Oladunjoye Olubunmi, Gallagher Molly, Wasser Tom, Oladunjoye Adeolu, Paladugu Susmita, Donato Anthony
Department of Internal Medicine, Reading Hospital, Tower Health System, Reading, PA, USA.
Drexel University College of Medicine, Philadelphia, PA, USA.
J Community Hosp Intern Med Perspect. 2021 Nov 15;11(6):747-752. doi: 10.1080/20009666.2021.1978154. eCollection 2021.
The USA suffered an initial wave of COVID-19 cases from March to July in 2020. Cases again surged in August 2020 as business restrictions were lifted. We aimed to describe demographic, treatment, and mortality differences between both waves.
We identified all hospitalized patients with COVID-19 infection in one US six-hospital health system between 1 March 2020 and 31 January 2021. We compared data obtained on patient demographics, treatment received, and mortality between first and second waves of the pandemic.
A total of 4434 hospitalized COVID patients were identified, including 1313 patients in the first wave and 3121 patients in the second wave. Mortality was significantly higher in the first wave as compared to the second wave (23.2% vs. 12.3%, < 0.001). Age and sex were similar in each wave. In the first wave, there were significantly more Non-Hispanic Black patients (28.8 vs. 18.1%, < 0.001) and Hispanic patients (26.6% vs. 14.9%, < 0.001) as compared to the second wave. There was a higher mortality rate in the first wave as compared to the second, which persisted after multivariable adjustment for sex, age, ethnicity, laboratory results at admission, treatment received, high flow use and mechanical ventilation (OR: 2.66, 95% CI: 1.83-3.87, < 0.001).
Mortality in the second wave was lower than the first wave with significantly higher utilization of steroids, remdesivir and convalescent plasma in second wave.
美国在2020年3月至7月经历了第一波新冠疫情。随着商业限制的解除，2020年8月病例再次激增。我们旨在描述两波疫情之间的人口统计学、治疗和死亡率差异。
我们确定了2020年3月1日至2021年1月31日期间在美国一个六医院医疗系统中所有因新冠病毒感染住院的患者。我们比较了疫情第一波和第二波期间获得的患者人口统计学、接受的治疗和死亡率数据。
共确定了4434例新冠住院患者，其中第一波有1313例，第二波有3121例。与第二波相比，第一波的死亡率显著更高（23.2%对12.3%，<0.001）。每一波的年龄和性别相似。与第二波相比，第一波中西班牙裔黑人患者（28.8%对18.1%，<0.001）和西班牙裔患者（26.6%对14.9%，<0.001）明显更多。与第二波相比，第一波的死亡率更高，在对性别、年龄、种族、入院时的实验室检查结果、接受的治疗、高流量吸氧使用和机械通气进行多变量调整后，这种差异仍然存在（比值比：2.66，95%置信区间：1.83 - 3.87，<0.001）。
第二波的死亡率低于第一波，第二波中类固醇、瑞德西韦和康复期血浆的使用率显著更高。
