COVID-19 clinical phenotypes and short-term outcomes: differences between the first and the second wave of pandemic in Italy

Portacci, Andrea; Carpagnano, Giovanna Elisiana; Tummolo, Maria Grazia; Santomasi, Carla; Palma, Lavinia; Fasano, Domenico Claudio; Resta, Emanuela; Lozupone, Madia; Solfrizzi, Vincenzo; Resta, Onofrio

doi:10.1080/17476348.2021.1960824

Cited by 13 publications

(18 citation statements)

References 30 publications

(30 reference statements)

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“…During the second wave, patients were younger, with fewer concomitant chronic conditions and a milder clinical presentation. Short-term clinical outcomes were better, with lower mortality rates and more transfers to a general ward [ 58 ].…”

Section: Resultsmentioning

confidence: 99%

Narrative Review of the COVID-19 Pandemic’s First Two Years in Italy

Beccia

Pilla

Causio

et al. 2022

IJERPH

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Italy was the first country in the western world to be affected by the COVID-19 pandemic, arguably among the worst-affected ones, counting 12 million cases and 150 thousand deaths two years since the first case. Facing new challenges, Italy has enacted different strategies and policies to limit the spread of the SARS-CoV-2 virus and treat those affected by COVID-19. This narrative review provided an overview of factors, measures, and actions that shaped Italy’s first two years of the COVID-19 pandemic by investigating epidemiological data and using a mixed-method approach. This narrative review aimed to summarize the most relevant aspects and measures and analyze available data to provide policymakers and healthcare providers with the instruments to learn from this pandemic and improve their preparedness for future pandemic events. The first two years of the pandemic differ in that, during the first year, significant necessary changes to the way health systems were organized were implemented, increasing healthcare spending and adopting social and physical distancing measures that were stricter than the ones adopted in the second year. However, as the pandemic progressed, increased knowledge of the virus and related variants, as well as the introduction of highly effective vaccines, which were not equally available to the whole population, resulted in a stratification of COVID-19 infections and deaths based on factors such as age, vaccination status, and individual susceptibility to the virus.

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Section: Resultsmentioning

confidence: 99%

Narrative Review of the COVID-19 Pandemic’s First Two Years in Italy

Beccia

Pilla

Causio

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…In different countries, a shift has been reported among patients infected with SARS-CoV-2 towards those younger and with fewer comorbidities, with a lower proportion of patients requiring oxygen therapy, a shorter length of hospital stay and lower mortality risk as the pandemic evolved. Most of these studies, however, include case-mixes from medical wards and critical care units, where the range of fatality rates was considerably different and thereby potential selection biases could have been present [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Patients with Acute Respiratory Failure Due to SARS-CoV-2 Interstitial Pneumonia Treated with CPAP in a Medical Intermediate Care Setting: A Retrospective Observational Study on Comparison of Four Waves

Accordino

Canetta

Bettini

et al. 2023

JCM

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Background: In COVID-19 patients non-invasive-positive-pressure-ventilation (NIPPV) has held a challenging role to reduce mortality and the need for invasive mechanical ventilation (IMV). The aim of this study was to compare the characteristics of patients admitted to a Medical Intermediate Care Unit for acute respiratory failure due to SARS-CoV-2 pneumonia throughout four pandemic waves. Methods: The clinical data of 300 COVID-19 patients treated with continuous positive airway pressure (CPAP) were retrospectively analysed, from March-2020 to April-2022. Results: Non-survivors were older and more comorbid, whereas patients transferred to ICU were younger and had fewer pathologies. Patients were older (from 65 (29–91) years in I wave to 77 (32–94) in IV, p < 0.001) and with more comorbidities (from Charlson’s Comorbidity Index = 3 (0–12) in I to 6 (1–12) in IV, p < 0.001). No statistical difference was found for in-hospital mortality (33.0%, 35.8%, 29.6% and 45.9% in I, II, III and IV, p = 0.216), although ICU-transfers rate decreased from 22.0% to 1.4%. Conclusions: COVID-19 patients have become progressively older and with more comorbidities even in critical care area; from risk class analyses by age and comorbidity burden, in-hospital mortality rates remain high and are thus consistent over four waves while ICU-transfers have significantly reduced. Epidemiological changes need to be considered to improve the appropriateness of care.

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“…An Italian study reported that patients in the first wave were more frequently affected by multiple chronic diseases [ 8 ]. We reported that in Tabasco, Mexico, patients admitted in the third wave had a higher number of comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, it has been suggested that the phenotypic difference in hospitalized patients are related to the variants associated with different stages (or waves) of the COVID-19 pandemic [ 8 ]. A difference in behavior between pandemic waves has recently been reported, where the third wave reported in Spain involved less use of mechanical ventilation and, as a consequence, lower incidence of nosocomial infections, complications, length of stay in the ICU, and mortality [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Virological Features of SARS-CoV-2 Variants during the Four Waves of the Pandemic in the Mexican Southeast

et al. 2023

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We conducted a retrospective study using a population of patients who were hospitalized at Dr. Juan Graham Casasus Hospital in Villahermosa (Tabasco, Mexico) and had a positive RT-PCR test for SARS-CoV-2 between June 2020 and January 2022. We analyzed all medical records, including demographic data, SARS-CoV-2 exposure history, underlying comorbidities, symptoms, signs at admission, laboratory findings during the hospital stay, outcome, and whole-genome sequencing data. Finally, the data were analyzed in different sub-groups according to distribution during waves of the COVID-19 pandemic regarding Mexican reports from June 2020 to January 2022. Of the 200 patients who tested positive via PCR for SARS-CoV-2, only 197 had samples that could be sequenced. Of the samples, 58.9% (n = 116) were males and 41.1% (n = 81) females, with a median age of 61.7 ± 17.0 years. Comparisons between the waves of the pandemic revealed there were significant differences in the fourth wave: the age of patients was higher (p = 0.002); comorbidities such as obesity were lower (p = 0.000), while CKD was higher (p = 0.011); and hospital stays were shorter (p = 0.003). The SARS-CoV-2 sequences revealed the presence of 11 clades in the study population. Overall, we found that adult patients admitted to a third-level Mexican hospital had a wide range of clinical presentations. The current study provides evidence for the simultaneous circulation of SARS-CoV-2 variants during the four pandemic waves.

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COVID-19 clinical phenotypes and short-term outcomes: differences between the first and the second wave of pandemic in Italy

Cited by 13 publications

References 30 publications

Narrative Review of the COVID-19 Pandemic’s First Two Years in Italy

Narrative Review of the COVID-19 Pandemic’s First Two Years in Italy

Clinical Characteristics and Outcomes of Patients with Acute Respiratory Failure Due to SARS-CoV-2 Interstitial Pneumonia Treated with CPAP in a Medical Intermediate Care Setting: A Retrospective Observational Study on Comparison of Four Waves

Clinical and Virological Features of SARS-CoV-2 Variants during the Four Waves of the Pandemic in the Mexican Southeast

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