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

Autor: Abhilash Paul Prabhakar Kundavaram, Saravanan Selvan, Vivek Raja, Ponnivalavan Mathiyalagan, Rohini Kanagarajan, Narmadha P Reddy, Natarajan Rajendiran, Darpanarayan Hazra, Karthik Gunasekaran, Mahesh Moorthy, Audrin Lenin, Divya Mathew, Ramya Iyyadurai, George M Varghese, Christopher DJ, Melvin Joy, John Victor Peter
Rok vydání: 2022
Předmět:
Zdroj: BMJ Open. 12:e062724
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2022-062724
Popis: ObjectivesTo compare the clinical severity and outcome of hospitalised patients during the two waves of the COVID-19 pandemic in India.SettingA tertiary care referral hospital in South India.ParticipantsSymptomatic 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 measuresThe 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.ResultsThe 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%, p60 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.ConclusionThe 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.
Databáze: OpenAIRE