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. 2021 May 24;10(11):2274.
doi: 10.3390/jcm10112274.

Patient Characteristics and Clinical Course of COVID-19 Patients Treated at a German Tertiary Center during the First and Second Waves in the Year 2020

Thomas Theo Brehm  1   2 , Andreas Heyer  1 , Kevin Roedl  3 , Dominik Jarczak  3 , Axel Nierhaus  3 , Michael F Nentwich  3 , Marc van der Meirschen  1 , Alexander Schultze  4 , Martin Christner  5 , Walter Fiedler  6 , Nicolaus Kröger  7 , Tobias B Huber  8 , Hans Klose  6 , Martina Sterneck  1 , Sabine Jordan  1 , Benno Kreuels  1 , Stefan Schmiedel  1   2 , Marylyn M Addo  1   2 , Samuel Huber  1 , Ansgar W Lohse  1   2 , Stefan Kluge  3 , Julian Schulze Zur Wiesch  1   2
Affiliations

Patient Characteristics and Clinical Course of COVID-19 Patients Treated at a German Tertiary Center during the First and Second Waves in the Year 2020

Thomas Theo Brehm et al. J Clin Med. .

Abstract

In this study, we directly compared coronavirus disease 2019 (COVID-19) patients hospitalized during the first (27 February-28 July 2020) and second (29 July-31 December 2020) wave of the pandemic at a large tertiary center in northern Germany. Patients who presented during the first (n = 174) and second (n = 331) wave did not differ in age (median [IQR], 59 years [46, 71] vs. 58 years [42, 73]; p = 0.82) or age-adjusted Charlson Comorbidity Index (median [IQR], 2 [1, 4] vs. 2 [0, 4]; p = 0.50). During the second wave, a higher proportion of patients were treated as outpatients (11% [n = 20] vs. 20% [n = 67]), fewer patients were admitted to the intensive care unit (43% [n = 75] vs. 29% [n = 96]), and duration of hospitalization was significantly shorter (median days [IQR], 14 [8, 34] vs. 11 [5, 19]; p < 0.001). However, in-hospital mortality was high throughout the pandemic and did not differ between the two periods (16% [n = 27] vs. 16% [n = 54]; p = 0.89). While novel treatment strategies and increased knowledge about the clinical management of COVID-19 may have resulted in a less severe disease course in some patients, in-hospital mortality remained unaltered at a high level. These findings highlight the unabated need for efforts to hamper severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) transmission, to increase vaccination coverage, and to develop novel treatment strategies to prevent mortality and decrease morbidity.

Keywords: COVID-19; SARS-CoV-2; first wave; hospital; mortality; patients; second wave; treatment.

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Conflict of interest statement

A.N. declares that he received lecture honoraria and travel reimbursement over the past five years from CytoSorbents Europe, Biotest AG, and ThermoFisher Scientific. S.K. declares that he has received personal fees for lectures or consultancy and/or research support from Ambu, Astra Zeneca, Bard, Baxter, Bayer, Biotest, CytoSorbents, Daiichi Sankyo, E.T.ViewLtd, Fisher & Paykel, Fresenius Medical Care, Gilead, Mitsubishi Tanabe, MSD, Pfizer, Philips, Xenios, and Zoll. The authors declare they have no competing financial interest.

Figures

Figure 1
Figure 1
The numbers of COVID-19 patients newly admitted to our hospital or seen as outpatients in our emergency department are listed for each month. The dotted line represents the border between the first and the second wave (29 July 2020).
Figure 2
Figure 2
(a) Sex distribution, (b) disease severity, and (c) and in-hospital mortality of COVID-19 patients at our center during the first wave (left) and second wave (right) of the pandemic stratified by age group.
Figure 3
Figure 3
The proportion of patients discharged alive during the first and second waves compared by the log-rank test.
See this image and copyright information in PMC

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