Comparison of demographic and clinical characteristics of hospitalized COVID‐19 patients with severe/critical illness in the first wave versus the second wave

Abstract

Due to current advances and growing experience in the management of coronavirus Disease 2019 , the outcome of COVID-19 patients with severe/critical illness would be expected to be better in the second wave compared with the first wave. As our hospitalization criteria changed in the second wave, we aimed to investigate whether a favorable outcome occurred in hospitalized COVID-19 patients with only severe/critical illness. Among 642 laboratory-confirmed hospitalized COVID-19 patients in the first wave and 1121 in the second wave, those who met World Health Organization (WHO) definitions for severe or critical illness on admission or during follow-up were surveyed. Data on demographics, comorbidities, C-reactive protein (CRP) levels on admission, and outcomes were obtained from an electronic hospital database. Univariate analysis was performed to compare the characteristics of patients in the first and second waves. There were 228 (35.5%) patients with severe/critical illness in the first wave and 681 (60.7%) in the second wave. Both groups were similar in terms of age, gender, and comorbidities, other than chronic kidney disease. Median serum CRP levels were significantly higher in patients in the second wave compared with those in the first wave [109 mg/L (interquartile range [IQR]: 65-157) vs. 87 mg/L (IQR: 39-140); p < 0.001]. However, intensive care unit admission and mortality rates were similar among the waves.Even though a lower mortality rate in the second wave has been reported in previous studies, including all hospitalized COVID-19 patients, we found similar demographics and outcomes among hospitalized COVID-19 patients with severe/ critical illness in the first and second wave.

Associations of vaccine status with characteristics and outcomes of hospitalized severe COVID-19 patients in the booster era

“…Among the non-vaccinated patients in our study, main baseline characteristics were in accordance with studies from previous COVID-19 waves [ 12 , 29 – 32 ]. Hospitalized vaccinated patients were older, predominantly males and had more comorbidities.…”

“…It is possible that because of their baseline characteristics, vaccinated patients had higher likelihood of comorbidity-related complications secondary to COVID-19 and were less reluctant to arrive to the hospital. The general mean hospital duration was 8 days, which is shorter than several previous cohorts (10–13 days) [ 11 , 32 , 33 ]. Only severe patients were included in our cohort, further highlighting the gap in hospital duration from previous studies.…”

“…Severe COVID-19 disease has high rates of adverse outcomes. Over 15% of hospitalized COVID-19 patients need intubation and 20% die [ 30 , 32 , 35 , 36 ]. Our study showed similar findings regarding intubation and death.…”

Prevalence and Impact of Preexisting Comorbidities on Overall Clinical Outcomes of Hospitalized COVID-19 Patients

“…This variation in outcomes over time could be attributed to the emergence of new variants/mutants of the virus, improvement in overall understanding of the disease management such as evolving therapeutic regimes, preparedness in healthcare settings, and most importantly, the implementation of mass vaccination drives. Our observations are consistent with other studies that reported both similarities [ 24 ] and variations [ 21 ] in their data over a period of time. All the above observations are presented in Supplementary Tables 1 - 4 .…”

Kidney Dysfunction and Its Progression in Patients Hospitalized Duo to COVID-19: Contribution to the Clinical Course and Outcomes

“…The period of the patients’ inclusion in the study was long, covering both the first and second wave of the pandemic disease. This might have affected the demographic and clinical characteristics of patients admitted to the hospital, and the choice of treatment, adequately to the changing knowledge about the specific course of COVID-19, and finally the mortality rate [ 54 ]. On the other hand, the study covered a large group of patients, analyzing not only in-hospital mortality, but also deaths within 90 and 180 days from admission to hospital, which may increase the strength of the obtained results.…”