Nagy Éva, Golopencza Péter, Barcs István, Ludwig Endre
Schools of PhD Studies, Semmelweis University, 1085 Budapest, Hungary.
Bajcsy-Zsilinszky Hospital and Outpatient Clinic, 1106 Budapest, Hungary.
Trop Med Infect Dis. 2023 Mar 1;8(3):153. doi: 10.3390/tropicalmed8030153.
Different variants of coronavirus 2 (SARS-CoV-2), a virus responsible for severe acute respiratory syndrome, caused several epidemic surges in Hungary. The severity of these surges varied due to the different virulences of the variants. In a single-center, retrospective, observational study, we aimed to assess and compare morbidities and mortality rates across the epidemic waves I to IV with special regard to hospitalized, critically ill patients. A significant difference was found between the surges with regard to morbidity ( < 0.001) and ICU mortality ( = 0.002), while in-hospital mortality rates ( = 0.503) did not differ significantly. Patients under invasive ventilation had a higher incidence of bloodstream infection (aOR: 8.91 [4.43-17.95] < 0.001), which significantly increased mortality (OR: 3.32 [2.01-5.48]; < 0.001). Our results suggest that Waves III and IV, caused by the alpha (B.1.1.7) and delta (B.1.617.2) variants, respectively, were more severe in terms of morbidity. The incidence of bloodstream infection was high in critically ill patients. Our results suggest that clinicians should be aware of the risk of bloodstream infection in critically ill ICU patients, especially when invasive ventilation is used.
导致严重急性呼吸综合征的冠状病毒2（SARS-CoV-2）的不同变体在匈牙利引发了多次疫情高峰。由于变体的毒力不同，这些高峰的严重程度也有所不同。在一项单中心、回顾性、观察性研究中，我们旨在评估和比较第一波至第四波疫情期间的发病率和死亡率，特别关注住院的重症患者。在发病率（<0.001）和重症监护病房死亡率（=0.002）方面，各波疫情之间存在显著差异，而住院死亡率（=0.503）没有显著差异。接受有创通气的患者发生血流感染的发生率更高（调整后比值比：8.91[4.43 - 17.95]，<0.001），这显著增加了死亡率（比值比：3.32[2.01 - 5.48]；<0.001）。我们的结果表明，分别由α（B.1.1.7）和δ（B.1.617.2）变体引起的第三波和第四波疫情在发病率方面更为严重。重症患者中血流感染的发生率很高。我们的结果表明，临床医生应意识到重症监护病房重症患者发生血流感染的风险，尤其是在使用有创通气时。
