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A Retrospective Observational Study to Compare the Clinical and Laboratory Parameters of Patients Requiring
Milind1, Sandeep Tak2, Sudhakar Nayak3
1Resident Doctor, Department of Medicine, Dr S N Medical College, Jodhpur, Rajasthan, India, Corresponding Author.
Insights
The Omicron-driven COVID-19 wave showed less severe illness and better patient outcomes compared to the Delta-driven wave in India. Increased vaccination rates and potentially lower Omicron virulence contributed to these improved results.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- The COVID-19 pandemic has seen multiple waves driven by different variants.
- Understanding the clinical and epidemiological differences between waves is crucial for patient management.
Purpose of the Study:
- To compare clinical and laboratory parameters of hospitalized patients during the Omicron-driven 3rd wave versus the Delta-driven 2nd wave of COVID-19 in India.
- To assess differences in disease severity, patient outcomes, and laboratory markers between the two waves.
Main Methods:
- Retrospective, cross-sectional observational study including 100 hospitalized patients from each wave (2nd and 3rd).
- Data collected on patient symptoms, severity of illness, intensive care unit (ICU) admission, oxygenation needs, length of hospital stay, and discharge status.
- Laboratory parameters (D-dimer, CRP, NL ratio, serum lactate) and computed tomography (CT) severity scores were analyzed.
- Vaccination status of patients was recorded.
Main Results:
- Symptoms like cough, shortness of breath, and loss of taste were more prevalent in the 2nd wave (Delta) compared to the 3rd wave (Omicron).
- The 2nd wave showed significantly higher disease severity, increased ICU admissions, and poorer outcomes (need for oxygen at discharge) (p < 0.0001).
- Vaccination rates were substantially higher in the 3rd wave (67%) versus the 2nd wave (11%) (p < 0.0001).
- Laboratory markers (D-dimer, CRP, serum lactate) and CT severity scores were significantly more deranged in the 2nd wave (p < 0.05 and p < 0.0001, respectively).
Conclusions:
- The Omicron-driven 3rd wave was associated with significantly reduced disease severity, lower inflammatory response, and better patient outcomes compared to the Delta-driven 2nd wave.
- Higher vaccination coverage and potentially lower intrinsic virulence of the Omicron variant played a significant role in the improved outcomes observed during the 3rd wave.
Abstract:
Background: Following the outbreak of coronavirus in Wuhan, China in 2019, there has been multiple waves of different variants of COVID-19 throughout the world in the continuum of a pandemic. This study aims to compare different clinical and laboratory parameters of hospitalized patients in Omicron-driven 3rd wave vs Delta-driven 2nd wave in India. Materials and methods: This was a retrospective cross-sectional observational study that was done in the Department of General Medicine, Mahatma Gandhi Hospital, Dr S N Medical College, Jodhpur (Rajasthan). It included 100 patients of 3rd wave and 2nd wave respectively who were hospitalized. The primary outcome of the study was patient's survival and condition at discharge and secondary outcomes included length of hospital stay and mode of oxygenation. Results: The presence of cough, shortness of breath, and loss of taste are more common symptoms in 2nd wave vs 3rd wave with p-value being 0.0002, 0.004, and < 0.0001 respectively. The severity of illness, need for intensive care unit (ICU), and outcome in terms of discharge with oxygen or without oxygen were also statistically significant in the 2nd wave vs 3rd wave with p-value being < 0.0001 for all three variables. A total of 67% of patients were vaccinated in 3rd wave group compared to 11% in 2nd wave group (p-value < 0.0001). Comparison of laboratory parameters also revealed statistically significant results with D-dimer, quantitative C-reactive protein (CRP), normal (NL) ratio, and serum lactate being more deranged in the 2nd wave compared to the 3rd wave with p-value being < 0.05. Comparison of involvement of lung parenchyma based on computed tomography (CT) severity score revealed p-value < 0.0001 that is statistically relevant. Conclusion: Omicron-driven 3rd wave was associated with significantly less severity, less inflammatory response, and better outcome compared to Delta-driven 2nd wave. More vaccination and probably less intrinsic virulence during 3rd wave has a major role in the better outcome.
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