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Observational Study
. 2022 Nov;17(8):2219-2228.
doi: 10.1007/s11739-022-03052-3. Epub 2022 Aug 15.

Comparison between the first and second COVID-19 waves in Internal Medicine wards in Milan, Italy: a retrospective observational study

Deborah Blanca  1   2 , Selene Nicolosi  1   2 , Alessandra Bandera  2   3 , Francesco Blasi  2   4 , Marco Mantero  2   4 , Cinzia Hu  5 , Margherita Migone de Amicis  5 , Tiziano Lucchi  6 , Giuseppina Schinco  6 , Flora Peyvandi  2   7 , Roberta Gualtierotti  2   7 , Anna Ludovica Fracanzani  2   8 , Rosa Lombardi  2   8 , Ciro Canetta  2   9 , Nicola Montano  1   2 , Lorenzo Beretta  10 ; Covid Network
Affiliations
Observational Study

Comparison between the first and second COVID-19 waves in Internal Medicine wards in Milan, Italy: a retrospective observational study

Deborah Blanca et al. Intern Emerg Med. 2022 Nov.

Abstract

COVID-19 spread in two pandemic waves in Italy between 2020 and 2021. The aim of this study is to compare the first with the second COVID-19 wave, analyzing modifiable and non-modifiable factors and how these factors affected mortality in patients hospitalized in Internal Medicine wards. Consecutive patients with SARS-CoV-2 infection and dyspnea requiring O2 supplementation were included. The severity of lung involvement was categorized according to the patients' oxygen need. Six hundred and ten SARS-CoV-2 hospitalized patients satisfied the inclusion criteria. The overall estimated 4-week mortality was similar in the two pandemic waves. Several variables were associated with mortality after univariate analysis, but they lacked the significance after multivariable adjustment. Steroids did not exert any protective effect when analyzed in time-dependent models in the whole sample; however, steroids seemed to exert a protective effect in more severe patients. When analyzing the progression to different states of O2 supplementation during hospital stay, mortality was almost exclusively associated with the use of high-flow O2 or CPAP. The analysis of the transition from one state to the other by Cox-Markov models confirmed that age and the severity of lung involvement at admission, along with fever, were relevant factor for mortality or progression.

Keywords: COVID-19; Internal Medicine; LMWH; O2 supplementation; SARS-CoV-2; Survival.

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Conflict of interest statement

The authors declare they have no conflicts of interest. This work was not supported by any grant.

Figures

Fig. 1
Fig. 1
Estimated survival. Estimated survival (Kaplan–Meier curves) in the 1st (black line) and 2nd (red line) pandemic waves
Fig. 2
Fig. 2
Progression to different states
See this image and copyright information in PMC

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References

    1. World Health Organization, Mission China Joint (2020) Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). WHO-China Jt Mission Coronavirus Dis 2019. 2019.
    1. WHO COVID-19 global table data May 5th 2021 at 10
    1. Xu XW, Wu XX, Jiang XG, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020;368:1–7. doi: 10.1136/bmj.m606. - DOI - PMC - PubMed
    1. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA J Am Med Assoc. 2020;323:1061–1069. doi: 10.1001/jama.2020.1585. - DOI - PMC - PubMed
    1. Ejaz H, Alsrhani A, Zafar A, et al. COVID-19 and comorbidities: deleterious impact on infected patients. J Infect Public Health. 2020;13:1833–1839. doi: 10.1016/j.jiph.2020.07.014. - DOI - PMC - PubMed

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