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The Second- vs First-wave COVID-19: More of the Same or a Lot Worse? A Comparison of Mortality between the Two Waves in Patients Admitted to Intensive Care Units in Nine Hospitals in Western Maharashtra

Priya Ranganathan, Khalid Khatib, Subhal Dixit, Ameya Joshi, Sweta Singh, Abhijit Deshmukh, Rahul Pandit, Mukund Joshi, Kapil Zirpe, Bindu Mulakavalupil, Sayi Prasad, Zafer Khan Amanulla, Vatsal Kothari, Sourabh Ambapkar, Shrikant Shastrabuddhe, Vinod Gosavi, Charlotte Saldhanah, Saanvi Ambapkar, Madhura Bapte, Anmol Zirpe, Gowri Sayiprasad

2021Indian Journal of Critical Care Medicine45 citationsDOIOpen Access PDF

Abstract

BACKGROUND: India, along with the rest of the world, faced the challenging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The second wave in India lagged behind that in the Western world, due to different timing of seasons. There is scarce data about the differences between the two waves, for intensive care unit (ICU) patients. We present the data of 3,498 patients from 9 ICUs of western Maharashtra. MATERIALS AND METHODS: We collected prospective data of hospitalized, RT-PCR confirmed, coronavirus-2019 (COVID-19) patients, from nine tertiary centers, after institutional ethics committee (IEC) approval. Then, we segregated and analyzed the data of patients admitted to the ICU, for comorbidities, high-resolution computed tomography (HRCT) score, ventilatory support, etc. The primary outcomes were ICU and hospital mortality. We also performed multivariable analysis for predictors of ICU mortality. RESULTS: <0.001) and need for ventilatory support of any type. More patients received steroids during the second wave. On multivariable regression, male gender, ICU admission during the second wave, increasing HRCT score, and need for intubation and mechanical ventilation were significant predictors of ICU mortality. CONCLUSION: ICU patients admitted during the two waves were of the similar age, but there were more females, and more patients had comorbidities during the second wave. The ICU and hospital mortality were significantly higher during the second wave. HOW TO CITE THIS ARTICLE: Zirpe KG, Dixit S, Kulkarni AP, Pandit RA, Ranganathan P, Prasad S, et al. The Second- vs First-wave COVID-19: More of the Same or a Lot Worse? A Comparison of Mortality between the Two Waves in Patients Admitted to Intensive Care Units in Nine Hospitals in Western Maharashtra. Indian J Crit Care Med 2021; 25(12):1343-1348.

Topics & Concepts

MedicineIntensive care unitMechanical ventilationIntubationIntensive careCoronavirus disease 2019 (COVID-19)Emergency medicinePandemicAPACHE IISeverity of illnessIntensive care medicineInternal medicineSurgeryDiseaseInfectious disease (medical specialty)COVID-19 Clinical Research StudiesCOVID-19 and healthcare impactsSARS-CoV-2 and COVID-19 Research