Lalla U, Koegelenberg C F N, Allwood B W, Sigwadhi L N, Irusen E M, Zemlin A E, Masha T E, Erasmus R T, Chapanduka Z C, Prozesky H, Taljaard J, Parker A, Decloedt E H, Retief F, Jalavu T P, Ngah V D, Yalew A, Tamuzi J L, Baines N, McAllister M, Zumla A, Nyasulu P S
Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Afr J Thorac Crit Care Med. 2021 Dec 31;27(4). doi: 10.7196/AJTCCM.2021.v27i4.185. eCollection 2021.
The second wave of coronavirus disease 2019 (COVID-19), dominated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Beta variant, has been reported to be associated with increased severity in South Africa (SA).
To describe and compare clinical characteristics, management and outcomes of COVID-19 patients admitted to an intensive care unit (ICU) in SA during the first and second waves.
In a prospective, single-centre, descriptive study, we compared all patients with severe COVID-19 admitted to ICU during the first and second waves. The primary outcomes assessed were ICU mortality and ICU length of stay (LOS).
In 490 patients with comparable ages and comorbidities, no difference in mortality was demonstrated during the second compared with the first wave (65.9% v. 62.5%, p=0.57). ICU LOS was longer in the second wave (10 v. 6 days, p<0.001). More female admissions (67.1% v. 44.6%, p<0.001) and a greater proportion of patients were managed with invasive mechanical ventilation than with non-invasive respiratory support (39.0% v. 14%, p<0.001) in the second wave.
While clinical characteristics were comparable between the two waves, a higher proportion of patients was invasively ventilated and ICU stay was longer in the second. ICU mortality was unchanged.
据报道，在南非，以严重急性呼吸综合征冠状病毒2（SARS-CoV-2）贝塔变种为主导的2019冠状病毒病（COVID-19）第二波疫情与病情加重有关。
描述和比较南非第一波和第二波疫情期间入住重症监护病房（ICU）的COVID-19患者的临床特征、治疗和结局。
在一项前瞻性、单中心描述性研究中，我们比较了第一波和第二波疫情期间入住ICU的所有重症COVID-19患者。评估的主要结局是ICU死亡率和ICU住院时间（LOS）。
在490名年龄和合并症相当的患者中，与第一波相比，第二波的死亡率没有差异（65.9%对62.5%，p=0.57）。第二波的ICU住院时间更长（10天对6天，p<0.001）。第二波中女性入院患者更多（67.1%对44.6%，p<0.001），与无创呼吸支持相比，接受有创机械通气治疗的患者比例更高（39.0%对14%，p<0.001）。
虽然两波疫情期间的临床特征相似，但第二波中接受有创通气的患者比例更高，ICU住院时间更长。ICU死亡率没有变化。
