Department of Infectious Diseases, Hospital de la Santa Creu i Sant Pau, Institut de Recerca del Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Department of Infectious Diseases, Hospital de la Santa Creu i Sant Pau, Institut de Recerca del Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Clin Microbiol Infect. 2021 Jul;27(7):1040.e7-1040.e10. doi: 10.1016/j.cmi.2021.04.005. Epub 2021 Apr 19.
We aimed to assess differences in patients' profiles in the first two surges of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Barcelona, Spain.
We prospectively collected data from all adult patients with SARS-CoV-2 infection diagnosed at the Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. All the patients were diagnosed through nasopharyngeal swab PCR. The first surge spanned from 1st March to 13th August 2020, while surge two spanned from 14th August to 8th December 2020.
There were 2479 and 852 patients with microbiologically proven SARS-CoV-2 infection in surges one and two, respectively. Patients from surge two were significantly younger (median age 52 (IQR 35) versus 59 (40) years, respectively, p < 0.001), had fewer comorbidities (379/852, 44.5% versus 1237/2479, 49.9%, p 0.007), and there was a shorter interval between onset of symptoms and diagnosis (median 3 (5) versus 4 (5) days, p < 0.001). All-cause in-hospital mortality significantly decreased for both the whole population (24/852, 2.8% versus 218/2479, 8.8%, p < 0.001) and hospitalized patients (20/302, 6.6% versus 206/1570, 13.1%, p 0.012). At adjusted logistic regression analysis, predictors of in-hospital mortality were older age (per year, adjusted odds ratio (aOR) 1.079, 95%CI 1.063-1.094), male sex (aOR 1.476, 95%CI 1.079-2.018), having comorbidities (aOR 1.414, 95%CI 0.934-2.141), ICU admission (aOR 3.812, 95%CI 1.875-7.751), mechanical ventilation (aOR 2.076, 95%CI 0.968-4.454), and coronavirus disease 2019 (COVID-19) during surge one (with respect to surge two) (aOR 2.176, 95%CI 1.286-3.680).
First-wave SARS-CoV-2-infected patients had a more than two-fold higher in-hospital mortality than second-wave patients. The causes are likely multifactorial.
我们旨在评估西班牙巴塞罗那严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）大流行前两波中患者特征的差异。
我们前瞻性地收集了在西班牙巴塞罗那圣十字圣保罗医院（Hospital de la Santa Creu i Sant Pau）诊断为 SARS-CoV-2 感染的所有成年患者的数据。所有患者均通过鼻咽拭子 PCR 确诊。第一波从 2020 年 3 月 1 日持续到 8 月 13 日，而第二波从 8 月 14 日持续到 12 月 8 日。
第一波和第二波中分别有 2479 名和 852 名经微生物学证实的 SARS-CoV-2 感染患者。第二波患者明显更年轻（中位数年龄 52（IQR 35）与 59（40）岁，p<0.001），合并症较少（379/852，44.5%与 1237/2479，49.9%，p<0.007），症状出现到诊断的间隔更短（中位数 3（5）与 4（5）天，p<0.001）。全因住院死亡率均显著降低，包括所有患者（24/852，2.8%与 218/2479，8.8%，p<0.001）和住院患者（20/302，6.6%与 206/1570，13.1%，p<0.012）。经调整的逻辑回归分析显示，住院死亡率的预测因素为年龄较大（每年，调整后的优势比（aOR）1.079，95%CI 1.063-1.094）、男性（aOR 1.476，95%CI 1.079-2.018）、合并症（aOR 1.414，95%CI 0.934-2.141）、入住 ICU（aOR 3.812，95%CI 1.875-7.751）、机械通气（aOR 2.076，95%CI 0.968-4.454）和第一波 COVID-19（与第二波相比）（aOR 2.176，95%CI 1.286-3.680）。
第一波 SARS-CoV-2 感染患者的住院死亡率是第二波患者的两倍多。原因可能是多因素的。
