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Evolution of hospitalized patient characteristics through the first three COVID-19 waves in Paris area using machine

Camille Jung1, Jean-Baptiste Excoffier2, Mathilde Raphaël-Rousseau3

  • 1Clinical Research Center, CHI Créteil, Créteil, France.

Plos One
|February 22, 2022
PubMed

Insights

Patient profiles for severe COVID-19 evolved across waves, with risk factors like age and comorbidities becoming less influential in later stages. This shift reflects changes in hospital practices and early vaccination efforts.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Severe COVID-19 patient characteristics are known, but their evolution across pandemic waves remains understudied.
  • Understanding these changes is crucial for adapting healthcare strategies during evolving outbreaks.

Purpose of the Study:

  • To analyze the evolution of patient characteristics associated with severe coronavirus disease 2019 (COVID-19) through the first three waves in France.
  • To identify changes in risk factors and patient demographics for severe COVID-19 over time.

Main Methods:

  • Retrospective analysis of a prospectively maintained database from a Paris University Hospital.
  • Inclusion of 1076 hospitalized patients across three COVID-19 waves.
  • Multivariate logistic regression and machine learning with explainability methods to analyze patient characteristics and risk factors.

Main Results:

  • Severe COVID-19 cases represented 29%, 31%, and 18% of hospitalizations in the first, second, and third waves, respectively.
  • Initial risk factors included advanced age (≥70 years), male gender, diabetes, and obesity; cardiovascular issues were protective.
  • The influence of age, gender, and comorbidities on severe COVID-19 decreased in the third wave compared to the first two.

Conclusions:

  • The profile of hospitalized patients with severe COVID-19 evolved significantly across the initial three waves.
  • Reduced impact of traditional risk factors in the third wave suggests the influence of evolving hospital practices and targeted vaccination campaigns.
  • Continuous monitoring of patient demographics and risk factors is essential for effective pandemic management.

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