引言虽然2019年冠状病毒病(COVID-19)的特异性治疗已经开始,住院患者的总死亡率仍然显著.我们的研究旨在评估患者的临床特征和结果,比较不同的COVID-19感染高峰期。方法回顾性研究2020年3月1日至4月24日和2020年11月1日至12月31日期间确诊为COVID-19的所有成人住院患者,这对应于我院COVID-19感染的第一波和第二波,分别。比较了患者的人口统计学和临床特征,并将其用于倾向匹配。临床结果,比如需要插管,随后比较了两组的肾脏替代治疗和住院患者死亡率.结果第二次COVID-19波患者的体重指数明显较高(32.58vs29.83,p<0.001),以及哮喘的患病率(14%和8%,p=0.019)和慢性肾脏疾病(42%vs18%,p<0.001)。几乎所有第二次COVID-19波中的患者都接受了皮质类固醇治疗(99%vs30%,p<0.001),和显着更多的患者接受了remdesivir(43%vs2%,p<0.001)。同时,第二次COVID-19波中的患者均未接受托珠单抗或羟氯喹治疗。临床结果的差异,例如需要肾脏替代疗法或插管,中位住院时间无统计学意义.在两个COVID-19高峰期之间,住院死亡率基本保持不变。讨论/结论在我们的机构中,在倾向匹配分析后,临床结果,如需要肾脏替代疗法,在两个COVID-19高峰期之间,插管和住院死亡率保持不变。
Introduction While Coronavirus disease 2019 (COVID-19) specific treatments have been instituted, overall mortality rates among hospitalized patients remain significant. Our study aimed to evaluate patient clinical characteristics and outcomes comparing the different COVID-19 infection peak periods. Methods This is a retrospective study of all adult patients hospitalized with a confirmed diagnosis of COVID-19 between March 1 to April 24, 2020 and November 1 to December 31, 2020, which corresponded to the first and second waves of COVID-19 infection in our institution, respectively. Demographic and clinical characteristics of the patients were compared and used for propensity matching. Clinical outcomes, such as need for intubation, renal replacement therapy and inpatient mortality were subsequently compared between the two groups. Results Patients in the second COVID-19 wave had a significantly higher body mass index (32.58 vs 29.83, p <0.001), as well as prevalence of asthma (14% vs 8%, p=0.019) and chronic kidney disease (42% vs 18%, p <0.001). Almost all patients in the second COVID-19 wave received corticosteroid treatment (99% vs 30%, p <0.001), and significantly more patients received remdesivir (43% vs 2%, p <0.001). Meanwhile, none of the patients in the second COVID-19 wave were treated with tocilizumab or hydroxychloroquine. Differences in clinical outcomes, such as need for renal replacement therapy or intubation, and median length of stay were not statistically significant. Inpatient mortality remained largely unchanged between the two COVID-19 peak periods. Discussion/ Conclusion In our institution, after propensity matched analysis, clinical outcomes such as need for renal replacement therapy, intubation and inpatient mortality remained unchanged between the two COVID-19 peak periods.