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Mortality in Two Waves of COVID-19: A Comparative Analysis of a Tertiary Care Hospital in India

Saurabh Vig1, Jitendra K Meena2, Abhishek Kumar3

  • 1Onco-Anesthesiology and Palliative Medicine, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND.

Cureus
|October 13, 2023
PubMed

Insights

The second wave of COVID-19 saw a tenfold increase in hospital mortality compared to the first wave in India. This surge was characterized by more severe presentations and deaths directly from COVID-19 acute respiratory distress syndrome.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Critical Care Medicine

Background:

  • COVID-19 presented with distinct surges globally.
  • Variations in disease severity and mortality between waves were noted in several countries.

Purpose of the Study:

  • To compare in-hospital mortality between the first and second COVID-19 waves.
  • To analyze differences in disease characteristics and outcomes during these waves at an Indian tertiary care hospital.

Main Methods:

  • Retrospective data collection from a tertiary care hospital in India.
  • Defined wave periods: Wave 1 (March 2020-December 2020), Wave 2 (April 2021-June 2021).
  • Primary outcomes: Total Hospital Mortality Rate (TMR) and Case Fatality Rate (CFR).

Main Results:

  • Wave 2 exhibited approximately a tenfold higher mortality rate than Wave 1 (TMR: 20.3% vs 2.4%; CFR: 17.7% vs 1.5%).
  • Wave 2 cases showed a higher proportion of severe disease at presentation.
  • Faster symptom progression to death and increased deaths from COVID-19 acute respiratory distress syndrome (ARDS) in Wave 2, including in patients without comorbidities.

Conclusions:

  • Findings align with global pooled hospital mortality data.
  • Demonstrated a significant increase in COVID-19 disease severity and mortality during the second wave in the study setting.
  • Highlighted the direct impact of COVID-19 ARDS as a cause of mortality, particularly in Wave 2.

Keywords:
case fatality rate.covid wave 1covid wave 2covid-19total mortality rate

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