新冠疫情第一波、第二波和第三波中COVID-19的临床表现、结局及医院流行病学趋势差异：医院记录回顾与前瞻性队列研究
Difference in presentation, outcomes, and hospital epidemiologic trend of COVID-19 among first, second, and third waves: a review of hospital records and prospective cohort study.
作者信息
Mahmud Reaz, Islam Md Ashikul, Haque Md Emdadul, Hussain Dewan A, Islam Mohammad R, Monayem Farhana B, Kamal Mohammad M, Sina Hashmi, Islam Mohammad F, Datta Ponkaj K, Sayeed S K Jakaria B, Dhali Sabbir A, Islam Khairul, Ratul Rifat H, Hossain S K Md Rubaed, Prince Habib N, Chowdhury Ahmed H, Ahmed Kazi G U, Miah Md Titu, Rahman Md Mujibur
机构信息
Department of Neurology, Dhaka Medical College.
National Institute of Neurosciences and Hospital.
出版信息
Ann Med Surg (Lond). 2023 Jul 6;85(8):3816-3826. doi: 10.1097/MS9.0000000000001024. eCollection 2023 Aug.
UNLABELLED
This study aimed to examine the differences in epidemiologic and disease aspects among patients with coronavirus disease-19 (COVID-19).
METHODS
The authors reviewed the hospital records between April 2020 and September 2021 and followed up on the patients for post-COVID complications.
FINDINGS
Older adult patients were predominantly affected during the third wave, and middle-aged patients were predominantly affected during the first and second waves. Men were predominantly admitted, considering the three waves, although more women were admitted in the second wave. Cough was more common in the second and third waves than in the first wave 522 (59.7%). Respiratory distress was the most common in the third wave, 251(67.1%), and least common in the first wave, 403 (46.1%). Anosmia was more common in the third wave 116 (31.2%). In the third wave, patients presenting in a critical state 23 (6.2%) and with severe disease 152 (40.8%) were more common. The hospital admission median (IQR) was longer in the first wave, 12 (8-20), than in other waves. More patients were admitted in the first wave (52%) than in the other waves, and patients received more oxygen in the third wave (75%) than in the other waves. Death occurred more commonly in the first wave (51%) than in the other waves. The positivity rate was higher in the third wave (22.8%) than in the other waves. In the third wave, the positivity rate was higher in women (24.3%) than in men. Post-COVID cough increased in the second wave, and fatigue was higher in the third wave than in the other waves. Tiredness and memory loss were greater during the second wave than in other waves.
CONCLUSION
The authors found differences in the presentation, outcomes, and hospital epidemiologic trend of COVID-19 among the three waves.
未标注
本研究旨在探讨新型冠状病毒肺炎（COVID-19）患者在流行病学和疾病方面的差异。
方法
作者回顾了2020年4月至2021年9月期间的医院记录，并对患者进行随访以了解COVID-19后并发症情况。
结果
在第三波疫情期间，老年患者受影响最为严重，而在第一波和第二波疫情期间，中年患者受影响最为严重。考虑到三波疫情，男性入院人数居多，不过在第二波疫情中女性入院人数更多。咳嗽在第二波和第三波疫情中比在第一波疫情中更为常见，有522例（59.7%）。呼吸窘迫在第三波疫情中最为常见，有251例（67.1%），在第一波疫情中最不常见，有403例（46.1%）。嗅觉丧失在第三波疫情中更为常见，有116例（31.2%）。在第三波疫情中，处于危重症状态的患者有23例（6.2%），患有重症的患者有152例（40.8%）更为常见。第一波疫情期间患者的住院中位时间（四分位间距）为12天（8 - 20天），比其他波次更长。第一波疫情中入院的患者（52%）比其他波次更多，第三波疫情中患者吸氧的比例（75%）比其他波次更高。死亡在第一波疫情中比在其他波次中更为常见（51%）。第三波疫情中的阳性率（22.8%）高于其他波次。在第三波疫情中，女性的阳性率（24.3%）高于男性。COVID-19后咳嗽在第二波疫情中有所增加，疲劳在第三波疫情中比其他波次更为严重。疲倦和记忆力减退在第二波疫情期间比其他波次更为严重。
结论
作者发现三波疫情期间COVID-19在临床表现、结局和医院流行病学趋势方面存在差异。
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