AI Article Synopsis
- This study compared the clinical severity and outcomes of hospitalized COVID-19 patients in India during the first wave (April-Dec 2020) and the second wave (April-May 2021).
- Results showed that the second wave had a significantly higher proportion of critical illness, increased need for oxygen and other treatments, and higher mortality rates (19.2% compared to 9.3%).
- Key factors associated with higher mortality included being over 60, having high D-dimer levels, requiring supplemental oxygen, and being hospitalized during the second wave.
Article Abstract
Objectives: To compare the clinical severity and outcome of hospitalised patients during the two waves of the COVID-19 pandemic in India.
Setting: A tertiary care referral hospital in South India.
Participants: Symptomatic SARS CoV-2 reverse transcriptase PCR positive patients presenting to the emergency department during the two waves were recruited. The first wave spanned between April and December 2020 and the second wave between April and May 2021.
Primary And Secondary Outcome Measures: The primary outcome of interest was mortality. Secondary outcomes included illness severity at presentation, need for oxygen therapy, non-invasive ventilation (NIV) and hospital or intensive care unit admission.
Results: The mean (SD) age of the 4971 hospitalised patients in the first wave was similar to the 2293 patients in the second wave (52.5±15.4 vs 52.1±15.1 years, p=0.37). When compared with the first wave, during the second wave, a higher proportion of patients presented with critical illness (11% vs 1.1%, p<0.001) and needed supplemental oxygen therapy (n=2092: 42.1% vs n=1459: 63.6%; p<0.001), NIV (n=643; 12.9% vs n=709; 30.9%; p<0.001) or inotropes/vasoactive drugs (n=108; 2.2% vs n=77: 3.4%; p=0.004). Mortality was higher during the second wave (19.2% vs 9.3%; p<0.001). On multivariable regression analysis, age >60 years (risk ratio, RR 2.80; 95% CI 2.12 to 3.70), D-dimer >1000 ng/mL (RR 1.34; 95% CI 1.15 to 1.55), treatment with supplemental oxygen (RR 14.6; 95% CI 8.98 to 23.6) and presentation during the second wave (RR 1.40; 95% CI 1.21 to 1.62) were independently associated with mortality.
Conclusion: The second wave of the COVID-19 pandemic in India appeared to be associated with more severe presentation and higher mortality when compared with the first wave. Increasing age, elevated D-dimer levels and treatment with supplemental oxygen were independent predictors of mortality.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9679869 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2022-062724 | DOI Listing |
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