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Clinical Comparison of the COVID Waves 2-5. An Inpatient Retrospective Comparative Analysis from Karachi, Pakistan - IDSA

Mary Wilson

Well-known member
Published: 07 February 2025​

Open Forum Infectious Diseases, ofaf072, https://doi.org/10.1093/ofid/ofaf072

Muneeba Ahsan Sayeed, Elisha Shalim, Shaiza Farman, Fizza Farooqui, Beenish Syed, Ishfaque Ahmed, Anika Iqbal, Aneel Kumar, Raniyah Akhter, Furkan Hyder, Hasan Ali Shah, Adeel Hussain, Sarwat Rasheed, Saba Afshan, Rizwana Salik Nukrich, Madiha Raza, Haseeb U Rehman, Abdul Razzaque, Abdul Wahid Rajput, Muhammad Saeed Quraishy​

Abstract

Background
Each COVID wave is unique in its clinical presentation and outcome. In this study, we compared the clinical characteristics and outcome of COVID waves 2-5 in inpatient settings.

Methods
A retrospective study was conducted at the Sindh Infectious Diseases Hospital and Research Center on adult patients who were admitted with a positive COVID PCR from July 2020–Mar 2022. SPSS 26 analyzed data.

Results
Total 3190 COVID-19 patients were admitted. Wave 2 had the highest percentage of discharges compared to mortality (81%, p-value 0.0001). Cytokine Release Syndrome (CRS) was most common in wave 3 (32.7%, p-value 0.0001). On comparison, severe COVID on admission was predominant in wave 4 (79.4%, p-value 0.0001) with highest intubation rate (27.1%, p-value 0.0001), septic shock (24.3%, p-value 0.0001) and disease progression (50.8%, p-value 0.0001). In wave 5 majority were elderly (median age 68 years), had mild COVID (22.4%, p-value 0.0001), most having co-morbidities (84.6%, p-value 0.0001) and ratio of acute kidney injury was high (29.2%, p-value 0.0001). Mortality was lowest in wave 2 (18.9%, p-value 0.0001) while highest in wave 4 (42.5%, p-value 0.0001; OR 3.18, CI 2.6-3.8 compared to wave 2).

Conclusion
Each wave had some unique characteristics compared to other waves with wave 4 being the deadliest one in terms of disease severity and outcome, which was driven by delta variant.​

https://watermark.silverchair.com/o...sLqceWb2KHIeA9y7OWQgnEgTy2aBtpj5dDfyq0MCDDHaa
 
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