Patient Characteristics and Clinical Course of COVID-19 Patients Treated at a German Tertiary Center during the First and Second Waves in the Year 2020

Abstract

In this study, we directly compared coronavirus disease 2019 (COVID-19) patients hospitalized during the first (27 February–28 July 2020) and second (29 July–31 December 2020) wave of the pandemic at a large tertiary center in northern Germany. Patients who presented during the first (n = 174) and second (n = 331) wave did not differ in age (median [IQR], 59 years [46, 71] vs. 58 years [42, 73]; p = 0.82) or age-adjusted Charlson Comorbidity Index (median [IQR], 2 [1, 4] vs. 2 [0, 4]; p = 0.50). During the second wave, a higher proportion of patients were treated as outpatients (11% [n = 20] vs. 20% [n = 67]), fewer patients were admitted to the intensive care unit (43% [n = 75] vs. 29% [n = 96]), and duration of hospitalization was significantly shorter (median days [IQR], 14 [8, 34] vs. 11 [5, 19]; p < 0.001). However, in-hospital mortality was high throughout the pandemic and did not differ between the two periods (16% [n = 27] vs. 16% [n = 54]; p = 0.89). While novel treatment strategies and increased knowledge about the clinical management of COVID-19 may have resulted in a less severe disease course in some patients, in-hospital mortality remained unaltered at a high level. These findings highlight the unabated need for efforts to hamper severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) transmission, to increase vaccination coverage, and to develop novel treatment strategies to prevent mortality and decrease morbidity.

High Mortality of COVID-19 Early after Allogeneic Stem Cell Transplantation: A Retrospective Multicenter Analysis on Behalf of the German Cooperative Transplant Study Group

“…A similar observation was made in a large study of patients with hematological malignancies on behalf of the European Hematology Association (EHA), with a significantly decreased mortality rate between the first (March–May 2020) and the second COVID-19 wave (October–December 2020, 40.7 % vs. 24.8 %) 16 . In contrast, several studies on hospitalized COVID-19 patients show diverging results with both equal, lower and increased in-hospital mortality in the later phases of the pandemic 38 , 39 , 40 . Comparing treatment modalities is hindered by the variety of treatments used, but only 6.1 % of patients in our cohort received specific monoclonal antibodies that were not available in the first phases.…”

Critically ill COVID-19 patients in northeast Brazil: mortality predictors during the first and second waves including SAPS 3

“…In some countries the patients in the second wave were younger than in the first wave, 11 , 12 while other countries did not disclose important differences. 13 …”

“… 14 , 15 Although some studies have reported a higher occurrence of comorbidities in the first wave, 16 recent studies have not reported differences in the prevalence of comorbidities between the two waves. 12 , 13 It is important to note that vaccination in Brazil started in January 2021, with the elderly and patients with comorbidities as a priority, which is probably one of the factors that would explain the change in the age group observed in the second wave and, consequently, a lower prevalence of comorbidities.…”

Patients Admitted for Variant Alpha COVID-19 Have Poorer Outcomes than Those Infected with the Old Strain

“…Among these, the variant alpha (20I/501Y.V1) became rapidly prevalent across Europe in early 2021 [5][6][7] and is now the dominant strain in France, accounting for over 90% of current infections in the Southeastern region of the country [8]. While the clinical presentation of the old strain has been widely described [1][2][3]9], little is known of the clinical characteristics and outcomes of patients infected by the variant alpha. While Challen et al found higher risks of mortality, Frampton et al confirmed the increased transmissibility but not the severity [10,11].…”