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Comparative Study
. 2022 Apr;17(3):675-684.
doi: 10.1007/s11739-021-02842-5. Epub 2021 Oct 12.

Comparison of characteristics and outcomes of patients admitted to hospital with COVID-19 during wave 1 and wave 2 of the current pandemic

David Fluck  1 , Suzanne Rankin  2 , Andrea Lewis  2 , Jonathan Robin  2 , Jacqui Rees  3 , Jo Finch  3 , Yvonne Jones  3 , Gareth Jones  3 , Kevin Kelly  3 , Paul Murray  4 , Michael Wood  4 , Christopher Henry Fry  5 , Thang Sieu Han  6   7
Affiliations
Comparative Study

Comparison of characteristics and outcomes of patients admitted to hospital with COVID-19 during wave 1 and wave 2 of the current pandemic

David Fluck et al. Intern Emerg Med. 2022 Apr.

Abstract

In this study of patients admitted with COVID-19, we examined differences between the two waves in patient characteristics and outcomes. Data were collected from the first COVID-19 admission to the end of study (01/03/2020-31/03/2021). Data were adjusted for age and sex and presented as odds ratios (OR) with 95% confidence intervals (CI). Among 12,471 admissions, 1452 (11.6%) patients were diagnosed with COVID-19. On admission, the mean (± SD) age of patients with other causes was 68.3 years (± 19.8) and those with COVID-19 in wave 1 was 69.4 years (± 18.0) and wave 2 was 66.2 years (± 18.4). Corresponding ages at discharge were 67.5 years (± 19.7), 63.9 years (± 18.0) and 62.4 years (± 18.0). The highest proportion of total admissions was among the oldest group (≥ 80 years) in wave 1 (35.0%). When compared with patients admitted with other causes, those admitted with COVID-19 in wave 1 and in wave 2 were more frequent in the 40-59 year band: 20.8, 24.6 and 30.0%; consisted of more male patients: 47.5, 57.6 and 58.8%; and a high LACE (Length of stay, Acuity of admission, Comorbidity and Emergency department visits) index (score ≥ 10): 39.4, 61.3 and 50.3%. Compared to wave-2 patients, those admitted in wave 1 had greater risk of death in hospital: OR = 1.58 (1.18-2.12) and within 30 days of discharge: OR = 2.91 (1.40-6.04). Survivors of COVID-19 in wave 1 stayed longer in hospital (median = 6.5 days; interquartile range = 2.9-12.0) as compared to survivors from wave 2 (4.5 days; interquartile range = 1.9-8.7). Patient characteristics differed significantly between the two waves of COVID-19 pandemic. There was an improvement in outcomes in wave 2, including shorter length of stay in hospital and reduction of mortality.

Keywords: Coronavirus; Frequent readmission; LACE index; Length of stay; Mortality.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Numbers (A) and proportions (B) of admissions with COVID-19 and other causes between 01/03/2020 and 31/03/2021
Fig. 2
Fig. 2
Distribution of deaths in hospital amongst men and women (A) and those with a high LACE index (B) by admissions in pre-pandemic period and COVID-19 pandemic period
Fig. 3
Fig. 3
Length of stay in hospital amongst patients who died in hospital and those who survived to discharge. Bars represent the 5th and 95th percentiles
See this image and copyright information in PMC

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