COVID-19, a tale of two peaks: patients’ characteristics, treatments, and clinical outcomes

Autor: Orly Sapir, Amir Gal-Oz, Yoav Granot, Aviram Hochstadt, Eihab Ghantous, Ariel Borohovitz, Lior Lupu, Yishay Szekely, Ilan Merdler, Yaron Arbel, Nadav Furie, Merav Ingbir, Shmuel Banai, Philippe Taieb, Yael Lichter, Ariel Banai, Yan Topilsky
Rok vydání: 2021
Předmět:
Adult
Male
medicine.medical_specialty
Convalescent plasma
Coronavirus disease 2019 (COVID-19)
Hospitalized patients
medicine.medical_treatment
Patient characteristics
030204 cardiovascular system & hematology
Antiviral Agents
03 medical and health sciences
chemistry.chemical_compound
Mechanical ventilation
Age Distribution
0302 clinical medicine
Tocilizumab
Internal medicine
Internal Medicine
medicine
Humans
030212 general & internal medicine
Mortality
Sex Distribution
COVID-19 Serotherapy
Dexamethasone
Aged
Retrospective Studies
Alanine
business.industry
Treatments
Immunization
Passive
COVID-19
Middle Aged
Respiration
Artificial
Adenosine Monophosphate
Im - Original
COVID-19 Drug Treatment
Hospitalization
chemistry
Baseline characteristics
Disease Progression
Emergency Medicine
Female
business
medicine.drug
Zdroj: Internal and Emergency Medicine
ISSN: 1970-9366
1828-0447
DOI: 10.1007/s11739-021-02711-1
Popis: Coronavirus 2019 disease (COVID-19) continues to challenge healthcare systems globally as many countries are currently experiencing an increase in the morbidity and mortality. Compare baseline characteristics, clinical presentation, treatments, and clinical outcomes of patients admitted during the second peak to those admitted during the first peak. Retrospective analysis of 258 COVID-19 patients consecutively admitted to the Tel Aviv Medical Center, of which, 131 during the first peak (March 21–May 30, 2020) and 127 during the second peak (May 31–July 16, 2020). First and second peak patients did not differ in baseline characteristics and clinical presentation at admission. Treatment with dexamethasone, full-dose anticoagulation, tocilizumab, remdesivir, and convalescent plasma transfusion were significantly more frequent during the second peak, as well as regimens combining 3–4 COVID-19-directed drugs. Compared to the first peak, 30-day mortality and invasive mechanical ventilation rates as well as adjusted risk were significantly lower during the second peak (10.2%, vs 19.8% vs p = 0.028, adjusted HR 0.39, 95% CI 0.19–0.79, p = 0.009 and 8.8% vs 19.3%, p = 0.002, adjusted HR 0.29, 95% CI 0.13–0.64, p = 0.002; respectively). Rates of 30-day mortality and invasive mechanical ventilation, as well as adjusted risks, were lower in the second peak of the COVID-19 pandemic among hospitalized patients. The change in treatment strategy and the experienced gained during the first peak may have contributed to the improved outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s11739-021-02711-1.
Databáze: OpenAIRE
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