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Observational Study
. 2021 Nov 24:10:1197.
doi: 10.12688/f1000research.73988.1. eCollection 2021.

Comparing the first and second waves of COVID-19 in a tertiary university hospital in Barcelona

Yolima Cossio  1   2 , Marta-Beatriz Aller  1   2 , Maria José Abadias  1   2 , Jose-Manuel Domínguez  1 , Maria-Soledad Romea  1   2 , Maria-Àngels Barba  1   2 , Maria-Isabel Rodríguez  1 , Antonio Roman  1   2 , Albert Salazar  1   2
Affiliations
Observational Study

Comparing the first and second waves of COVID-19 in a tertiary university hospital in Barcelona

Yolima Cossio et al. F1000Res. .

Abstract

Background: Hospitals have constituted the limiting resource of the healthcare systems for the management of the COVID-19 pandemic. As the pandemic progressed, knowledge of the disease improved, and healthcare systems were expected to be more adapted to provide a more efficient response. The objective of this research was to compare the flow of COVID-19 patients in emergency rooms and hospital wards, between the pandemic's first and second waves at the University Hospital of Vall d'Hebron (Barcelona, Spain), and to compare the profiles, severity and mortality of COVID-19 patients between the two waves.

Methods: A retrospective observational analysis of COVID-19 patients attending the hospital from February 24 to April 26, 2020 (first wave) and from July 24, 2020, to May 18, 2021 (second wave) was carried out. We analysed the data of the electronic medical records on patient demographics, comorbidity, severity, and mortality.

Results: The daily number of COVID-19 patients entering the emergency rooms (ER) dropped by 65% during the second wave compared to the first wave. During the second wave, patients entering the ER were significantly younger (61 against 63 years old p<0.001) and less severely affected (39% against 48% with a triage level of resuscitation or emergency; p<0.001). ER mortality declined during the second wave (1% against 2%; p<0.000). The daily number of hospitalised COVID-19 patients dropped by 75% during the second wave. Those hospitalised during the second wave were more severely affected (20% against 10%; p<0.001) and were referred to the intensive care unit (ICU) more frequently (21% against 15%; p<0.001). Inpatient mortality showed no significant difference between the two waves.

Conclusions: Changes in the flow, severity and mortality of COVID-19 patients entering this tertiary hospital during the two waves may reflect a better adaptation of the health care system and the improvement of knowledge on the disease.

Keywords: covid-19; hospital management; tertiary hospital.

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Conflict of interest statement

No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. 14 days-CI in Catalonia and COVID-19 hospital admissions (emergency or hospitalization).
The orange dashed line shows the cumulative incidence threshold that has been defined as a very high-risk situation in Spain. The blue dashed line represents the two waves of the pandemic in Catalonia according to the criteria defined in the article.
Figure 2.
Figure 2.. Distribution of the number of hospital admissions per day during the first and second waves.
See this image and copyright information in PMC

References

    1. Haldane V, De Foo C, Abdalla SM, et al. : Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries. Nat. Med. 2021;27:964–980. 2021. 10.1038/s41591-021-01381-y - DOI - PubMed
    1. OECD/European Union: Health at a Glance: Europe 2020: State of Health in the EU Cycle. Paris: OECD Publishing;2020. 10.1787/82129230-en - DOI
    1. World Health Organization: Maintaining essential health services: operational guidance for the COVID-19 context. World Health Organization;2020. Published 2020. Accessed October 29, 2021. Reference Source
    1. Real Decreto 463/2020: de 14 de marzo, por el que se declara el estado de alarma para la gestión de la situación de crisis sanitaria ocasionada por el COVID-19.Published 2020. Accessed July 7, 2021. Reference Source
    1. Redondo-Bravo L, Moros MJS, Sanchez EVM, et al. : The first wave of the COVID-19 pandemic in Spain: characterisation of cases and risk factors for severe outcomes, as at 27 April 2020. Eurosurveillance. 2020;25(50):2001431. - PMC - PubMed

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