Comparing India's Second COVID Wave with the First Wave-A Single-Center Experience

Area of Science:

• Infectious Diseases
• Epidemiology
• Critical Care Medicine

Background:

• The COVID-19 pandemic presented a severe second wave in India.
• This study compares the clinical characteristics of the first and second waves of SARS-CoV-2 in India.

Purpose of the Study:

• To compare the clinical profile of COVID-19 patients during the first and second waves in India.
• To identify differences in demographics, symptoms, severity, and outcomes between the two waves.

Main Methods:

• Retrospective observational study design.
• Analysis of demographic data, symptoms, comorbidities, investigations, treatments, and outcomes.
• Comparison between patients from the first wave (April-June 2020) and the second wave (March-May 2021).

Main Results:

• The second wave predominantly affected an older demographic (mean age 50.5 years) compared to the first wave (mean age 37.1 years).
• Patients in the second wave exhibited lower oxygen saturation, higher severity scores (CT score 29.5 vs 23.2), and increased incidence of severe acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and acute liver injury.
• Outcomes were worse in the second wave, with significantly higher rates of oxygen requirement (81.8% vs 11.2%), invasive ventilation (24.5% vs 0.9%), ICU/HDU admissions (56.4% vs 12.0%), and mortality (29% vs 9.6%).

Conclusions:

• The second wave of COVID-19 in India was associated with higher prevalence of older age, increased oxygen and ventilator requirements, higher ICU admissions, and more organ failures.
• These factors contributed to increased fatalities during the second wave.
• Future pandemic preparedness strategies should account for these observed differences.