COVID-19, a tale of two peaks: patients' characteristics, treatments, and clinical outcomes.
Adenosine Monophosphate
/ analogs & derivatives
Adult
Age Distribution
Aged
Alanine
/ analogs & derivatives
Antiviral Agents
/ therapeutic use
COVID-19
/ therapy
Disease Progression
Female
Hospitalization
Humans
Immunization, Passive
Male
Middle Aged
Respiration, Artificial
/ statistics & numerical data
Retrospective Studies
Sex Distribution
COVID-19 Drug Treatment
COVID-19 Serotherapy
COVID-19
Mechanical ventilation
Mortality
Treatments
Journal
Internal and emergency medicine
ISSN: 1970-9366
Titre abrégé: Intern Emerg Med
Pays: Italy
ID NLM: 101263418
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
21
11
2020
accepted:
21
01
2021
pubmed:
3
4
2021
medline:
25
8
2021
entrez:
2
4
2021
Statut:
ppublish
Résumé
Coronavirus 2019 disease (COVID-19) continues to challenge healthcare systems globally as many countries are currently experiencing an increase in the morbidity and mortality. Compare baseline characteristics, clinical presentation, treatments, and clinical outcomes of patients admitted during the second peak to those admitted during the first peak. Retrospective analysis of 258 COVID-19 patients consecutively admitted to the Tel Aviv Medical Center, of which, 131 during the first peak (March 21-May 30, 2020) and 127 during the second peak (May 31-July 16, 2020). First and second peak patients did not differ in baseline characteristics and clinical presentation at admission. Treatment with dexamethasone, full-dose anticoagulation, tocilizumab, remdesivir, and convalescent plasma transfusion were significantly more frequent during the second peak, as well as regimens combining 3-4 COVID-19-directed drugs. Compared to the first peak, 30-day mortality and invasive mechanical ventilation rates as well as adjusted risk were significantly lower during the second peak (10.2%, vs 19.8% vs p = 0.028, adjusted HR 0.39, 95% CI 0.19-0.79, p = 0.009 and 8.8% vs 19.3%, p = 0.002, adjusted HR 0.29, 95% CI 0.13-0.64, p = 0.002; respectively). Rates of 30-day mortality and invasive mechanical ventilation, as well as adjusted risks, were lower in the second peak of the COVID-19 pandemic among hospitalized patients. The change in treatment strategy and the experienced gained during the first peak may have contributed to the improved outcomes.
Identifiants
pubmed: 33797029
doi: 10.1007/s11739-021-02711-1
pii: 10.1007/s11739-021-02711-1
pmc: PMC8016151
doi:
Substances chimiques
Antiviral Agents
0
remdesivir
3QKI37EEHE
Adenosine Monophosphate
415SHH325A
Alanine
OF5P57N2ZX
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1629-1639Informations de copyright
© 2021. Società Italiana di Medicina Interna (SIMI).
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