PLoS ONE (Jan 2021)

Clinical management and outcome differences between first and second waves among COVID-19 hospitalized patients: A regional prospective observational cohort.

  • María Zuil,
  • Iván D Benítez,
  • Ramón Cabo-Gambín,
  • Carlos Manzano Senra,
  • Anna Moncusí-Moix,
  • Clara Gort-Paniello,
  • David de Gonzalo-Calvo,
  • Marta Molinero,
  • Jose Javier Vengoechea Aragoncillo,
  • Thais Comella,
  • Jordi de Batlle,
  • Gerard Torres,
  • Antoni Torres,
  • Ferrán Barbé,
  • Jessica González

DOI
https://doi.org/10.1371/journal.pone.0258918
Journal volume & issue
Vol. 16, no. 10
p. e0258918

Abstract

Read online

The objective was to describe the clinical characteristics and outcomes of hospitalized COVID-19 patients during the two different epidemic periods. Prospective, observational, cohort study of hospitalized COVID-19. A total of 421 consecutive patients were included, 188 during the first period (March-May 2020) and 233 in the second wave (July-December 2020). Clinical, epidemiological, prognostic and therapeutic data were compared. Patients of the first outbreak were older and more comorbid, presented worse PaO2/FiO2 ratio and an increased creatinine and D-dimer levels at hospital admission. The hospital stay was shorter (14.5[8;29] vs 8[6;14] days, p<0.001), ICU admissions (31.9% vs 13.3%, p<0.001) and the number of patients who required mechanical ventilation (OR = 0.12 [0.05-10.26]; p<0.001) were reduced. There were no significant differences in hospital and 30-day after discharge mortality (adjusted HR = 1.56; p = 0.1056) or hospital readmissions. New treatments and clinical strategies appear to improve hospital length, ICU admissions and the requirement for mechanical ventilation. However, we did not observe differences in mortality or readmissions.