Comparison of clinical outcomes and mortality in COVID 19 patients admitted during the first versus second wave in the ICU of a tertiary care centre in North India.

ABSTRACT

Background- India, like many countries, has experienced two surges of the COVID 19 pandemic. Empirical data shows a difference in the effects of the virus between the two periods.We decided to compare the behaviour of the disease in its two major outbreaks in critically ill patients so as to obtain a better understanding and improve clinical outcomes. Methods- This was a retrospective study conducted by obtaining patients data from hospital records during the first st wave from 1 April 2020 to 30 June 2020 and comparing it to the records in second wave 15 March 2021 to 15 June 2021. Patient demographics, clinical presentation, mechanical ventilation and overall ICU outcomes were compared. Results- 89 patients admitted during first wave and 100 patients admitted during second wave during the chosen period were selected for the purpose of this study. Second wave predominantly involved the young and middle aged while majority of patients during first wave belonged to older age group with co morbidities. The most frequent signs and symptoms during both waves were fever, cough, pneumonia and tachypnea. Conclusion- The second wave was characterised by higher infectivity in a comparatively younger age group whereas first wave showed older age groups being primarily infected. However, the case fatality rate during first wave was higher than second wave.