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Expert Rev Respir Med . COVID-19 Clinical Phenotypes and Short-term Outcomes: Differences Between the First and the Second Wave of Pandemic in Italy

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  • Expert Rev Respir Med . COVID-19 Clinical Phenotypes and Short-term Outcomes: Differences Between the First and the Second Wave of Pandemic in Italy


    Expert Rev Respir Med


    . 2021 Jul 27.
    doi: 10.1080/17476348.2021.1960824. Online ahead of print.
    COVID-19 Clinical Phenotypes and Short-term Outcomes: Differences Between the First and the Second Wave of Pandemic in Italy


    Andrea Portacci 1 , Giovanna Elisiana Carpagnano 1 , Maria Grazia Tummolo 1 , Carla Santomasi 1 , Lavinia Palma 1 , Domenico Fasano 2 , Emanuela Resta 3 , Madia Lozupone 4 , Vincenzo Solfrizzi 2 , Francesco Panza 5 , Onofrio Resta 1



    Affiliations

    Abstract

    Objectives: There are no comparison studies between patients belonging to the first and second waves of the pandemic of the SARS-CoV-2, the virus triggering coronavirus disease 2019 (COVID-19). In this retrospective observational study, we analyzed clinical characteristics and the short-term outcomes of two groups of laboratory-confirmed COVID-19 patients with moderate-to-severe acute respiratory distress syndrome (ARDS) belonging to two different waves of the pandemic.
    Methods: We analyzed 97 consecutive patients from 11 March, 2020 to 31 May, 2020 and 52 consecutive patients from 28 August, 2020 to 15 October, 2020.
    Results: Patients belonging to the second wave were younger, had a lower number of concomitant chronic conditions (multimorbidity), and a milder clinical phenotype. Medical treatments and respiratory support use have changed during the COVID-19 pandemic, according with different laboratory results and disease clinical features. Patients in the second wave had better short-term clinical outcomes, with a lower death rate and more step-down transfers to general ward.
    Conclusion: The present findings showed a clear phenotypic difference in patients hospitalized at different stages of the COVID-19 pandemic in Italy. These results can help to stratify clinical risk and to better tailor medical treatments and respiratory supports for patients with ARDS and COVID-19 pneumonia.

    Keywords: Assisted ventilation; Critical care; Intermediate RICU; Italy; Pandemic; Survival.

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