Increase in pneumonia deaths in 2020 linked to Covid-19

Report shows fewer people admitted to acute hospitals in 2020 than previous year

Covid-19 has been linked to an increase in hospital deaths from respiratory illnesses during 2020 despite a decline in the overall number of cases treated in Irish hospitals during the first year of the pandemic.

Data published on Wednesday shows a significant increase in pneumonia deaths from 103 per 1,000 admissions in 2019 to 131 in 2020.

“This rise can be directly attributed to Covid-19,” according to the sixth National Audit of Hospital Mortality (NAHM) report.

Hospital Report

Analysis showed that in 2020 Covid-19 had either been laboratory confirmed or clinically diagnosed in some 19.4 per cent of pneumonia cases.

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The data is compiled by the National Office of Clinical Audit (NOCA) and presents numbers in “crude mortality” terms, or the number of deaths per 1,000 hospital admissions. By comparison, crude pneumonia death rates between 2011 and 2020 rose from 127 to 131 per 1,000 admissions.

NAHM clinical lead Bridget Egan noted it was "reassuring that there have been no hospitals with mortality outcomes outside of expected ranges in the 2020 data, despite the numbers of cases with Covid-19 in hospitals".

Attendance reluctance

Overall, there was a reduction in the number of cases admitted for in-hospital treatment in acute hospitals in 2020 compared with 2019, a decline that was anecdotally linked to people’s reluctance to go into hospital because of the threat posed by Covid-19.

The report, which analysed 30 public hospitals, examines mortality rates for six medical conditions including heart attacks, heart failure, stroke, chronic obstructive pulmonary disease and pneumonia.

Heart failure deaths in hospitals decreased significantly, by 22 per cent, between 2011 and 2020 from 81 per 1,000 admissions to 63. Ischaemic stroke deaths fell by 42 per cent, from 123 to 71 in the same period.

Haemorrhagic stroke deaths were down by 21 per cent, from 355 to 280 per 1,000 admissions. Acute myocardial infarction, or heart attack deaths, also declined steadily. Deaths from chronic obstructive pulmonary disease (COPD) were largely steady at 38 per 1,000 admissions.

Curbs lifted

A further 4,160 PCR-confirmed cases of Covid-19 were reported in the State on Tuesday in addition to the 4,655 positive antigen tests registered through the Health Service Executive’s online system. There were 635 patients with the disease in hospital on Tuesday morning, down 30 in 24 hours, including 63 in intensive care (down four).

Meanwhile, Stormont’s chief scientific adviser has said the lifting of legal Covid-19 restrictions in Northern Ireland on Tuesday evening should not be viewed as “freedom day”.

Prof Ian Young urged people to continue to wear face masks in certain public settings, even though it will no longer be expected under law.

Hospitality business owners hailed the easing of regulations as the “beginning of the end” of the pandemic and expressed hope that trade would return to normal. Covid-19 certificates are no longer needed to gain entry to nightclubs and large unseated indoor events following the changes.

The deaths of four more people who had Covid-19 were reported in the North on Tuesday, as well as 2,987 cases. There were 476 Covid-19 patients in Northern Irish hospitals, including 12 in intensive care. – Additional reporting: PA

Mark Hilliard

Mark Hilliard

Mark Hilliard is a reporter with The Irish Times