Wave comparisons of clinical characteristics and outcomes of COVID-19 admissions - Exploring the impact of treatment and strain dynamics
| Autor: | Robert Livingstone, Hannah Burke, André Freitas, Michael Celinski, Hang Phan, Florina Borca, Paul A. Fitzpatrick, Oskar Wysocki, Anna Freeman, Paul O'Regan, Ahilanadan Dushianthan, Donal Landers, James Batchelor, Tom Wilkinson, Alastair Watson |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
COVID-19 variants Coronavirus disease 2019 (COVID-19) Psychological intervention Article Dexamethasone law.invention Odds law Virology Internal medicine medicine Humans Hospital patients Hospitals Teaching COVID-19 waves Manchester Cancer Research Centre business.industry SARS-CoV-2 ResearchInstitutes_Networks_Beacons/mcrc COVID-19 Retrospective cohort study Intensive care unit United Kingdom COVID-19 Drug Treatment Hospitalization Intensive Care Units Infectious Diseases Cohort business medicine.drug |
| Zdroj: | Freeman, A, Watson, A, O'Regan, P, Wysocki, O, Burke, H, Freitas, A, Livingstone, R, Dushianthan, A, Celinski, M, Batchelor, J, Phan, H, Borca, F, Fitzpatrick, P, Landers, D & Wilkinson, T MA 2022, ' Wave comparisons of clinical characteristics and outcomes of COVID-19 admissions-Exploring the impact of treatment and strain dynamics ', Journal of Clinical Virology, vol. 146, 105031 . https://doi.org/10.1016/j.jcv.2021.105031 Journal of Clinical Virology |
| Popis: | OBJECTIVES: Dexamethasone has now been incorporated into the standard of care for COVID-19 hospital patients. However, larger intensive care unit studies have failed to show discernible improvements in mortality in the recent wave. We aimed to investigate the impacts of these factors on disease outcomes in a UK hospital study.METHODS: This retrospective observational study reports patient characteristics, interventions and outcomes in COVID-19 patients from a UK teaching hospital; cohort 1, pre 16th June-2020 (pre-dexamethasone); cohort 2, 17th June to 30th November-2020 (post-dexamethasone, pre-VOC 202,012/01 as dominant strain); cohort 3, 1st December-2020 to 3rd March-2021 (during establishment of VOC202012/01 as the dominant strain).RESULTS: Dexamethasone treatment was more common in cohorts 2 and 3 (42.7% and 51.6%) compared with cohort 1 (2.5%). After adjusting for risk, odds of death within 28 days were 2-fold lower in cohort 2 vs 1 (OR:0.47,[0.27,0.79],p = 0.006). Mortality was higher cohort 3 vs 2 (20% vs 14%); but not significantly different to cohort 1 (OR: 0.86,[0.64, 1.15],p = 0.308).CONCLUSIONS: The real world finding of lower mortality following dexamethasone supports the published trial evidence and highlights ongoing need for research with introduction of new treatments and ongoing concern over new COVID-19 variants. |
| Databáze: | OpenAIRE |
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