Differences in COVID-19 treatment across Japan : analysis of the COVID-19 Registry Japan (COVIREGI-JP)

Asai, Yusuke; Ohashi, Takahisa; Imai, Keiji; Murata, Koichi; Tsuzuki, Shinya; Matsunaga, Nobuaki; Ohmagari, Norio

doi:10.1016/J.JIAC.2023.09.005

Title

Differences in COVID-19 treatment across Japan : analysis of the COVID-19 Registry Japan (COVIREGI-JP)

Author

Asai, Yusuke

Ohashi, Takahisa

Imai, Keiji

Murata, Koichi

Tsuzuki, Shinya

Matsunaga, Nobuaki

Ohmagari, Norio

Abstract

Background: This study investigated the differences between metropolitan and non-metropolitan areas in the treatment of hospitalized patients with COVID-19 using data from the nationwide COVID-19 Registry Japan (COVIREGI-JP).Methods: Data of patients hospitalized for COVID-19 during waves 2-4 (June 1, 2020-June 30, 2021) treated in one of the 800 medical institutions participating in the Registry were extracted. Treatment and treatment out-comes were evaluated in inpatients with moderate 2 and severe disease using propensity score matching per-formed between metropolitan and non-metropolitan areas.Results: A total of 32797 patients were identified during epidemic waves 2-4. After matching (wave 2, n = 307; wave 3, n = 913; wave 4, n = 479), the population comprised mostly elderly patients with a median age of >= 65 years (IQR: 52-81 years) and median SpO2 of 93/94 (IQR: 91%-96%), and the proportion of patients with moderate 2 (SpO2 <= 93%/require oxygenation) vs severe disease (ICU admission) ranged from 82.7% to 89.8% vs 10.2% to 17.3% in metropolitan areas vs non-metropolitan areas, respectively, across all epidemic waves. Noninvasive mechanical ventilation was used significantly more in waves 2 and 3 and invasive mechanical ventilation in wave 4 in metropolitan vs non-metropolitan areas, compared with other waves. In wave 2, death as an outcome was significantly higher in metropolitan vs non-metropolitan areas compared with patient discharge to home/transfer.Conclusion: During the COVID-19 epidemic, starting from wave 2 up until and through wave 4, no clear dif-ferences in mortality rates and no regional differences in treatment provision patterns were observed between metropolitan and non-metropolitan areas in Japan.

Language

English

Source (journal)

Journal of infection and chemotherapy. - Tokyo, 1995, currens

Publication

Tokyo : 2024

ISSN

1341-321X [print]

1437-7780 [online]

DOI

10.1016/J.JIAC.2023.09.005

Volume/pages