Mortality and Risk of Hospitalized COVID-19 Patients During Different Pandemic Spikes

In a recent study published in scientific reportinvestigators evaluated mortality associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) alpha (B.1.1.7) and delta (B.1.617.2) variant infections.

Background

SARS-CoV-2 has evolved into new subspecies around the world since the beginning of the 2019 coronavirus disease (COVID-19) pandemic. Variants are defined by the World Health Organization (WHO) using three criteria: increased transmissibility, increased virulence or altered clinical presentation, and efficacy of public health measures, vaccines, and treatments. decline.

The trajectory of mortality from COVID-19 is diverse and difficult to explain because there are many phases in COVID-19 waves, duration, diversity of potential comorbidities in patients, and hospital burden. Mortality trends were also consistent with intensive care unit (ICU) mortality trends. This was due to a large number of cases requiring her admission to the ICU during the pandemic. Studies assessing mortality trajectories over time during COVID-19 waves are needed, as patient surges can adversely affect outcomes.

About research

In the current study, researchers evaluated mortality and mortality risk associated with hospitalized COVID-19 patients at various COVID-19 surges.

Between 21 March 2021 and 3 October 2021, COVID-19 hospitalized patients in Tehran province participated in this multicenter observational study. A registry database monitored by the Tehran coronavirus task force was used to obtain study data. In March 2020, Iran launched a central registry of novel coronavirus infections. All suspected, probable, and confirmed cases of COVID-19 were prospectively recorded in the national registry of the COVID-19 database, according to WHO definition guidelines.

The primary study outcome was mortality among hospitalized COVID-19 positive patients. Censored cases were defined as patients who were discharged or unavailable for follow-up. The time from the date of admission to the date of death or the date of discharge was called survival time. In addition to demographic factors such as age, sex, smoking habits, and nationality, studies included variables such as symptoms such as anorexia, vomiting, paralysis, diarrhea, fever, myalgia, dysosmia, and dysgeusia. It was Comorbidities such as heart disease, hypertension, human immunodeficiency virus (HIV), neurological disease, asthma, neurological disease, hypertension, immunodeficiency; substance abuse, residential county, computed tomography (CT) results.

result

From 21 March 2021 to 3 October 2021, 270,624 COVID-19 positive patients were hospitalized in Tehran. The median age of patients with COVID-19 was 50 years, 50.2% were male, and by mid-August he had two peaks in the number of hospitalized patients with COVID-19. These peaks were associated with the prevalence of SARS-CoV-2 alpha and delta variants, respectively. During the second peak, patients were more likely to belong to the youngest age group. There was no difference between the first and her second peaks in the proportion of patients admitted to the ICU and those who were not.

The proportion of men infected with COVID-19 was 51.9 in March, but dropped to 47.3 in October. The patient’s median age decreased from 55 years in March to 48 years in October. At the first peak in April, the number of cases was 25.5 under 40 years, 16.5 between 40-49 years and 19.1 between 50-59 years. After that, the number of cases increased to 31.4, 20.0 and 21.0 for his second peak in August. Contrary to the pattern of patients over the age of 60, the proportion of hospitalized patients in this age group was found to be lower in August than in April.

During the study period, 18,623 COVID-19 patients died. The mortality rate for his COVID-19 patients admitted to non-ICU wards was 3.2 for him, while the mortality rate for patients admitted to the ICU was 34.0. The strongest correlations were found between patient outcomes and age, length of hospital stay, dyspnea, comorbidities, renal disease, chest discomfort, hypertension, and diabetes.

Patients admitted in June were shown to have a reduced risk of death from COVID-19 compared to those admitted in March. Men had a 17% higher risk of death than women. The likelihood of succumbing to COVID-19 increases with age, with people over the age of 89 at greatest risk. Additionally, a higher number of comorbidities was associated with a higher risk of death from COVID-19, and those with three or more comorbidities were at higher risk.

Mortality among patients admitted to the ICU rose from March to April, then stabilized through May and declined during the initial COVID-19 peak in January. Mortality spiked at his second peak in July, peaked in August, and then declined in September and he in October. However, non-ICU patient mortality spiked in April and July. Additionally, non-ICU patients had the highest mortality during the first peak of COVID-19.

Conclusion

Overall, the findings showed that while mortality decreased between March and October 2021, the risk of hospitalization and death from COVID-19 increased. Moreover, compared to the surge in SARS-CoV-2 alpha variant infections, the surge in delta variants was associated with a higher likelihood of death from COVID-19.