Comparison of the Clinico-Demographic Profile of Patients Admitted to the COVID ICU of a Tertiary Care Hospital in Assam During the First and Second Waves of the COVID-19 Pandemic

TL;DR

This study compares patient characteristics and outcomes in a hospital's COVID ICU during the first and second waves of the pandemic in Assam.

Contribution

The study provides a local-level comparison of clinico-demographic profiles and outcomes between the first and second waves of COVID-19 in a specific region.

Findings

The second wave saw more patients aged 40-60 compared to the first wave's older patients.

The second wave had higher oxygen and ventilatory support needs and longer hospital stays.

Despite similar symptoms and co-morbidities, the second wave had lower mortality but more discharges against medical advice.

Abstract

Background: With the passage of time, COVID-19 strains have mutated, leading to newer strains, and reports are there on the differences in presentation, severity, and infectivity of COVID-19 in the first two waves of the pandemic.

Objective: Comparison of the clinico-demographic profile and outcomes of patients admitted to the COVID ICU during the first and second waves.

Materials and methods: A hospital-based cross-sectional study was conducted for a period of six months among patients admitted to the COVID ICU of Jorhat Medical College and Hospital, a tertiary care hospital in Assam, including 284 patients. Data were collected from bed head tickets available in the Medical Records Department office. The t-test and χ2 test were used to compare data between the two waves.

Results: In the first wave, most of the patients were 60 years and above, while in the second wave, the majority of cases were between 40 and 60 years (χ2 = 13.002, p = 0.011). The presenting symptoms and the type of co-morbidities were similar in both waves. Mean delay in testing and hospitalization was significantly more in the second wave (p = 0.005 and 0.02, respectively). Requirement of high flow O2 therapy (p = 0.006) and ventilatory support (p = 0.03) was higher in the second wave. The treatment protocol remained the same in both waves, except for universal use of remdesivir and decreased plasma therapy use in the second wave. The mean duration of hospital stay was longer in the second wave (p = 0.02). There was a decrease in deaths from 42.1% to 36.1%, while discharges against medical advice increased from 2.1% to 12.5%.

Conclusions: The data of the study gave us an insight into the changes and similarities of the two waves. Understanding the disease at the local level can help us be better prepared in case of any further recurrence of the pandemic.

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