Hospital stay and mortality vary by pandemic wave and vaccination status in severe COVID-19.
Photo by Markus Spiske / Unsplash
Key Takeaway
Note hospital stay and ventilation peaked in waves 2nd and 3rd, with lower mortality observed in vaccinated patients.
This retrospective descriptive cohort study included 1,425 patients with severe COVID-19. Data were collected from the National Institute of Respiratory Diseases in Mexico City and the Regional High Specialty Hospital of the Yucatán Peninsula–IMSS Bienestar in Merida between March 2020 and November 2022. The population was evaluated across pandemic waves including the 1st, 2nd, 3rd, and 4th to 6th waves. Primary outcomes included all clinical and demographic variables at hospital admission.
Patient demographics shifted over time. At the 1st wave, patients were predominantly male and younger, whereas the 4th to 6th waves showed a high frequency of subjects with heart disease. The longest hospital stay, with a median of 23 days, occurred during the 2nd and 3rd waves. Additionally, the highest percentage of invasive mechanical ventilation, recorded at 81.02%, was observed during the 2nd and 3rd waves.
Mortality was lower in the vaccinated group compared to the unvaccinated group. Safety data regarding adverse events, serious adverse events, and discontinuations were not reported. The study did not report specific limitations or funding sources. Secondary outcomes included hospital stay, invasive mechanical ventilation, and mortality.
Practice relevance was not reported. Clinicians should note these associations without inferring causality due to the observational design and unreported limitations.
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View Original Abstract ↓
BackgroundThroughout the COVID-19 pandemic, there was variability in outcomes and in the clinical and demographic characteristics of patients with severe disease. We aimed to compare clinical and demographic variables at hospital admission among patients with severe COVID-19 at two high-specialty centers in Mexico during the pandemic waves, accounting for relevant virus variants and patients' vaccination status.MethodsThis retrospective, descriptive study included medical records of 1,425 patients hospitalized with COVID-19 (March 2020–November 2022) at the National Institute of Respiratory Diseases (INER, Mexico City, Mexico) and the Regional High Specialty Hospital of the Yucatán Peninsula–IMSS Bienestar (Merida, Yucatán, Mexico). The comparison was performed between the 1st wave, the 2nd and 3rd waves, and the 4th to 6th waves in Mexico, among the pre-dominant SARS-CoV-2 variants (Delta and Omicron), and vaccination status during the Omicron stage.ResultsAt the 1st wave, patients were pre-dominantly male and younger; whereas in the 4th to 6th waves, a high frequency of subjects with heart disease was observed. The longest hospital stay (median 23 days) and the highest percentage of invasive mechanical ventilation (81.02%) were observed during the 2nd and 3rd waves. Heart diseases and D-dimer were relevant during the Omicron stage. Clinical and demographic variables were similar between unvaccinated and vaccinated subjects, although the mortality was lower in the vaccinated group.ConclusionsThese differences in the studied variables across pandemic waves and SARS-CoV-2 variants help explain the variability in clinical outcomes throughout the COVID-19 pandemic.
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