Evidence map›Paper›PMID 36410807›Full record

ArticleBMJ open2022

Retrospective study of comparison of clinical severity and outcome of hospitalised COVID-19 patients during the first and second waves of the pandemic in India.

Abhilash Paul Prabhakar Kundavaram, Saravanan Selvan, Vivek Raja, Ponnivalavan Mathiyalagan, Rohini Kanagarajan, Narmadha P Reddy, Natarajan Rajendiran, Darpanarayan Hazra, Karthik Gunasekaran, Mahesh Moorthy and 7 more

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 1 institution in 1 country.

Abhilash Paul Prabhakar KundavaramEmergency Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Saravanan SelvanEmergency Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Vivek RajaEmergency Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Ponnivalavan MathiyalaganEmergency Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Rohini KanagarajanEmergency Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Narmadha P ReddyEmergency Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Natarajan RajendiranEmergency Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.ORCID 0000-0002-9367-0470
Darpanarayan HazraEmergency Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Karthik GunasekaranDepartment of General Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India karthikgunasekaran@yahoo.com.ORCID 0000-0002-8615-5753
Mahesh MoorthyDepartment of Clinical Virology, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Audrin LeninDepartment of General Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Divya MathewDepartment of General Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Ramya IyyaduraiDepartment of General Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
George M VargheseDepartment of Infectious Disease, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Christopher DjDepartment of Pulmonary Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Melvin JoyDepartment of Biostatistics, Christian Medical College Vellore, Vellore, Tamil Nadu, India.ORCID 0000-0001-9323-994X
John Victor PeterDepartment of General Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Christian Medical College, Vellore · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare the clinical severity and outcome of hospitalised patients during the two waves of the COVID-19 pandemic in India.

settingA tertiary care referral hospital in South India.

participantsSymptomatic SARS CoV-2 reverse transcriptase PCR positive patients presenting to the emergency department during the two waves were recruited. The first wave spanned between April and December 2020 and the second wave between April and May 2021. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome of interest was mortality. Secondary outcomes included illness severity at presentation, need for oxygen therapy, non-invasive ventilation (NIV) and hospital or intensive care unit admission.

resultsThe mean (SD) age of the 4971 hospitalised patients in the first wave was similar to the 2293 patients in the second wave (52.5±15.4 vs 52.1±15.1 years, p=0.37). When compared with the first wave, during the second wave, a higher proportion of patients presented with critical illness (11% vs 1.1%, p<0.001) and needed supplemental oxygen therapy (n=2092: 42.1% vs n=1459: 63.6%; p<0.001), NIV (n=643; 12.9% vs n=709; 30.9%; p<0.001) or inotropes/vasoactive drugs (n=108; 2.2% vs n=77: 3.4%; p=0.004). Mortality was higher during the second wave (19.2% vs 9.3%; p<0.001). On multivariable regression analysis, age >60 years (risk ratio, RR 2.80; 95% CI 2.12 to 3.70), D-dimer >1000 ng/mL (RR 1.34; 95% CI 1.15 to 1.55), treatment with supplemental oxygen (RR 14.6; 95% CI 8.98 to 23.6) and presentation during the second wave (RR 1.40; 95% CI 1.21 to 1.62) were independently associated with mortality.

conclusionThe second wave of the COVID-19 pandemic in India appeared to be associated with more severe presentation and higher mortality when compared with the first wave. Increasing age, elevated D-dimer levels and treatment with supplemental oxygen were independent predictors of mortality.

Indexed as

COVID-19Influenza, HumanAdultAgedHumansMiddle AgedOxygenPandemicsRetrospective StudiesOxygenCOVID-19epidemiologypublic healthrespiratory infections

Identifiers

PMID36410807
PMCPMC9679869
OpenAlexW4309531123

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.