Medicine, Hamad Medical Corporation, Doha, Qatar
Clinical Medicine, Qatar University College of Medicine, Doha, Qatar.
BMJ Open. 2022 Jun 28;12(6):e061610. doi: 10.1136/bmjopen-2022-061610.
To compare the patient profile and outcomes in Qatar during the first and second waves of the COVID-19 pandemic.
A retrospective observational study was conducted comparing the demographic, clinical and laboratory characteristics of patients with COVID-19 infection admitted to a secondary care hospital, during the first and second waves of the pandemic.
1039 patients from the first wave and 991 from the second wave who had pneumonia on chest X-ray and had a confirmed SARS-CoV-2 infection by a real-time PCR test of a nasopharyngeal swab were included. Patients with a normal chest X-ray and those who had a negative PCR test despite a positive COVID-19 antigen test were excluded.
Length of stay, need for mechanical ventilation, final disposition and mortality were the key outcomes studied RESULTS: Influenza like symptoms (18.5% in the first wave vs 36.1% in the second wave, p 0.001), cough (79.2% vs 87%, p<0.001) and dyspnoea (27.5% vs 38% p<0.001) were more common in the second wave. Second wave patients had significantly higher respiratory rate, lower peripheral oxygen saturation, needed more supplemental oxygen and had higher incidence of pulmonary embolism. More patients received hydroxychloroquine and antibiotics during the first wave and more received steroids, antivirals and interleukin-1 antagonist during the second wave. The second wave had a shorter length of stay (14.58±7.75 vs 12.61±6.16, p<0.001) and more patients were discharged home (22% vs 10%, p<0.001).
Patients who presented during the second wave of COVID-19 pandemic appeared to be more ill clinically and based on their laboratory parameters. They required shorter hospitalisation and were more likely to be discharged home. This could represent greater expertise in handling such patients that was acquired during the first wave as well as use of more appropriate and combination therapies during the second wave.
比较 COVID-19 大流行第一波和第二波期间卡塔尔的患者特征和结局。
回顾性观察性研究比较了一家二级保健医院收治的 COVID-19 感染患者的人口统计学、临床和实验室特征，这些患者在大流行的第一波和第二波期间均患有肺炎，并通过鼻咽拭子实时 PCR 检测证实 SARS-CoV-2 感染。排除胸部 X 线正常和 PCR 检测阴性但 COVID-19 抗原检测阳性的患者。
住院时间、机械通气需求、最终转归和死亡率是研究的主要结局。
流感样症状（第一波 18.5%，第二波 36.1%，p<0.001）、咳嗽（79.2% vs 87%，p<0.001）和呼吸困难（27.5% vs 38%，p<0.001）在第二波更为常见。第二波患者的呼吸频率明显更高，外周血氧饱和度更低，需要更多的补充氧气，肺栓塞的发生率更高。第一波期间更多的患者接受了羟氯喹和抗生素，第二波期间更多的患者接受了皮质类固醇、抗病毒药物和白细胞介素-1 拮抗剂。第二波的住院时间更短（14.58±7.75 天 vs 12.61±6.16 天，p<0.001），更多的患者出院回家（22% vs 10%，p<0.001）。
在 COVID-19 大流行第二波期间就诊的患者在临床上似乎病情更重，且根据实验室参数来看也是如此。他们的住院时间更短，更有可能出院回家。这可能代表在第一波期间获得了处理此类患者的更多专业知识，以及在第二波期间使用了更合适和联合的治疗方法。
