Critical Care Medical Centers May Play an Important Role in Reducing the Risk of COVID-19 Death in Japan
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COVID-19
Critical Care Medical Centers May Play an Important Role in Reducing the Risk of COVID-19 Death in Japan Yohei Ishikawa 1 & Toru Hifumi 1
&
Mitsuyoshi Urashima 2
Accepted: 23 September 2020 # The Author(s) 2020
Abstract Marked differences in COVID-19 mortalities have been observed among 47 prefectures in Japan. Here, we explored associations between COVID-19 mortalities and medical and public health capacities in individual prefectures. The following data by prefecture were abstracted from open resources provided by the Ministry of Health, Labour and Welfare in Japan as of May 24, 2020: total number of COVID-19 deaths; polymerase chain reaction (PCR)-positive ratio (i.e., number of patients with PCR-positive results/number of patients aiming diagnosis of COVID-19 or individuals in close contacted with COVID-19 patients); number of call centers, outpatient centers, and hospital beds specifically for patients diagnosed with COVID-19; and others. The primary outcome was COVID-19 mortality per million population. Multiple and simple linear regression models were applied. Two variables were significantly associated with COVID-19 mortality: PCR-positive ratio (P < 0.001) and number of critical care medical centers per million population (P = 0.001). PCR-positive ratio was positively associated with COVID-19 mortality (aR-sqr = 0.522). Low PCR-positive ratio, especially ≤ 4%, was associated with low COVID-19 mortality. Critical care medical centers may also play an important role in reducing the risk of COVID-19 death. Keywords COVID-19 . SARS-CoV-2 . Mortality . Polymerase chain reaction
Introduction The coronavirus disease 2019 (COVID-19) pandemic resulted in 337,687 deaths around the world [1] and 830 deaths in Japan consisting of 47 prefectures, as of May 24, 2020 [2]. Marked differences in COVID-19 mortalities have been observed among 47 prefectures in Japan. For example, mortalities have exceeded 20 per million population in Ishikawa, Toyama, and Tokyo, compared to less than 1 per million population in 24 other prefectures. Moreover, huge disparities exist in medical and public heath capacities per capita across the 47 prefectures. We therefore explored associations This article is part of the Topical Collection on COVID-19 * Toru Hifumi [email protected] 1
Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
2
Division of Molecular Epidemiology, The Jikei University School of Medicine, 3-19-18, Nishi-shinbashi, Minato-ku, Tokyo 105-8471, Japan
between COVID-19 mortalities and medical and public health capacities (e.g., hospital beds per population) in individual prefectures as an ecological study.
Methods The following data by prefecture were abstracted from open resources provided by the Ministry of Health, Labour and Welfare in Japan as of May 24, 2020 [2, 3]: total number of COVID-19 deaths; polymerase chain reaction (PCR)-positive ratio (i.e., number of patients with PCR-positive results/ number of patients a
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