Abstract
In this study of patients admitted with COVID-19, we examined differences between the two waves in patient characteristics and outcomes. Data were collected from the first COVID-19 admission to the end of study (01/03/2020–31/03/2021). Data were adjusted for age and sex and presented as odds ratios (OR) with 95% confidence intervals (CI). Among 12,471 admissions, 1452 (11.6%) patients were diagnosed with COVID-19. On admission, the mean (± SD) age of patients with other causes was 68.3 years (± 19.8) and those with COVID-19 in wave 1 was 69.4 years (± 18.0) and wave 2 was 66.2 years (± 18.4). Corresponding ages at discharge were 67.5 years (± 19.7), 63.9 years (± 18.0) and 62.4 years (± 18.0). The highest proportion of total admissions was among the oldest group (≥ 80 years) in wave 1 (35.0%). When compared with patients admitted with other causes, those admitted with COVID-19 in wave 1 and in wave 2 were more frequent in the 40–59 year band: 20.8, 24.6 and 30.0%; consisted of more male patients: 47.5, 57.6 and 58.8%; and a high LACE (Length of stay, Acuity of admission, Comorbidity and Emergency department visits) index (score ≥ 10): 39.4, 61.3 and 50.3%. Compared to wave-2 patients, those admitted in wave 1 had greater risk of death in hospital: OR = 1.58 (1.18–2.12) and within 30 days of discharge: OR = 2.91 (1.40–6.04). Survivors of COVID-19 in wave 1 stayed longer in hospital (median = 6.5 days; interquartile range = 2.9–12.0) as compared to survivors from wave 2 (4.5 days; interquartile range = 1.9–8.7). Patient characteristics differed significantly between the two waves of COVID-19 pandemic. There was an improvement in outcomes in wave 2, including shorter length of stay in hospital and reduction of mortality.
Highlights
The coronavirus disease (COVID-19) pandemic has emerged as the biggest cause of mortality world-wide in the past year [1]
Rapid advances in treatment played a crucial role in the improvement of survival [8,9,10,11,12], there were many other measures recommended by public health bodies including: protection of vulnerable groups, older individuals and those living in residential care homes; greater hygiene control and social distancing; rapid testing systems; and the timing of lockdowns [13]
In this study of patients admitted with COVID-19 during the first 13 months of the pandemic, we examined differences between wave 1 and wave 2 in patient characteristics, including: age, sex and LACE index; outcomes in hospital including length of stay (LOS) and in-patient mortality; and post-discharge outcomes including early readmissions and short-term mortality
Summary
The coronavirus disease (COVID-19) pandemic has emerged as the biggest cause of mortality world-wide in the past year [1]. There are other reasons that may contribute to the excess mortality During this COVID-19 pandemic, there were two distinct waves observed in almost every country [6]. In this study of patients admitted with COVID-19 during the first 13 months of the pandemic, we examined differences between wave 1 and wave 2 in patient characteristics, including: age, sex and LACE index (an indicator of health status); outcomes in hospital including length of stay (LOS) and in-patient mortality; and post-discharge outcomes including early readmissions and short-term mortality. Methods comprised mortality and clinical characteristics, as well as care quality, including: the LOS; readmission frequency; comorbidities; and the number of previous emergency department visits [14, 15]. Chi-square tests were used to determine categorical variables including age bands, sex, LACE index and mortality in relation to COVID-19 wave 1 and wave 2. Analyses were performed using IBM SPSS Statistics, v23.0 (IBM Corp., Armonk, NY)
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