SARS-CoV-2 PCR-positive and PCR-negative cases of pneumonia admitted to the hospital during the peak of COVID-19 pandemic: analysis of in-hospital and post-hospital mortality.

BACKGROUND: During the spike of COVID-19 pandemic in Kazakhstan (June-2020), multiple SARS-CoV-2 PCR-test negative pneumonia cases with higher mortality were reported by media. We aimed to study the epidemiologic characteristics of hospitalized PCR-test positive and negative patients with analysis of in-hospital and post-hospital mortality. We also compare the respiratory disease characteristics between 2019 and 2020. METHODS: The study population consist of 17,691 (March-July-2020) and 4600 (March-July-2019) hospitalized patients with respiratory diseases (including COVID-19). The incidence rate, case-fatality rate and survival analysis for overall mortality (in-hospital and post-hospital) were assessed. RESULTS: The incidence and mortality rates for respiratory diseases were 4-fold and 11-fold higher in 2020 compared to 2019 (877.5 vs 228.2 and 11.2 vs 1.2 per 100,000 respectively). The PCR-positive cases (compared to PCR-negative) had 2-fold higher risk of overall mortality. We observed 24% higher risk of death in males compared to females and in older patients compared to younger ones. Patients residing in rural areas had 66% higher risk of death compared to city residents and being treated in a provisional hospital was associated with 1.9-fold increased mortality compared to those who were treated in infectious disease hospitals. CONCLUSION: This is the first study from the Central Asia and Eurasia regions, evaluating the mortality of SARS-CoV-2 PCR-positive and PCR-negative respiratory system diseases during the peak of COVID-19 pandemic. We describe a higher mortality rate for PCR-test positive cases compared to PCR-test negative cases, for males compared to females, for elder patients compared to younger ones and for patients living in rural areas compared to city residents.

[The Infectious Disease Subsidiary Hospital of Rijeka] / Bolnica­podruznica za zarazne bolesti u Rijeci

In the late 19th and early 20th centuries, a hospital for infectious diseases in the Zenikovic area was operating in Rijeka as a hospital - subsidiary of the City Hospital of St. Spirit. After purchasing the property of the naval captain Dionysius Jakovcic, the existing buildings were adapted, and several other buildings, necessary for the organization of an infectious hospital, were constructed in the early eighties of the 19th century. The terrain and buildings were divided into clean and unclean areas. The main building was adapted to the main facilities for treatment and accommodation, while the smaller building was used for economic purposes. Due to the increase of the capacity at the turn of the century, further adaptations were made, larger wooden barracks and other temporary facilities were also constructed. The terrain of the hospital was linked to two ambitious projects of the hospitals in Rijeka, which were created at the beginning of the 20th century but were not realized.The hospital operated until the twenties of the 20th century when this department together with the City Hospital was moved to the former Naval Academy complex, while the hospital area was given a new purpose in the interwar and postwar periods.