Comparison of clinical evolution in two different waves of COVID-19 infection

ABSTRACT

Background: COVID-19 is a worldwide emergency;hospitals are subjected to intense workloads, reduced compared to the previous waves, for advent of vaccination and use of immunomodulators Aim: to evaluate the clinical outcome of patients during the last wave in a Spoke hospital and compare the results with those of the end of 2020. Methods: In the period Dec. 21-Jan. 22 we treated 105 patients (62 men, average age 68.4 y, range 30-99, 51 polipathological), 56 of them with complete vaccination cycle ;the mean age of the vaccinated was lower (65.2+-15.1 vs 71.8+-15.7);in addition to therapy with EBPM and dexamethasone if indicated, 23 with risk factors were treated with casirivimab and indevimab 1200+1200 mg, 33 with remdesivir and 9 baricitinib;6 patients with combination therapies. The mean hospital stay was 7.9 days, range 3-24. Results: 10 patients died (5 unvaccinated) and 13 needed UTI (10 NIV support, 6 unvaccinated, and 3 IOT, 2 unvaccinated) but with a favorable evolution in over 2/3 of the cases;the other patients were discharged at home. Considering then other 75 hospitalized patients between Dec 20-Jan21, 53 men, average age 69.5 y, range 36-91, treated only with standard therapy (EBPM and steroid), the average stay had been 12.6 days and the previous outcome was 23 transferred UTI (8 intubated) and total of 17 deaths. Conclusions: With advent of vaccines, monoclonal antibodies, antivirals and immunomodulators, hospitalization times, the need for intensive care (13 vs 23) and deaths (10 vs 17) have been approximately halved.