This publication has been produced by Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, part of NHS National Services Scotland. ARHAI publications are not made available under terms of the OGL.

About this release

This release by Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, part of NHS National Services Scotland, provides data for COVID-19 hospital onset mortality in Scotland for the period 7 March 2020 to 31 March 2022.

Deaths occurring in patients with COVID-19 are an important measure of patient outcome. Therefore, monitoring mortality in hospital patients and publishing the data is critical to improve care of patients, inform the development of infection prevention and control measures, shape policy and guide research.

Main points

  • This report describes patients diagnosed in hospital with COVID-19 who die from all causes within 28 days.
  • Overall, nearly a fifth of patients diagnosed in hospital died within 28 days. Just over a fifth of patients with a probable or definite hospital onset died within 28 days.
  • The difference is due to differences in demographics. Probable or definite hospital onset COVID-19 cases were older. Older cases are likely to be sicker and have more underlying ill health.
  • There is no evidence that patients developing definite hospital onset COVID-19 are at an increased risk of death compared with other patients diagnosed with COVID-19 on day 1 or 2 of admission (non-hospital onset status).
  • Patients with probable hospital onset status had a small but significantly higher odds of death compared with other patients diagnosed with COVID-19 on day 1 or 2 of admission (non-hospital onset status). This is likely to be due to differences in the patient population which are unavailable to control for in this analysis.
  • Older patients in hospital have an increased risk of infection. This includes COVID-19. These patients are more likely to die from other causes. The causes can not be identified using all-cause mortality.
  • Preventing transmission of SARS-CoV-2 in all settings is critical to reducing morbidity and mortality from COVID-19. Infection prevention and control precautions and early detection and management of cases is vital in efforts to reduce the spread of SARS-CoV-2 in hospital settings.
Table 1: COVID-19 cases who died from all causes within 28 days by onset status in Scotland overall: specimen dates up to 31 March 20221,2,3
Hospital onset status Mortality within 28 days (n) Mortality within 28 days (%) Total cases
Non-hospital onset (day 1 or 2 of admission) 2,889 16.3% 17,771
Indeterminate hospital onset (days 3-7) 560 19.0% 2,942
Probable hospital onset (days 8-14) 770 24.0% 3,205
Definite hospital onset (days 15+) 1,675 21.6% 7,750
Total 5,894 18.6% 31,668

1. Source of data is Electronic Communication of Surveillance in Scotland (ECOSS) data, the Rapid Admission Preliminary Inpatient Data (RAPID) data or local admission data, and National Records of Scotland (NRS).
2. The data used has not been adjusted for potential factors that may affect mortality e.g. severity of COVID-19 disease and patient comorbidities.
3. Cases diagnosed in the community (not during an inpatient stay) were excluded from these analyses

Background

Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, part of National Services Scotland works closely with Public Health Scotland to deliver the COVID-19 response. Local and national monitoring in hospital settings is required to reduce COVID-19 infections.

Further information

Find out more in the full report and on the COVID-19 pages on the PHS website.  

Information on the epidemiology of COVID-19 in healthcare settings and COVID-19 hospital onset cases is also produced by ARHAI Scotland.

The next release of this publication will be subject to additional cases in the intervening period.

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Older versions of this publication

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence, Health Protection Scotland or Improving Health websites.

Last updated: 07 October 2022
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