ArticleBMC infectious diseases2022
Time-dependent risk of COVID-19 death with overwhelmed health-care capacity in Japan, 2020-2022.
Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Changes in life expectancy and life span equality during the COVID-19 epidemic in 2020-22 in Japan.PloS one · 2026Article
- Mortality Prediction Performance Under Geographical, Temporal, and COVID-19 Pandemic Dataset Shift: External Validation of the Global Open-Source Severity of Illness Score Model.Critical care explorations · 2025Article
- Science-based exit from stringent countermeasures against COVID-19: Mortality prediction using immune landscape between 2021 and 2022 in Japan.Vaccine: X · 2024Article
- Combined effect of early diagnosis and treatment on the case fatality risk of COVID-19 in Japan, 2020.Scientific reports · 2023Article
- Alzheimer's and dementia: Diagnosis, assessment, and disease monitoring global, regional, and national burden of Alzheimer's disease and other dementias (ADODs) and their risk factors, 1990-2021: A systematic analysis for the Global Burden of Disease study 2021.Alzheimer's & dementia (Amsterdam, Netherlands)Article
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Abstract
backgroundIt has been descriptively argued that the case fatality risk (CFR) of coronavirus disease (COVID-19) is elevated when medical services are overwhelmed. The relationship between CFR and pressure on health-care services should thus be epidemiologically explored to account for potential epidemiological biases. The purpose of the present study was to estimate the age-dependent CFR in Tokyo and Osaka over time, investigating the impact of caseload demand on the risk of death.
methodsWe estimated the time-dependent CFR, accounting for time delay from diagnosis to death. To this end, we first determined the time distribution from diagnosis to death, allowing variations in the delay over time. We then assessed the age-dependent CFR in Tokyo and Osaka. In Osaka, the risk of intensive care unit (ICU) admission was also estimated.
resultsThe CFR was highest among individuals aged 80 years and older and during the first epidemic wave from February to June 2020, estimated as 25.4% (95% confidence interval [CI] 21.1 to 29.6) and 27.9% (95% CI 20.6 to 36.1) in Tokyo and Osaka, respectively. During the fourth wave of infection (caused by the Alpha variant) in Osaka the CFR among the 70s and ≥ 80s age groups was, respectively, 2.3 and 1.5 times greater than in Tokyo. Conversely, despite the surge in hospitalizations, the risk of ICU admission among those aged 80 and older in Osaka decreased. Such time-dependent variation in the CFR was not seen among younger patients < 70 years old. With the Omicron variant, the CFR among the 80s and older in Tokyo and Osaka was 3.2% (95% CI 3.0 to 3.5) and 2.9% (95% CI 2.7 to 3.1), respectively.
conclusionWe found that without substantial control, the CFR can increase when a surge in cases occurs with an identifiable elevation in risk-especially among older people. Because active treatment options including admission to ICU cannot be offered to the elderly with an overwhelmed medical service, the CFR value can potentially double compared with that in other areas of health care under less pressure.
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