Comparison of SARS-CoV-2 related in-hospital mortality, ICU admission and mechanical ventilation of 1.4 million patients in Germany and Switzerland, 2019 to 2022.

Abstract

In the 2020 emergence of SARS-CoV-2, global response lacked unified treatment and surveillance, resulting in diverse impacts due to varied healthcare resources and national guidelines. Germany and Switzerland curbed the virusinitially by promptly tracking and testing, bolstered by strong governmental capacity. This study aimed to assess country-specific healthcare disparities and their impact on ICU admission rates, mechanical ventilation, and in-hospital mortality. To enhance healthcare quality using real-world data, the "Initiative of Quality Medicine" (IQM) was established. Pseudonymised routine data from participating hospitals, during 01/01/2019-31/12/2022, was retrospectively analysed, focusing on patients with SARI ± SARS-CoV-2-infection (U07.1). Cohorts were matched based on various factors and multivariable analyses included logistic regression. 1.421.922 cases of SARI ± U07.1 involving 386 German and 41 Swiss hospitals were included. Patients in Germany were older (mean: 69.4 vs. 66.5years) and had more comorbidities than in Switzerland (p < .001). Patients in Germany were also more likely to be treated on ICU (28% vs. 20%, OR 1.5 95% CI 1.5-1.6, p < .001) and mechanically ventilated (20% vs. 15%, OR 1.4, 95% CI 1.4-1.5, p < .001). The in-hospital mortality was significantly higher in Germany than in Switzerland (21% vs. 12%, OR 2.0, 95% CI 1.9-2.0, p < .001). Matched cohorts showed reduced differences, but Germany still exhibited higher in-hospital mortality. Discrepancies were evident in both pre-pandemic and pandemic analyses, highlighting existing disparities between both countries. IQM data from Swiss and German hospitals reveals country-specific differences in SARI ± U07.1 outcomes, highlighting higher in-hospital mortality in Germany, with uncertain causes suggesting varied treatments and resources.