National Center for Global Health and Medicine

• Oral Steroid Pulse Therapy for Polymyalgia Rheumatica
• The potential and challenges of TREM2-targeted therapy in Alzheimer's disease: insights from the INVOKE-2 study
• Decoding Alzheimer's Disease: Single-Cell Sequencing Uncovers Brain Cell Heterogeneity and Pathogenesis
• Deep cervical lymphaticovenous anastomosis in Alzheimer's disease: A promising frontier or premature enthusiasm?
• Expression of SARS-CoV-2 spike protein in cerebral Arteries: Implications for hemorrhagic stroke Post-mRNA vaccination
• Difference in clinical courses and causes of COVID-19-related deaths in hospitalized patients infected with omicron and delta variants: A retrospective study in Japan
• Serum proteomics reveals early biomarkers of Alzheimer's disease: The dual role of APOE-ε4
• A Unique Case of MBD5 and CCM2 Deletions Leading to a Severe Neurological Phenotype With Prolonged Status Epilepticus

https://www.hosp.ncgm.go.jp/en/index.html

National Center for Global Health and Medicine in Tokyo

Tetsuo Hara

Atsushi Fukui

Sakurai et al. conducted a retrospective observational study on patients with COVID-19 admitted to the National Center for Global Health and Medicine who subsequently died during the delta (July-September 2021) and omicron variant outbreaks (December 2021-August 2022). Among the 20 patients who died during the delta variant epidemic, the main causes of death were pneumonia (n = 16, 80%), preadmission complications (n = 3, 15%), and complications occurring during hospitalization (n = 1, 5%). However, during the omicron variant epidemic, 7/24 patients (29%) died of pneumonia, 11 (46%) died of complications before admission, and 6 (25%) died of complications during admission. During the omicron variant outbreak, two-thirds of the COVID-19 deaths during hospitalization were not primarily caused by pneumonia, unlike the delta variant outbreak, during which pneumonia had a greater impact on mortality. As patient demographics and clinical pictures change, the establishment of medical infrastructure for patients with life-threatening comorbidities and careful monitoring of acute COVID-related complications are essential ¹⁾

Sakurai et al.'s study contributes important preliminary observations about the evolving nature of COVID-19 mortality. However, its limited sample size, single-center design, and lack of detailed covariate adjustment restrict the strength of its conclusions. The key takeaway—that pneumonia is no longer the dominant cause of COVID-related death in the Omicron era—serves as a vital reminder for clinicians and policymakers to adapt strategies to the changing clinical landscape of the pandemic.