COVID-19 in three waves in a tertiary referral hospital in Belgium: a comparison of patient characteristics,...

Area of Science:

• Infectious Diseases
• Epidemiology
• Critical Care Medicine

Background:

• Limited comparative data exists on COVID-19 patient characteristics and outcomes across different epidemic waves.
• Understanding temporal trends in patient profiles and management is crucial for optimizing care strategies.

Purpose of the Study:

• To compare patient characteristics, clinical management, and outcomes of hospitalized COVID-19 patients across the first three epidemic waves (2020-2021).
• To identify factors influencing disease severity and mortality during different phases of the pandemic.

Main Methods:

• Retrospective observational study of adult COVID-19 patients admitted to Antwerp University Hospital between February 2020 and June 2021.
• Collection of standardized medical data from patient records.
• Multivariable logistic regression analysis to assess risk factors for critical outcomes.

Main Results:

• A total of 722 patients were analyzed across three waves, with increasing numbers of elderly and comorbid patients in later waves.
• Corticosteroid use and high-flow oxygen therapy increased over time.
• Despite rising complications, in-hospital mortality decreased progressively with each wave (16.6% to 11.9%).
• High C-reactive protein levels, Charlson comorbidity index ≥5, and interhospital transfers were associated with increased risk of ICU admission and mortality.

Conclusions:

• Mortality due to COVID-19 significantly decreased across successive epidemic waves, even with an increasing burden of patient comorbidities.
• Evolving clinical management strategies, including the use of high-flow oxygen therapy in non-intensive care units and the administration of corticosteroids, appear to be key drivers of improved patient outcomes.