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.
More on COVID
COVID-19 was the third leading cause of death in the United States in 2021
COVID-19 was the third leading cause of death in the United States in 2021
A 2021 U.S. mortality data report indicates COVID-19 was the third leading cause of death, following heart disease and cancer.
In 2021, COVID-19 remained the third leading cause of death in the United States, trailing only heart disease and cancer.
Serum resistin levels rise progressively with worsening severity of coronary heart disease and acute myocardial infarction in this meta-analysis
High blood resistin levels linked to heart disease severity in large analysis
A network meta-analysis of 9,169 subjects reveals that serum resistin levels increase stepwise as coronary heart disease severity worsens. W…
A large network meta-analysis found that higher serum resistin levels are linked to worse coronary heart disease and acute heart attacks.
Breast arterial calcification linked to increased cardiovascular mortality risk
Calcified breast arteries linked to higher risk of heart disease and death
This meta-analysis examined associations between breast arterial calcification and cardiovascular outcomes. The authors observed that the pr…
A large analysis shows breast arterial calcification is associated with higher risks of heart failure, stroke, and death in women.
Review of RISE-mitigation strategies in Ghana shows high immunization coverage and improved oxygen access
Ghana reduced oxygen travel distances and improved vaccine coverage with new pandemic strategies
This review uses mixed qualitative and quantitative approaches to evaluate RISE-mitigation strategies in Ghana. The analysis covers 10 novel…
New strategies in Ghana helped get oxygen closer to patients and reached 93% of people with vaccines while treating most confirmed cases.
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.
Primary community health care nurses improve patient outcomes and reduce costs compared to medical practitioners
Meta-analysis shows primary care nurses improve health and save money compared to medical practitioners
Related in Primary Care & Family Medicine
Transition programs for DMD vary widely with significant gaps in policy-driven implementation and neurodiversity support
Health systems for young people with Duchenne muscular dystrophy need better support and clear rules
This systematic review with narrative synthesis examines transition-related health systems for youth and adults living with Duchenne muscula…
A review of 42 studies shows care plans for teens with Duchenne muscular dystrophy vary widely. Most programs are temporary projects instead…
Structured exercise cuts depression, anxiety, and stress in university students with large to moderate effects
Structured Exercise Linked to Lower Depression, Anxiety, and Stress in Students
This systematic review and network meta-analysis of 2,127 university students found that structured exercise interventions were associated w…
A large review suggests structured exercise helps university students manage depression, anxiety, and stress better than doing nothing.
Patient-centred follow-up consultations improve goal attainment in CVD risk patients
Follow-up talks help heart patients reach health goals
This cluster-randomized trial in 712 patients with CVD risk factors found that those receiving patient-centred follow-up consultations had h…
Heart patients who had follow-up consultations were more likely to achieve their health goals, a new trial finds.
Wearable activity tracker adherence associated with reduced body fat in a 12-month randomized trial
Wearable tracker use linked to lower body fat in overweight adults
This randomized controlled trial examined 502 participants with a mean age of 45 years and mean BMI of 33.7 kg/m. The study assessed associa…
Wearable activity trackers linked to lower body fat in overweight adults after one year. This trial examined how consistent movement goals a…
From Other Specialties
Probiotics, synbiotics, and berberine modestly lower fasting glucose and HbA1c in type 2 diabetes
Probiotics and Berberine Modestly Lower Blood Sugar in Type 2 Diabetes
This meta-analysis of over 2,000 participants found that probiotics, synbiotics, and berberine produced significant but modest reductions in…
Probiotics, synbiotics, and berberine may help lower blood sugar and HbA1c, but the effects are modest.
High-dose ocrelizumab 1200/1800 mg shows no significant difference in disability progression versus 600 mg in MS
High-dose ocrelizumab did not further reduce disability progression in multiple sclerosis patients
This phase 3b randomized controlled trial in 860 and 753 patients with relapsing or primary progressive multiple sclerosis found that high-d…
A large trial found that higher doses of ocrelizumab did not lower the risk of disability progression compared to the standard dose in multi…
Ocrelizumab reduces disability progression risk in primary progressive multiple sclerosis versus placebo
Ocrelizumab reduces disability risk for primary progressive multiple sclerosis patients
This phase 3b trial evaluated intravenous ocrelizumab versus placebo in patients with primary progressive multiple sclerosis. The study foun…
A large trial found ocrelizumab significantly lowers the risk of disability progression in patients with primary progressive multiple sclero…
Prasinezumab showed non-significant delay in motor progression versus placebo in early-stage Parkinson's disease
Early Parkinson's drug trial shows no delay in motor progression
This phase 2b trial evaluated intravenous prasinezumab in individuals with early-stage Parkinson's disease on stable medication. The study f…
A Phase 2b trial of prasinezumab in early Parkinson's disease failed to meet its primary endpoint of delaying motor progression compared to …