Difference in presentation, outcomes, and hospital epidemiologic trend of COVID-19 among first, second, and third waves: a review of hospital records and prospective cohort study

Reaz Mahmud; Md Ashikul Islam; Md Emdadul Haque; Dewan A Hussain; Mohammad R Islam; Farhana B Monayem; Mohammad M Kamal; Hashmi Sina; Mohammad F Islam; Ponkaj K Datta; S K Jakaria B Sayeed; Sabbir A Dhali; Khairul Islam; Rifat H Ratul; S K Md Rubaed Hossain; Habib N Prince; Ahmed H Chowdhury; Kazi G U Ahmed; Md Titu Miah; Md Mujibur Rahman

doi:10.1097/MS9.0000000000001024

Difference in presentation, outcomes, and hospital epidemiologic trend of COVID-19 among first, second, and third waves: a review of hospital records and prospective cohort study

Ann Med Surg (Lond). 2023 Jul 6;85(8):3816-3826. doi: 10.1097/MS9.0000000000001024. eCollection 2023 Aug.

Authors

Reaz Mahmud¹, Md Ashikul Islam², Md Emdadul Haque¹, Dewan A Hussain³, Mohammad R Islam⁴, Farhana B Monayem⁵, Mohammad M Kamal⁶, Hashmi Sina¹, Mohammad F Islam¹, Ponkaj K Datta⁶, S K Jakaria B Sayeed², Sabbir A Dhali¹, Khairul Islam⁶, Rifat H Ratul⁷, S K Md Rubaed Hossain¹, Habib N Prince⁸, Ahmed H Chowdhury¹, Kazi G U Ahmed¹, Md Titu Miah⁶, Md Mujibur Rahman⁹

Affiliations

¹ Department of Neurology, Dhaka Medical College.
² National Institute of Neurosciences and Hospital.
³ National Institute of Chest Diseases and Hospital.
⁴ Department of Medicine, Shaheed Suhrawardy Medical College.
⁵ Sarkari Karmachari Hospital.
⁶ Department of Medicine, Dhaka Medical College.
⁷ COVID-19 Post-acute Care and Follow-up Clinic, Dhaka Medical College.
⁸ North South University.
⁹ Department of Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Abstract

This study aimed to examine the differences in epidemiologic and disease aspects among patients with coronavirus disease-19 (COVID-19).

Methods: The authors reviewed the hospital records between April 2020 and September 2021 and followed up on the patients for post-COVID complications.

Findings: Older adult patients were predominantly affected during the third wave, and middle-aged patients were predominantly affected during the first and second waves. Men were predominantly admitted, considering the three waves, although more women were admitted in the second wave. Cough was more common in the second and third waves than in the first wave 522 (59.7%). Respiratory distress was the most common in the third wave, 251(67.1%), and least common in the first wave, 403 (46.1%). Anosmia was more common in the third wave 116 (31.2%). In the third wave, patients presenting in a critical state 23 (6.2%) and with severe disease 152 (40.8%) were more common. The hospital admission median (IQR) was longer in the first wave, 12 (8-20), than in other waves. More patients were admitted in the first wave (52%) than in the other waves, and patients received more oxygen in the third wave (75%) than in the other waves. Death occurred more commonly in the first wave (51%) than in the other waves. The positivity rate was higher in the third wave (22.8%) than in the other waves. In the third wave, the positivity rate was higher in women (24.3%) than in men. Post-COVID cough increased in the second wave, and fatigue was higher in the third wave than in the other waves. Tiredness and memory loss were greater during the second wave than in other waves.

Conclusion: The authors found differences in the presentation, outcomes, and hospital epidemiologic trend of COVID-19 among the three waves.

Keywords: COVID waves; COVID-19; COVID-19 epidemiologic trend; COVID-19 presentation; post-COVID conditions.