Variation in Clinical Characteristics, Outcomes, and Mortality of Hospitalized Patients with COVID-19 during the Second Wave of the Pandemic: A Single-Center Experience

Abstract

As of February 2, 2021, the USA has 26,431,799 reported COVID-19 cases with 446,744 deaths. A high mortality rate (15%–40%) was reported among hospitalized patients with COVID-19 during the first wave of the pandemic. However, data regarding variation in COVID-19-related mortality and severity of illness among hospitalized patients with COVID-19 are heterogeneous. In this retrospective single-center study, we aimed to investigate the demographic characteristics, clinical presentations, disease severity, clinical outcomes, and in-hospital mortality of hospitalized patients with COVID-19 during the second wave of the pandemic. Adults with reverse transcription-PCR-confirmed SARS-CoV-2 infection were included. In-hospital mortality due to COVID-19 was the primary outcome, and intensive care unit admission, acute kidney injury, acute respiratory distress syndrome, respiratory failure requiring intubation, and septic shock were the secondary outcomes. A total of 101 adult patients were hospitalized with COVID-19 during the second wave study period. Of 101 patients, 8 were intubated and 6 died. The median duration of hospital stay was 6 days. Patients in the second wave were more likely to receive dexamethasone and remdesivir and less likely to require invasive mechanical ventilation. In-hospital mortality during the second wave was lower (5.9%) compared with the first wave (15.5%). At the last follow-up date, 86.1% were discharged alive from the hospital, 5.9% died and 7.9% were still in the hospital. Multivariate logistic regression showed higher odds of mortality were associated with higher age and elevated lactate dehydrogenase peak.

COVID-19-associated AKI

“…This may be due to improved treatment of COVID-19 or increased recognition of less severe AKI in COVID-19. However, these findings are not universal [ 36 ] and further longitudinal studies or meta-analyses are necessary to validate these findings.…”

Different clinical characteristics and outcomes of adult hospitalized SARS-CoV-2 pneumonia patients complicated by cardiovascular events during the first, delta and omicron waves of COVID-19

“…Another large study from Turkey compared CRP levels of hospitalized COVID-19 patients with severe or critical disease in the first and second waves, finding significantly higher CRP levels in the second wave ( 31 ). Literature shows that cardiac inflammation and microvascular procoagulant changes were lower in the delta wave than the first wave ( 32 ). In omicron myocardial injury cases, WBC, CRP, LDH and ferritin were found to be significantly lower than the first and delta waves ( 27 ).…”

Differences in Ventilation Management and Outcomes between the Two First Waves of the COVID-19 Pandemic—A Comparison between Two Nationwide Observational Studies in The Netherlands

“…Due to changing hospital and ICU admission policies, modifications in national and international guidelines that involved the introduction or abundance of certain therapies, the care and outcomes of critically ill COVID-19 patients may have changed over successive outbreaks. Indeed, reports from countries worldwide suggest variances in care and trends towards a shorter length of hospital stay and even lower mortality rates in consecutive waves [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. To date, few reports have described changes in care and outcomes in invasively ventilated COVID-19 patients within a single center, region, or country.…”