Clinical management and outcome differences between first and second waves among COVID-19 hospitalized patients: A regional prospective observational cohort

María Zuil; Iván D Benítez; Ramón Cabo-Gambín; Carlos Manzano Senra; Anna Moncusí-Moix; Clara Gort-Paniello; David de Gonzalo-Calvo; Marta Molinero; Jose Javier Vengoechea Aragoncillo; Thais Comella; Jordi de Batlle; Gerard Torres; Antoni Torres; Ferrán Barbé; Jessica González

doi:10.1371/journal.pone.0258918

Clinical management and outcome differences between first and second waves among COVID-19 hospitalized patients: A regional prospective observational cohort

PLoS One. 2021 Oct 28;16(10):e0258918. doi: 10.1371/journal.pone.0258918. eCollection 2021.

Authors

María Zuil¹, Iván D Benítez^{1

2}, Ramón Cabo-Gambín¹, Carlos Manzano Senra¹, Anna Moncusí-Moix^{1

2}, Clara Gort-Paniello^{1

2}, David de Gonzalo-Calvo^{1

2}, Marta Molinero^{1

2}, Jose Javier Vengoechea Aragoncillo¹, Thais Comella¹, Jordi de Batlle^{1

2}, Gerard Torres^{1

2}, Antoni Torres^{2

3}, Ferrán Barbé^{1

2}, Jessica González^{1

2}

Affiliations

¹ Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain.
² CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.
³ Pulmonary Department, Hospital Clinic, Universitat de Barcelona, IDIBAPS, ICREA, Barcelona, Spain.

Abstract

The objective was to describe the clinical characteristics and outcomes of hospitalized COVID-19 patients during the two different epidemic periods. Prospective, observational, cohort study of hospitalized COVID-19. A total of 421 consecutive patients were included, 188 during the first period (March-May 2020) and 233 in the second wave (July-December 2020). Clinical, epidemiological, prognostic and therapeutic data were compared. Patients of the first outbreak were older and more comorbid, presented worse PaO2/FiO2 ratio and an increased creatinine and D-dimer levels at hospital admission. The hospital stay was shorter (14.5[8;29] vs 8[6;14] days, p<0.001), ICU admissions (31.9% vs 13.3%, p<0.001) and the number of patients who required mechanical ventilation (OR = 0.12 [0.05-10.26]; p<0.001) were reduced. There were no significant differences in hospital and 30-day after discharge mortality (adjusted HR = 1.56; p = 0.1056) or hospital readmissions. New treatments and clinical strategies appear to improve hospital length, ICU admissions and the requirement for mechanical ventilation. However, we did not observe differences in mortality or readmissions.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
COVID-19 / epidemiology*
COVID-19 / mortality*
COVID-19 / therapy*
Cohort Studies
Epidemics / statistics & numerical data
Female
Hospital Mortality / trends
Hospitalization / statistics & numerical data
Hospitalization / trends
Humans
Intensive Care Units / statistics & numerical data
Male
Middle Aged
Prognosis
Prospective Studies
Respiration, Artificial / mortality
Risk Factors
SARS-CoV-2 / pathogenicity
Spain / epidemiology
Treatment Outcome

Grants and funding

Supported in part by ISCIII (CIBERESUCICOVID, COV20/00110), co-funded by ERDF, “Una manera de hacer Europa”. JdB acknowledges receiving financial support from Instituto de Salud Carlos III (Miguel Servet 2019: CP19/00108), co-funded by European Regional European Social Fund (ESF), “Investing in your future”. DdGC has received financial support from Instituto de Salud Carlos III (Miguel Servet 2020: CP20/00041), co-funded by the European Social Fund (ESF)/“Investing in your future”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.