Abstract
Background
Third wave of COVID-19 has affected several countries. Case fatality rates from first and second waves are expected to be surpassed by the current wave due to various variant transmissions. This study was aimed to compare and contrast the significant clinical markers between survivors and non-survivors during the third wave of COVID-19 to assess severity and prognosis.
Methods
It includes all the patients who were diagnosed with COVID-19 polymerase chain reaction (PCR) during the third wave, and were monitored for their disease course and outcomes. A total of 209 patients were included in the analysis via non-probability consecutive sampling method.
Results
The median age was higher in non-surviving patients (p = 0.010). Majority of deaths occurred in intensive care patients (p < 0.001) and those with diabetes (p = 0.032) and hypertension (p = 0.003). Fever was the most predominant symptom in all patients (78.9%), dyspnea was common among expired individuals (p = 0.043) while recovered patients were more likely to be asymptomatic (p = 0.044). Gastrointestinal symptoms were not found marked during this wave. Being on ventilator has higher mortality (p < 0.001). Predominant radiological findings were interstitial patches or infiltrate (43.7%). Multivariable analysis showed hypertension (p = 0.042), BiPAP/CPAP (p < 0.001), being on ventilator (p = 0.004), and ARDS (p < 0.001) was associated with poor survival while patchy interstitial infiltrates on X-ray had good survival probability (p = 0.032). On Kaplan-Meier survival analysis, hypertension (p = 0.003), BiPAP/CPAP (p = 0.008), ventilator (p = 0.025), ICU stay (p = 0.001), high-grade fever (p = 0.001), and ARDS (p < 0.001) had reduced cumulative survival.
Conclusion
Certain biochemical markers were more predictive of disease severity in the third-wave than the preceding waves.
【저자키워드】 COVID-19, SARS-CoV-2, pandemic, severity, Infection, 【초록키워드】 ARDS, Mortality, disease severity, variant, Symptom, hypertension, ICU, outcomes, X-ray, Probability, survival, PCR, Asymptomatic, Fever, Dyspnea, Patient, Case fatality rate, death, Gastrointestinal, second wave, Analysis, Predictive, ventilator, median age, individual, disease course, transmissions, cumulative, being, survivor, intensive care patient, radiological finding, non-survivor, interstitial, Kaplan-Meier survival analysis, polymerase chain, biochemical marker, recovered patient, Result, affected, occurred, include, the patient, reduced, predominant, expected, diabete, clinical marker, diagnosed with COVID-19, expired, patchy, severity and prognosis, surpassed, 【제목키워드】 Clinical outcome, Clinical course, biochemical markers, retrospective cohort study, COVID-19 positive patient,