Predictors of adverse outcome in the first and second waves of the COVID-19 pandemic: results from a UK centre

Christopher A Martin; Daniel Pan; George Hills; Deborah Modha; Prashanth Patel; Laura J Gray; David R Jenkins; Linda Barton; William Jones; Nigel J Brunskill; Pranab Haldar; Kamlesh Khunti; Manish Pareek

doi:10.1177/20499361221074569

Predictors of adverse outcome in the first and second waves of the COVID-19 pandemic: results from a UK centre

Ther Adv Infect Dis. 2022 Jan 30:9:20499361221074569. doi: 10.1177/20499361221074569. eCollection 2022 Jan-Dec.

Authors

Affiliations

¹ Department of Respiratory Sciences, University of Leicester, Leicester, UK.
² Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
³ Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK.
⁴ Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
⁵ Department of Health Sciences, University of Leicester, Leicester, UK.
⁶ Department of Haematology, University Hospitals of Leicester NHS Trust, Leicester, UK.
⁷ Business Intelligence Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
⁸ NIHR Leicester Biomedical Research Centre, Leicester, East Midlands, LE5 4PW, UK.

Abstract

Background/aims: Data concerning differences in demographics/disease severity between the first and second waves of COVID-19 are limited. We aimed to examine prognosis in patients presenting to hospital with COVID-19 amongst different ethnic groups between the first and second waves in the UK.

Methods: In this retrospective cohort study, we included 1763 patients presenting to a regional hospital centre in Leicester (UK) and compared those in the first (n = 956) and second (n = 807) waves. Admission National Early Warning Scores, mechanical ventilation and mortality rate were lower in the second wave compared with the first.

Results: Thirty-day mortality risk in second wave patients was approximately half that of first wave patients [adjusted hazard ratio (aHR) 0.55, 95% confidence interval (CI) 0.40-0.75]. In the second wave, Black patients were at higher risk of 30-day mortality than White patients (4.73, 1.56-14.3).

Conclusion: We found that disporportionately higher risks of death in patients from ethnic minority groups were not equivalent across consecutive waves of the pandemic. This suggests that risk factors for death in those from ethnic minority groups are malleable and potentially reversible. Our findings need urgent investigation in larger studies.

Keywords: COVID-19; SARS-CoV-2; ethnicity; mortality.