Objective To determine the incidence of hospital admissions and associated mortality rates for non-covid medical conditions during the covid-19 pandemic. Design Nationwide, population based cohort study. Setting Denmark from 13 March 2019 to 27 January 2021. Participants All Danish residents >1 year of age. Main outcomes measures Population based healthcare registries that encompass the entire Danish population were used to compare hospital admission and mortality rates during the covid-19 pandemic (from 11 March 2020 to 27 January 2021) with the prepandemic baseline data (from 13 March 2019 to 10 March 2020). Hospital admissions were categorised as covid-19 when patients were assigned a diagnosis code for covid-19 within five days of admission. All patients were followed until migration, death, or end of follow-up, whichever came first. Rate ratios for hospital admissions were computed using Poisson regression and were directly standardised using the Danish population on 1 January 2019 as reference. 30 day mortality rate ratios were examined by Cox regression, adjusted for age and sex, and covid-19 diagnosis was used as a competing risk. Results 5 753 179 residents were identified during 567.8 million person weeks of observation, with 1 113 705 hospital admissions among 675 447 people. Compared with the prepandemic baseline period (mean hospital admission rate 204.1 per 100 000/week), the overall hospital admission rate for non-covid-19 conditions decreased to 142.8 per 100 000/week (rate ratio 0.70, 95% confidence interval 0.66 to 0.74) after the first national lockdown, followed by a gradual return to baseline levels until the second national lockdown when it decreased to 158.3 per 100 000/week (0.78, 0.73 to 0.82). This pattern was mirrored for most major diagnosis groups except for non-covid-19 respiratory diseases, nervous system diseases, cancer, heart failure, sepsis, and non-covid-19 respiratory infections, which remained lower throughout the study period. Overall 30 day mortality rates were higher during the first national lockdown (mortality rate ratio 1.28, 95% confidence interval 1.23 to 1.32) and the second national lockdown (1.20, 1.16 to 1.24), and these results were similar across most major diagnosis groups. For non-covid-19 respiratory diseases, cancer, pneumonia, and sepsis, the 30 day mortality rate ratios were also higher between lockdown periods. Conclusions Hospital admissions for all major non-covid-19 disease groups decreased during national lockdowns compared with the prepandemic baseline period. Additionally, mortality rates were higher overall and for patients admitted to hospital with conditions such as respiratory diseases, cancer, pneumonia, and sepsis. Increased attention towards management of serious non-covid-19 medical conditions is warranted.

中文翻译：

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丹麦发生Covid-19大流行期间非共生疾病的医院住院率和死亡率：基于全国人群的队列研究

目的确定covid-19大流行期间非covid医疗条件下的入院率和相关死亡率。在全国范围内进行基于人群的队列研究。从2019年3月13日至2021年1月27日在丹麦定居。参与者所有1岁以上的丹麦居民。主要结果衡量指标涵盖了整个丹麦人口的人群医疗保健登记处，用于比较covid-19大流行期间（从2020年3月11日至2021年1月27日）的住院率和死亡率与大流行前的基线数据（从2019年3月13日至10日）进行比较2020年3月）。当在入院后五天内为患者分配了针对covid-19的诊断代码时，医院入院分类为covid-19。随访所有患者，直至迁移，死亡或随访结束，以先到者为准。使用Poisson回归计算住院率，并使用2019年1月1日的丹麦人口直接标准化。通过Cox回归检查30天死亡率，并根据年龄和性别进行调整，并将covid-19诊断用作竞争风险。结果在5.678亿人的观察周内，确定了5 753 179名居民，其中675 447人中有1 113 705名住院病人。与大流行前基线期相比（平均住院率204.1 / 100 000 /周），非covid-19病情的整体住院率降低至142.8 / 100 000 / week（比率0.70，95％置信区间0.66至60.1）。 0.74）第一次国家锁定后，逐步恢复到基准水平，直到第二次国家锁定降至158。每10万/周3（0.78，0.73至0.82）。除非covid-19呼吸系统疾病，神经系统疾病，癌症，心力衰竭，败血症和非covid-19呼吸系统感染外，该模式在大多数主要诊断组中均得到反映，在整个研究期间，该比例仍然较低。在第一次全国禁闭期间（死亡率比为1.28，95％置信区间为1.23至1.32）和第二次全国禁闭（1.20、1.16至1.24），总体30天死亡率较高。在大多数主要诊断组中，这些结果相似。对于非covid-19呼吸系统疾病，癌症，肺炎和败血症，在禁闭期之间30天的死亡率也较高。结论与大流行前基线时期相比，全国禁闭期间所有主要的非covid-19主要疾病组的住院人数均下降。此外，总体死亡率较高，对于因呼吸系统疾病，癌症，肺炎和败血症而入院的患者，死亡率更高。有必要对严重的非covid-19严重医疗状况的管理给予更多关注。