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Published on: November 10, 2023
Comparison between COVID‑19 outcomes in the first 3 waves of the pandemic: a reference hospital report
Monika Bociąga-Jasik1,2, Wiktoria Wojciechowska2,3, Michał Terlecki2,3
1Department of Infectious Diseases and Tropical Medicine, Jagiellonian University Medical College, Kraków, Poland
Insights
Hospitalized COVID-19 patients showed evolving characteristics and outcomes across pandemic waves. Increased death rates and risk factors were observed in later waves, indicating shifts in disease impact and management.
Area of Science:
- Medical research
- Epidemiology
- Public health
Background:
- The COVID-19 pandemic evolved through distinct waves, each potentially impacting patient demographics and clinical outcomes.
- Understanding these changes is crucial for adapting healthcare strategies and improving patient care during public health crises.
Purpose of the Study:
- To analyze and compare the clinical characteristics and outcomes of patients hospitalized with COVID-19 during the first three pandemic waves.
- To identify factors influencing in-hospital mortality across these consecutive waves.
Main Methods:
- Retrospective analysis of medical records from 5191 COVID-19 patients admitted to a designated COVID-19 hospital between March 2020 and May 2021.
- Comparison of patient demographics, inflammatory markers, oxygen saturation, and mortality rates across three defined pandemic waves.
Main Results:
- Significant differences were observed in patient age, sex distribution, inflammatory marker levels, and oxygen saturation between waves 1, 2, and 3.
- Hospital death rates increased progressively from 10.4% in wave 1 to 19.8% in wave 2 and 20.3% in wave 3.
- Advanced age, male sex, comorbidities (cardiovascular, chronic kidney disease), elevated C-reactive protein, and later wave hospitalization were identified as risk factors for in-hospital death.
Conclusions:
- Consecutive COVID-19 waves exhibited distinct patient characteristics and clinical outcomes.
- These observed differences likely reflect evolving medical and organizational factors, including changes in isolation policies, hospitalization criteria, and treatment strategies.
- The findings underscore the dynamic nature of the pandemic and the need for adaptive healthcare responses.
Introduction:
The course of consecutive COVID‑19 waves was influenced by medical and organizational factors.
Objectives:
We aimed to assess the outcomes of patients hospitalized for COVID‑19 during the first 3 waves of the pandemic.
Patients And Methods:
We performed a retrospective analysis of medical records of all COVID‑19 patients admitted to the University Hospital in Kraków, Poland, a designated COVID‑19 hospital in Małopolska province, between March 1, 2020 and May 31, 2021. The waves were defined as 1, 2, and 3, and covered the periods of March 2020 to July 2020, August 2020 to January 2021, and February 2021 to May 2021, respectively. Patients' characteristics and outcomes for waves 1 through 3 were compared.
Results:
Data analyses included 5191 patients with COVID‑19. We found differences in age (mean [SD], 60.2 [17.3] years vs 62.4 [16.8] years vs 61.9 [16.1] years, respectively, for waves 1, 2, and 3; P = 0.003), sex distribution (proportion of women, 51.4% vs 44.2% vs 43.6%; P = 0.003), as well as concentrations of inflammatory markers and oxygen saturation (the lowest and the highest for wave 1, respectively; P <0.001). Hospital death rates in subsequent waves were 10.4%, 19.8%, and 20.3% (P <0.001). Despite similarities in patients' characteristics, the length of hospital and intensive care unit stay was shorter for wave 3 than for wave 2. The risk factors for in‑hospital death were: advanced age, male sex, cardiovascular or chronic kidney disease, higher C‑reactive protein level, and hospitalization during the second or third wave.
Conclusions:
We identified differences in patients' clinical characteristics and outcomes between consecutive pandemic waves, which probably reflect changes in terms of COVID‑19 isolation policy, hospitalization and treatment indications, and treatment strategies.
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