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. 2021 Dec 31;27(4):10.7196/AJTCCM.2021.v27i4.185.
doi: 10.7196/AJTCCM.2021.v27i4.185. eCollection 2021.

Comparison of patients with severe COVID-19 admitted to an intensive care unit in South Africa during the first and second wave of the COVID-19 pandemic

U Lalla  1 , C F N Koegelenberg  1 , B W Allwood  1 , L N Sigwadhi  2 , E M Irusen  1 , A E Zemlin  3 , T E Masha  4 , R T Erasmus  3 , Z C Chapanduka  5 , H Prozesky  6 , J Taljaard  6 , A Parker  6 , E H Decloedt  7 , F Retief  8 , T P Jalavu  3 , V D Ngah  2 , A Yalew  2   9   10 , J L Tamuzi  2 , N Baines  1 , M McAllister  2 , A Zumla  11 , P S Nyasulu  2   12
Affiliations

Comparison of patients with severe COVID-19 admitted to an intensive care unit in South Africa during the first and second wave of the COVID-19 pandemic

U Lalla et al. Afr J Thorac Crit Care Med. .

Abstract

Background: The second wave of coronavirus disease 2019 (COVID-19), dominated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Beta variant, has been reported to be associated with increased severity in South Africa (SA).

Objectives: To describe and compare clinical characteristics, management and outcomes of COVID-19 patients admitted to an intensive care unit (ICU) in SA during the first and second waves.

Methods: In a prospective, single-centre, descriptive study, we compared all patients with severe COVID-19 admitted to ICU during the first and second waves. The primary outcomes assessed were ICU mortality and ICU length of stay (LOS).

Results: In 490 patients with comparable ages and comorbidities, no difference in mortality was demonstrated during the second compared with the first wave (65.9% v. 62.5%, p=0.57). ICU LOS was longer in the second wave (10 v. 6 days, p<0.001). More female admissions (67.1% v. 44.6%, p<0.001) and a greater proportion of patients were managed with invasive mechanical ventilation than with non-invasive respiratory support (39.0% v. 14%, p<0.001) in the second wave.

Conclusion: While clinical characteristics were comparable between the two waves, a higher proportion of patients was invasively ventilated and ICU stay was longer in the second. ICU mortality was unchanged.

Keywords: COVID-19; ICU; SARS-CoV-2; clinical characteristics; management; mortality; outcomes; waves.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Fig. 1
Fig. 1
Assessing proportional hazards function using Schoenfeld residuals
Fig. 2
Fig. 2
Probability of survival curve of COVID-19 patients admitted in the ICU: first v. second wave. HR = hazard ratio
See this image and copyright information in PMC

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