tetano
Editor, Senior Moderator
Afr J Thorac Crit Care Med
. 2021 Dec 31;27(4):10.7196/AJTCCM.2021.v27i4.185.
doi: 10.7196/AJTCCM.2021.v27i4.185. eCollection 2021.
Comparison of patients with severe COVID-19 admitted to an intensive care unit in South Africa during the first and second wave of the COVID-19 pandemic
U Lalla[SUP] 1 [/SUP], C F N Koegelenberg[SUP] 1 [/SUP], B W Allwood[SUP] 1 [/SUP], L N Sigwadhi[SUP] 2 [/SUP], E M Irusen[SUP] 1 [/SUP], A E Zemlin[SUP] 3 [/SUP], T E Masha[SUP] 4 [/SUP], R T Erasmus[SUP] 3 [/SUP], Z C Chapanduka[SUP] 5 [/SUP], H Prozesky[SUP] 6 [/SUP], J Taljaard[SUP] 6 [/SUP], A Parker[SUP] 6 [/SUP], E H Decloedt[SUP] 7 [/SUP], F Retief[SUP] 8 [/SUP], T P Jalavu[SUP] 3 [/SUP], V D Ngah[SUP] 2 [/SUP], A Yalew[SUP] 2 9 10 [/SUP], J L Tamuzi[SUP] 2 [/SUP], N Baines[SUP] 1 [/SUP], M McAllister[SUP] 2 [/SUP], A Zumla[SUP] 11 [/SUP], P S Nyasulu[SUP] 2 12 [/SUP]
Affiliations
Abstract
Background: The second wave of coronavirus disease 2019 (COVID-19), dominated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Beta variant, has been reported to be associated with increased severity in South Africa (SA).
Objectives: To describe and compare clinical characteristics, management and outcomes of COVID-19 patients admitted to an intensive care unit (ICU) in SA during the first and second waves.
Methods: In a prospective, single-centre, descriptive study, we compared all patients with severe COVID-19 admitted to ICU during the first and second waves. The primary outcomes assessed were ICU mortality and ICU length of stay (LOS).
Results: In 490 patients with comparable ages and comorbidities, no difference in mortality was demonstrated during the second compared with the first wave (65.9% v. 62.5%, p=0.57). ICU LOS was longer in the second wave (10 v. 6 days, p<0.001). More female admissions (67.1% v. 44.6%, p<0.001) and a greater proportion of patients were managed with invasive mechanical ventilation than with non-invasive respiratory support (39.0% v. 14%, p<0.001) in the second wave.
Conclusion: While clinical characteristics were comparable between the two waves, a higher proportion of patients was invasively ventilated and ICU stay was longer in the second. ICU mortality was unchanged.
Keywords: COVID-19; ICU; SARS-CoV-2; clinical characteristics; management; mortality; outcomes; waves.
. 2021 Dec 31;27(4):10.7196/AJTCCM.2021.v27i4.185.
doi: 10.7196/AJTCCM.2021.v27i4.185. eCollection 2021.
Comparison of patients with severe COVID-19 admitted to an intensive care unit in South Africa during the first and second wave of the COVID-19 pandemic
U Lalla[SUP] 1 [/SUP], C F N Koegelenberg[SUP] 1 [/SUP], B W Allwood[SUP] 1 [/SUP], L N Sigwadhi[SUP] 2 [/SUP], E M Irusen[SUP] 1 [/SUP], A E Zemlin[SUP] 3 [/SUP], T E Masha[SUP] 4 [/SUP], R T Erasmus[SUP] 3 [/SUP], Z C Chapanduka[SUP] 5 [/SUP], H Prozesky[SUP] 6 [/SUP], J Taljaard[SUP] 6 [/SUP], A Parker[SUP] 6 [/SUP], E H Decloedt[SUP] 7 [/SUP], F Retief[SUP] 8 [/SUP], T P Jalavu[SUP] 3 [/SUP], V D Ngah[SUP] 2 [/SUP], A Yalew[SUP] 2 9 10 [/SUP], J L Tamuzi[SUP] 2 [/SUP], N Baines[SUP] 1 [/SUP], M McAllister[SUP] 2 [/SUP], A Zumla[SUP] 11 [/SUP], P S Nyasulu[SUP] 2 12 [/SUP]
Affiliations
- PMID: 35359698
- PMCID: PMC8948479
- DOI: 10.7196/AJTCCM.2021.v27i4.185
Abstract
Background: The second wave of coronavirus disease 2019 (COVID-19), dominated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Beta variant, has been reported to be associated with increased severity in South Africa (SA).
Objectives: To describe and compare clinical characteristics, management and outcomes of COVID-19 patients admitted to an intensive care unit (ICU) in SA during the first and second waves.
Methods: In a prospective, single-centre, descriptive study, we compared all patients with severe COVID-19 admitted to ICU during the first and second waves. The primary outcomes assessed were ICU mortality and ICU length of stay (LOS).
Results: In 490 patients with comparable ages and comorbidities, no difference in mortality was demonstrated during the second compared with the first wave (65.9% v. 62.5%, p=0.57). ICU LOS was longer in the second wave (10 v. 6 days, p<0.001). More female admissions (67.1% v. 44.6%, p<0.001) and a greater proportion of patients were managed with invasive mechanical ventilation than with non-invasive respiratory support (39.0% v. 14%, p<0.001) in the second wave.
Conclusion: While clinical characteristics were comparable between the two waves, a higher proportion of patients was invasively ventilated and ICU stay was longer in the second. ICU mortality was unchanged.
Keywords: COVID-19; ICU; SARS-CoV-2; clinical characteristics; management; mortality; outcomes; waves.