Comparative study between first and second wave of COVID-19 deaths in India - a single center study

Abstract

BackgroundThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is continuously evolving and many mutant variants of the virus are circulating in the world. Recurrent waves of COVID-19 have caused enormous mortality all over the world. It is of utmost importance for a health expert to understand the demographic and clinical attributes between the first and second waves of COVID-19 induced deaths.MethodThis was a hospital record based comparative study of baseline demographic, clinical and laboratory parameters of the first and second wave of COVID-19 in a tertiary care hospital in Uttarakhand, India. The study included all deceased patients admitted to the hospital during the first and second wave of COVID-19, i.e., between March 2020 to January 2021 and between March 2021 to June 2021, respectively.ResultThe study showed that there were more casualties in the second wave compared to the first, 475 (19.8%) and 424 (24.1%) respectively. There was no significant difference in terms of age. A male preponderance of mortality was evident in both the waves. The median duration of hospital stay was 5 (3-10) days in the second wave, which is significantly different from the corresponding duration in first wave (p<o.ooo). The most common clinical manifestation among the deceased were dyspnoea in both the waves, followed by fever and cough, the difference was statistically significant for cough (p< 0.000) The most prevalent comorbidity was diabetes mellitus (DM), followed by hypertension (HTN), with significant difference for HTN (p<0.003). The most frequently deranged lab parameter was lymphopenia with a significant difference across both the waves (p<0.000).ConclusionIn both the first and second COVID-19 waves, older males (>45 years) with comorbidities like HTN and DM were most susceptible for COVID-19 related mortality. The study also demonstrated that most of the baseline demographic and clinical characteristics which are attributed to the mortality were more common during the second wave of COVID-19.

Factors Affecting Outcome of Hospitalized Patients with COVID-19

“…Symptoms in the form of cough, sore throat, and loss of taste and smell were more common among deceased in second wave. The difference was statistically significant for cough (p< 0.000), sore throat (p<0.002), AMS (p< 0.002), headache (p< 0.025) and loss taste and smell (p< 0.001) among the two groups [22]. In the current study, there is a significant increased white blood cell count among COVID-19 patients of the second wave (p = 0.001), with about two-thirds (69.1%) of second wave patients showed white blood cell count > 8 (× 10⁹ per L) (p=0.001).…”

“…This was in accordance with the study by who showed that dyspnea was the most common presenting symptom among the patients in both the waves. Presence of associated comorbidities were associated with mortality in the two waves [22].…”

Clinical characteristics and laboratory profile of symptomatic COVID-19 patients from a tertiary Bangalore rural hospital: the lessons learnt

“…There was a significant difference in the course of the disease between SW and TW. 6 The reason for the clear differences across waves is not yet known, In SW, 62.5% percent required hospitalisation indicating the severity of the disease. The mortality was 16.8%.…”

Epidemiology of COVID‐19 mortality in Nepal: An analysis of the National Health Emergency Operation Center data

“…The COVID-19 pandemic has had an overwhelmingly greater impact on people's lives than the previous swine flu pandemic in 2009 [1]. No country has remained untouched by this pandemic, with multiple waves causing additional burden [2][3][4][5]. By the end of 2022, over 630 million confirmed cases and nearly 7 million deaths were recorded globally [4].…”