Al-Momenin Hospital of Qom City, in 2021. Likewise, time to event data, demographics, and baseline laboratory data was collected. Time of transfer to ICU, survivals, and possible predictors of hazards of death was compared within the variants of Omicron and delta. Results: Two hundred patients (62.98±19.94 years old, 94 females/106 males; 100 Delta and 100 Omicron variant) participated in this study. Fifty percent of the population had died. Cross-tabulation showed comparable death rates among variants of delta and omicron (50.5% vs. 51%; p=0.999). There was a statistically significant higher time to ICU admission in Delta variant victims than in Omicron variant victims. The mean survival time of delta variant patients was 21.52 days (95% CI: 17.96 -25.09) which was statistically higher than the mean survival of omicron patients (17.15 days, 95% CI: 13.65-20.64, p=0.018). The mean survival time of delta variant patients was statistically higher than omicron patients (21.52 vs. 17.15 days, p=0.018). Gender, age (years), and lymphocyte count were significant predictors of mortality based on the Cox regression analysis (P>0.05). There was a 5.9 times higher risk of mortality in females compared with males' gender after adjusting for other variables and a 5.6% increase in death risk with a 1-year increase in age, and a 31.8% decrease in death risk with a 1% lymphocyte percentage increase. Conclusion: Critically patients with Delta variant are getting ICU admitted later and withstand more days at ICU than Omicron patients. It seems that Omicron variant causes sudden deterioration of the patient's condition.

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Section: Resultscontrasting

confidence: 59%

Untitled

2023

J. Med. Chem. Sci.

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“…Moreover, the results of Ramin Sami et al's study reported an increase in the average length of stay in Isfahan hospitals in Iran during the Covid-19 pandemic(26). Of course, some previous studies have reported a decrease in the average length of stay during the Covid-19 pandemic (20,(27)(28)(29)(30)(31)(32) and others found no signi cant difference in the average length of stay during the Covid-19 pandemic (19). Longer length of stay at the onset of the pandemic can be attributed to the unknown nature of the disease and the lack of treatment guidelines, and as a result, the need for longer hospitalization (33).…”

Section: Discussionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Public Hospitals Performance Indicators in Iran: an Interrupted Time-series Analysis

Ranjbar,

Bazyar,

Sarkari

et al. 2023

Preprint

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Background The Covid-19 pandemic stretched health systems globally including in Iran. Hospital demand and performance was affected both directly and indirectly as a result of the pandemic. Analyzing hospital indicators can provide insights to deal with the consequences and challenges related to various aspects of future pandemics. Objective This study aimed to investigate the impact of the Covid-19 pandemic on key performance indicators of public hospitals in Iran. Methods We used time-series analysis to examine six key indicators of hospital performance: average length of stay, hospital mortality rate, number of surgeries, hospitalization rate, emergency visits, and bed occupancy rate. Data were extracted from four public hospitals in Yazd at two time intervals, 15 months before and after the outbreak of COVID-19. Data were analysed using interrupted time series analysis models with STATA17. Results Average length of stay (p = 0.02) and hospital mortality rate (p < 0.01) increased significantly following the outbreak of COVID-19, while the mean of other indicators such as number of surgeries (p = 0.01), hospitalization rate (p < 0.01), emergency visits (p < 0.01) and bed occupancy rate (p < 0.01) decreased significantly. The Covid-19 pandemic had an immediately reverse significant impact on the level changes of "hospitalization rate", "emergency visits" and "bed occupancy rate" indicators (p < 0.05). although the trend of surgeries indicator was affected significantly (p = 0.01) after the covid-19 outbreak. Conclusion We showed significant changes in most hospital indicators after the Covid-19 pandemic, reflecting the effect of this pandemic on the performance of hospitals. Understanding the impact of a pandemic on hospital indicators is necessary for decision-makers to effectively plan an effective pandemic response and to inform resource allocation decisions.

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“…The duration of hospitalisation in general wards and ICU follow a Gamma distribution, with means and variances sampled from estimates during the Australian Omicron outbreak. 18 Details of the clinical pathways model are given here. 10 .…”

Section: Clinical Pathwaysmentioning

confidence: 99%

Cost-effective boosting allocations in the post-Omicron era of COVID-19 management

Le,

Conway,

Akpan

et al. 2023

Preprint

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Background Following widespread exposure to Omicron variants, COVID-19 has transitioned to endemic cir- culation. Populations now have diverse infection and vaccination histories, resulting in heterogeneous immune landscapes. Careful consideration of vaccination is required through the post-Omicron phase of COVID-19 management to minimise disease burden. We assess the impact and cost-effectiveness of targeted COVID-19 vaccination strategies to support global vaccination recommendations. Methods We integrated immunological, transmission, clinical and cost-effectiveness models, and simulated populations with different characteristics and immune landscapes. We calculated the expected number of infections, hospitalisations and deaths for different vaccine scenarios. Costs (from a healthcare perspective) were estimated for exemplar country income level groupings in the Western Pacific Region. Results are reported as incremental costs and disability-adjusted life years averted compared to no additional vaccination. Parameter and stochastic uncertainty were captured through scenario and sensitivity analysis. Findings Across different population demographics and income levels, we consistently found that annual elder-targeted boosting strategies are most likely to be cost-effective or cost-saving, while paediatric programs are unlikely to be cost-effective. Results remained consistent while accounting for uncertain- ties in the epidemiological and economic models. Half-yearly boosting may only be cost-effective in higher income settings with older population demographics and higher cost-effectiveness thresholds. Interpretation These results demonstrate the value of continued booster vaccinations to protect against severe COVID-19 disease outcomes across high and middle-income settings and show that the biggest health gains relative to vaccine costs are achieved by targeting older age-groups. Funding Funded by the World Health Organization.

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Real-time analysis of hospital length of stay in a mixed SARS-CoV-2 Omicron and Delta epidemic in New South Wales, Australia

Cited by 12 publications

References 25 publications

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The Impact of the COVID-19 Pandemic on Public Hospitals Performance Indicators in Iran: an Interrupted Time-series Analysis

Cost-effective boosting allocations in the post-Omicron era of COVID-19 management

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