Department of Cardiology, Ashford and St Peter's Hospitals NHS Foundation Trust, Guildford Road, Chertsey, Surrey, KT16 0PZ, UK.
Department of Acute Medicine, Ashford and St Peter's Hospitals NHS Foundation Trust, Guildford Road, Chertsey, Surrey, KT16 0PZ, UK.
Intern Emerg Med. 2022 Apr;17(3):675-684. doi: 10.1007/s11739-021-02842-5. Epub 2021 Oct 12.
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.
在这项针对因 COVID-19 住院患者的研究中,我们研究了两波疫情中患者特征和结局的差异。数据来自 COVID-19 首次入院至研究结束(2020 年 3 月 1 日至 2021 年 3 月 31 日)期间的采集。数据经过年龄和性别调整,以比值比(OR)和 95%置信区间(CI)表示。在 12471 例住院患者中,1452 例(11.6%)被诊断为 COVID-19。入院时,其他病因患者的平均(±标准差)年龄为 68.3 岁(±19.8 岁),第 1 波 COVID-19 患者为 69.4 岁(±18.0 岁),第 2 波为 66.2 岁(±18.4 岁)。出院时的相应年龄为 67.5 岁(±19.7 岁)、63.9 岁(±18.0 岁)和 62.4 岁(±18.0 岁)。第 1 波疫情中年龄最大(≥80 岁)的患者在总住院患者中占比最高(35.0%)。与因其他病因住院的患者相比,第 1 波和第 2 波 COVID-19 患者中 40-59 岁年龄组的比例更高:分别为 20.8%、24.6%和 30.0%;男性患者比例更高:分别为 47.5%、57.6%和 58.8%;以及高 LACE(住院时间、入院严重程度、合并症和急诊就诊)指数(评分≥10):分别为 39.4%、61.3%和 50.3%。与第 2 波患者相比,第 1 波患者住院期间死亡风险更高:比值比(OR)为 1.58(1.18-2.12),出院后 30 天内死亡风险更高:OR 为 2.91(1.40-6.04)。第 1 波 COVID-19 幸存者的住院时间更长(中位数=6.5 天;四分位间距=2.9-12.0),而第 2 波幸存者的住院时间为 4.5 天(四分位间距=1.9-8.7)。两波 COVID-19 疫情中患者特征存在显著差异。第 2 波疫情的结局有所改善,包括住院时间缩短和死亡率降低。