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COVID-19 in three waves in a tertiary referral hospital in Belgium: a comparison of patient characteristics, management, and outcome.

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اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101231645 Publication Model: Electronic Cited Medium: Internet ISSN: 1743-422X (Electronic) Linking ISSN: 1743422X NLM ISO Abbreviation: Virol J Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: [London] : BioMed Central, 2004-
    • الموضوع:
      COVID-19*/epidemiology ; COVID-19*/therapy ; COVID-19*/mortality ; Tertiary Care Centers*/statistics & numerical data ; SARS-CoV-2*; Humans ; Belgium/epidemiology ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Hospitalization/statistics & numerical data ; Risk Factors ; Aged, 80 and over ; Adult ; Treatment Outcome ; Severity of Illness Index ; Comorbidity ; Intensive Care Units/statistics & numerical data
    • نبذة مختصرة :
      Purpose: Few studies have compared patient characteristics, clinical management, and outcome of patients with COVID-19 between the different epidemic waves. In this study, we describe patient characteristics, treatment, and outcome of patients admitted for COVID-19 in the Antwerp University Hospital over the first three epidemic waves of 2020-2021.
      Methods: Retrospective observational study of COVID-19 patients in a Belgian tertiary referral hospital. All adult patients with COVID-19, hospitalized between February 29, 2020, and June 30, 2021, were included. Standardized routine medical data was collected from patient records. Risk factors were assessed with multivariable logistic regression.
      Results: We included 722 patients, during the first (n = 179), second (n = 347) and third (n = 194) wave. We observed the lowest disease severity at admission during the first wave, and more elderly and comorbid patients during the second wave. Throughout the subsequent waves we observed an increasing use of corticosteroids and high-flow oxygen therapy. In spite of increasing number of complications throughout the subsequent waves, mortality decreased each wave (16.6%,15.6% 11.9% in 1st, 2nd and 3rd wave respectively). C-reactive protein above 150 mg/L was predictive for the need for intensive care unit admission (odds ratio (OR) 3.77, 95% confidence interval (CI) 2.32-6.15). A Charlson comorbidity index ≥ 5 (OR 5.68, 95% CI 2.54-12.70) and interhospital transfers (OR 3.78, 95% CI 2.05-6.98) were associated with a higher mortality.
      Conclusions: We observed a reduction in mortality each wave, despite increasing comorbidity. Evolutions in patient management such as high-flow oxygen therapy on regular wards and corticosteroid use may explain this favorable evolution.
      (© 2024. The Author(s).)
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    • Contributed Indexing:
      Keywords: COVID-19; Comparative analysis; Epidemic waves; Intensive care unit subgroup analysis.; Multivariable logistic regression; Retrospective cohort study
    • الموضوع:
      Date Created: 20240530 Date Completed: 20240531 Latest Revision: 20240606
    • الموضوع:
      20240607
    • الرقم المعرف:
      PMC11138039
    • الرقم المعرف:
      10.1186/s12985-024-02360-8
    • الرقم المعرف:
      38816850