sweden Archives - Amazing Health Advances

COVID-19 Mortality Rate Declines Significantly in Sweden

AHA Publisher — Wed, 04 Nov 2020 08:00:43 +0000

Dr. Ananya Mandal, MD via News-Medical Net – A new observational study by Swedish researchers shows a significant decline in death rates among hospitalized patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Their study titled, “Decline in mortality among hospitalized covid-19 patients in Sweden: a nationwide observational study,” was released online as a preprint on the medRxiv* server. Background The novel coronavirus SARS CoV-2 that causes coronavirus disease (COVID-19), has infected over 44 million individuals worldwide and claimed the lives of over 1.17 million. Most COVID cases are hospitalized for complications caused by the infection. The virus’s immense capacity to infect populations and spread rapidly has put enormous pressure on the healthcare system in general and on hospitals in particular, wrote the researchers. Those admitted to hospitals with COVID have a mortality of over 20 percent. Thirty-four percent of patients require intensive care. The proportion of patients requiring ICU admission is between 17 and 32 percent wrote the team. These numbers are derived from studies conducted between February and April 2020. With time, the understanding of the infection and its management has improved, and thus survival has also improved with time. This new study was undertaken among Swedish patients to see if there has been a change in mortality rates among hospitalized COVID-19 patients across the nation. The researchers attempted to see 60-day mortality (defined as death from any cause within 60 days of index hospital admission), mortality rate of the COVID-19 patients for both non-ICU treated, and ICU treated patients during the first 4 months of the pandemic. The data came from the Swedish National Board of Health and Welfare (NBHW). Flow chart of study inclusion: Patients hospitalized for covid-19 in Sweden 1 March – 30 June, 2020 Study design This was a nationwide observational cohort study of patients hospitalized in Sweden between 1st March and 30th June 2020. The patients had all tested positive for SARS-CoV-2 RNA between 14 days before to 5 days after admission. The code on their discharge was COVID-19. All hospitals in Sweden were included in the study. A total of 15,761 hospitalized patients with COVID-19 were included in the study. The data came from the Swedish National Board of Health and Welfare. 60-day all-cause mortality for the patients was recorded and analyzed. The patient population was classified according to the month of their admission. Relative risks of deaths in the patients by month of admission were calculated. Factors such as pre-existing comorbidities, age, gender and care dependency, and severe illness were considered. To assess the severity of illness, Simplified Acute Physiology, version 3 (SAPS3), and oxygenation index (PaO2/FiO2) were used among ICU admitted patients. Treatments and procedures they underwent in the ICU were also recorded. Timeline of patients admitted to, and in care, in hospitals for covid-19 in Sweden during the study period. Shown are number of patients admitted per day into hospital (by index admission date), and into ICU specifically (by ICU admission date) on left Y-axis; number of patients in care per day in hospital, and in ICU specifically on right Y-axis What was found? Overall results of the study can be summarized as: A total of 15,761 patients were admitted. The patients’ median age was 64 years (between 51 and 78 years), and of these, 57.5 percent were men. The highest number of admissions was during April 2020 The proportion of patients admitted to ICU was 14.4 percent overall. Age distribution of admitted patients changed over time, with the number of patients less than 40 years old and over 90 years of age rising between March and June. The overall all-cause 60-day mortality was 17.8 percent (between 17.2 and 18.4 percent) among Swedish patients hospitalized with COVID-19. The rates of deaths were 24.7 in March 2020 that fell to 13.3 percent in June 2020 Adjusted relative risk (RR) of death was 0.56 (95 percent CI, 0.51 to 0.63) for June, with rates inMarch used as a baseline. Compared to ICU admitted patients, relative risks of death for non-ICU patients were 0.60 (95 percent CI, 0.53 to 0.67) and 0.61 (95 percent CI, 0.48 to 0.79), respectively. Admission rates to the ICU fell from 19.5 percent (95 percent CI, 17.9 percent to 21.0 percent) in March to 11.0 percent (95 percent CI, 9.9 percent to 12.2 percent) in June 2020. In June, the proportion of ICU admitted patients receiving mechanical ventilation fell from 86.5 percent in March to 58.6 percent. In June, the proportion of ICU admitted patients receiving dialysis fell from 22.8 percent in March to 13.8 percent. SAPS3 and PaO2/FiO2 on ICU admission remained similar throughout the study period among the patients roportion of patients treated in ICU and receiving invasive mechanical ventilation during the hospital stay, according to month of hospital admission. Shown are proportions with 95% confidence intervals Conclusions and implications This study reveals that there has been a decline in the mortality rates among hospitalized Swedish COVID-19 patients with time over the pandemic. This decline is independent of the pre-existing comorbidities among the patients. Authors call for further research to understand the reasons behind this decline. Authors write, “The changing covid-19 mortality should be taken into account when management and results of studies from the first pandemic wave are evaluated.” *Important Notice medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information. Journal reference: Decline in mortality among hospitalised covid-19 patients in Sweden: a nationwide observational study Kristoffer Stralin, Erik Wahlstrom, Sten Walther, Mona Heurgren, Anna M Bennet-Bark, Thomas Linden, Johanna Holm, Hakan Hanberger medRxiv 2020.10.27.20220061; doi: https://doi.org/10.1101/2020.10.27.20220061, https://www.medrxiv.org/content/10.1101/2020.10.27.20220061v1 To read the original article click here.

The post COVID-19 Mortality Rate Declines Significantly in Sweden appeared first on Amazing Health Advances.

Sweden May Reach ‘Herd Immunity’ in Weeks as the Country Resists Total Lockdown

AHA Publisher — Sat, 25 Apr 2020 07:00:05 +0000

Angela Betsaida B. Laguipo, BSN via News-Medical Net – Herd immunity is a form of indirect protection against infectious diseases where a population develops sufficient immunity to a disease that that infection cannot spread within the group. A population can reach herd immunity if a large proportion has been exposed to the virus. Now, Sweden resisted total lockdown measures, unlike its neighboring countries, while experts believe herd immunity will be achieved in Stockholm within weeks. Europe has been badly hurt by the coronavirus disease (COVID-19). Several countries in Europe report a high number of confirmed cases, including Spain, Italy, France, Germany, and the United Kingdom. These countries have imposed lockdown measures, social distancing behaviors, and travel bans, in the attempt to contain the spread of the virus that causes COVID-19, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). “In major parts of Sweden, around Stockholm, we have reached a plateau (in new cases), and we already see the effect of herd immunity, and in a few weeks, we’ll see even more of the effects of that. And in the rest of the country, the situation is stable,” Dr. Anders Tegnell, chief epidemiologist at Sweden’s Public Health Agency, said in a statement. Voluntary Measures The country’s top epidemiologist says that Stockholm could attain herd immunity in weeks amid the country’s low-level lockdown measures. The measures are voluntary, and the government has faith in the residents that they will avoid social contact, while the country’s borders have remained open. Herd immunity is reached when approximately 60 percent of the population becomes immune to a virus. However, without a vaccine, scientists are analyzing if exposure and recovery from the COVID-19 will provide long-term immunity. In some countries such as Japan, China, and South Korea, reinfections of SARS-CoV-2 have been reported. “Each country has to reach ‘herd immunity’ in one way or another, and we are going to reach it in a different way,” Dr. Tegnell added. There are enough signals to show that we can think about herd immunity, about recurrence. Very few cases of reinfection have been reported globally so far. How long the herd immunity will last, we do not know, but there is definitely an immune response. As of writing, the country has reached an infection toll of 16,755 and a death toll of 2,021, which is a fatality rate of 12 percent, higher than the rates in other countries. Dr. Tegnell also said that the mortality rate in the country is high because the virus was introduced to nursing homes, endangering the lives of older adults. The sudden spike in novel coronavirus cases in Stockholm has raised questions about the country’s decision to combat the pandemic without resorting to lockdowns, which have left most of the countries in Europe in a standstill. Most countries have closed schools and have taken authoritarian measures to impose social distancing, implement curfews, band meeting of more than two people in public, and limit exposure to potential carriers. Sweden did something different. Rather than imposing strict social distancing measures and policies, the country aimed to keep public life as open as possible. People are still allowed to go to restaurants, send their children to school, and get a haircut, even if the cases have been rapidly increasing and the number of deaths has mounted. Stockholm alone accounts for more than half the fatalities. Little Restrictions Sweden’s foreign minister, Ann Linde, explains that the country’s approach is not similar to other countries. The government has not imposed a lockdown, and it relies on the people taking responsibility themselves. The coronavirus measures the country has rolled out include bars, restaurants, and malls remain open, and school classes are not suspended. The government has encouraged everyone against nonessential travels, while those who are 70 years old and above to stay at home. The only restrictions are that crowds of more than 50 people are banned, restaurants and bars are to serve only those who are seated, and people are barred from visiting nursing homes. Regardless of lenient lockdown measures, the country has ramped up its testing capacities, Sweden initially tested those who report symptoms or those who came to the hospital. Increasing testing capacities is the key to help the health system cope with the number of admissions. This way, the country can flatten the curve and prevent overwhelming the health system. The country is testing around 20,000 people each week but plans to increase that to about 100,000 in a few weeks. To read the original article click here.

The post Sweden May Reach ‘Herd Immunity’ in Weeks as the Country Resists Total Lockdown appeared first on Amazing Health Advances.