Retrospective study of comparison of clinical severity and outcome of hospitalised COVID-19 patients during the first and second waves of the pandemic in India.
BMJ Open
; 12(11): e062724, 2022 11 21.
Статья
в английский
| MEDLINE | ID: covidwho-2137739
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 OUTCOMEMEASURES:
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.ключевые слова
Полный текст:
Имеется в наличии
Коллекция:
Международные базы данных
база данных:
MEDLINE
Основная тема:
Influenza, Human
/
COVID-19
Тип исследования:
Наблюдательное исследование
/
Прогностическое исследование
Пределы темы:
Взрослые
/
Пожилые
/
Люди
/
Middle aged
Язык:
английский
Журнал:
BMJ Open
Год:
2022
Тип:
Статья
Аффилированная страна:
Bmjopen-2022-062724
Документы, близкие по теме
MEDLINE
...
LILACS
LIS