Observational studyRespiratory investigation2021
Clinical characteristics of COVID-19 in Osaka, Japan: Comparison of the first-third waves with the fourth wave.
Observational study in Respiratory investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 21 citations in OpenAlex.
- Profile of COVID-19 cases during four waves of the pandemic from May 2020 to March 2022 in the Haut-Ogooué region in Gabon.BMC public health · 2026Article
- Changes in proportions of Cesarean section before and during the COVID-19 pandemic in Japan.The journal of obstetrics and gynaecology research · 2025Observational
- Clinical characteristics of coronavirus disease 2019 in patients undergoing laparoscopic bariatric/metabolic surgery: a nationwide survey in Japan.Surgery today · 2025Article
- Change in the Proportion of Death at Home during the COVID-19 Pandemic and Its Associated Factors in the Municipality Level: A Nationwide Study in Japan.JMA journal · 2024Article
- Influence of the COVID-19 Outbreak in Vulnerable Patients (Pediatric Patients, Pregnant Women, and Elderly Patients) on an Emergency Medical Service System: A Pre- and Post-COVID-19 Pandemic Comparative Study Using the Population-Based ORION Registry.Medicina (Kaunas, Lithuania) · 2024Article
- Observational
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- COVID-19 in Patients with Pre-Existing Interstitial Lung Disease: Potential Value of a Steroid-Based Treatment Strategy.Journal of clinical medicine · 2023Article
- Reviewing COVID-19 from an anesthesiologist's perspective in 2022: JA symposium.Journal of anesthesia · 2023Article
- Factors associated with COVID-19 length of hospitalization and mortality during four epidemic waves, March 2020-November 2021, Suriname.Revista panamericana de salud publica = Pan American journal of public health · 2023Article
- Descriptive epidemiology of COVID-19 in Japan 2020: insights from a multihospital database.Annals of clinical epidemiology · 2023Article
- Characteristics of hospitalized patients with COVID-19 during the first to fifth waves of infection: a report from the Japan COVID-19 Task Force.BMC infectious diseases · 2022Article
- Delirium in Patients with COVID-19 in Japan.Internal medicine (Tokyo, Japan) · 2022Article
- Evolution of the Clinical Profile and Outcomes of Unvaccinated Patients Affected by Critical COVID-19 Pneumonia from the Pre-Vaccination to the Post-Vaccination Waves in Italy.Pathogens (Basel, Switzerland) · 2022Article
- The clinical course, biochemical markers, and clinical outcomes of COVID-19 positive patients from the third wave in Pakistan: A retrospective cohort study.Annals of medicine and surgery (2012) · 2022Article
- Changes in Characteristics and Outcomes of Newly Initiated Physician-Led Home Visit Care Before and During the Coronavirus Disease 2019 Pandemic: A Multicenter Retrospective Study in Japan.Journal of primary care & community healthArticle
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe fourth wave of COVID-19 in Osaka Prefecture, Japan, caused a medical crisis. Here, we aim to identify the risk factors for COVID-19 severity and compare patients between the first-third waves and the fourth wave.
methodsWe performed an observational retrospective study of COVID-19 cases at the National Hospital Organization Kinki-Chuo Chest Medical Center.
resultsWe identified 404 patients (median age: 71.0 years [interquartile range: 56.0-80.0]), of whom 199 (49.1%) had mild disease, 142 (35.2%) had moderate disease, and 63 (15.6%) had severe disease. The overall mortality rate was 5.4% (22/404). Based on multivariate logistic regression analysis, cardiovascular disease, fever, dyspnea, and several inflammatory biomarkers were independent risk factors for moderate to severe disease. For every 1 mg/dL increase in C-reactive protein, 10 IU/L increase in lactate dehydrogenase, and 100 ng/mL increase in ferritin, the risk for moderate to severe disease increased by 18.3%, 12.9%, and 8.9%, respectively. Overall disease severity in the fourth wave was higher than in the first-third waves. However, there was no significant difference in mortality. Because of a shortage of beds, four of the 28 severe patients (14.3%) in the fourth wave could not be transferred to the advanced hospital.
conclusionsCardiovascular disease, fever, dyspnea, and several inflammatory biomarkers were risk factors for moderate to severe COVID-19 in our cohort. During the fourth wave, COVID-19 severity worsened, increasing the number of patients who could not be transferred to beds for severe cases, resulting in a medical crisis in Osaka.
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