Gunjan Kumar1, Aparna Mukherjee1, Ravendra K Sharma2, Geetha R Menon2, Damodar Sahu2, Naveet Wig3, Samiran Panda4, Vishnu Vardhan Rao2, Sujeet Singh5, Randeep Guleria6, Balram Bhargava7. 1. Clinical Studies, Trial & Projection Unit, Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India. 2. ICMR-National Institute of Medical Statistics, New Delhi, India. 3. Department of Medicine, All India Institute of Medical Sciences, New Delhi, India. 4. Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India. 5. National Centre for Disease Control, New Delhi, India. 6. All India Institute of Medical Sciences, New Delhi, India. 7. Indian Council of Medical Research, New Delhi,, India.
Abstract
Background & objectives: : India witnessed a massive second surge of COVID-19 cases since March 2021 after a period of decline from September 2020. Data collected under the National Clinical Registry for COVID-19 (NCRC) were analysed to describe the differences in demographic and clinical features of COVID-19 patients recruited during these two successive waves. Methods: : The NCRC, launched in September 2020, is an ongoing multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized, confirmed COVID-19 patients were captured in an electronic data portal from 41 hospitals across India. Patients enrolled during September 1, 2020 to January 31, 2021 and February 1 to May 11, 2021 constituted participants of the two successive waves, respectively. Results: : As on May 11, 2021, 18961 individuals were recruited in the registry, 12059 and 6903 reflecting in-patients from the first and second waves, respectively. Mean age of the patients was significantly lower in the second wave [48.7 (18.1) yr vs. 50.7 (18.0) yr, P< 0.001] with higher proportion of patients in the younger age group intervals of < 20, and 20-39 yr. Approximately 70 per cent of the admitted patients were = 40 yr of age in both waves of the pandemic. The proportion of males were slightly lower in second wave as compared to the first [4400 (63.7%) vs. 7886 (65.4%), P=0.02]. Commonest presenting symptom was fever in both waves. In the second wave, a significantly higher proportion [2625 (48.6%) vs. 4420 (42.8%), P< 0.003] complained of shortness of breath, developed ARDS [422(13%) vs. 880 (7.9%), P< 0.001], required supplemental oxygen [1637 (50.3%) vs. 4771 (42.7%), P< 0.001], and mechanical ventilation [260 (15.9%) vs. 530 (11.1%), P< 0.001]. Mortality also significantly increased in the second wave [OR: 1.35 (95% CI: 1.19, 1.52)] in all age groups except in < 20 yr. Interpretation & conclusions: : The second wave of COVID-19 in India was slightly different in presentation than the first wave, with a younger demography, lesser comorbidities, and presentation with breathlessness in greater frequency.
Background & objectives: : India witnessed a massive second surge of COVID-19 cases since March 2021 after a period of decline from September 2020. Data collected under the National Clinical Registry for COVID-19 (NCRC) were analysed to describe the differences in demographic and clinical features of COVID-19patients recruited during these two successive waves. Methods: : The NCRC, launched in September 2020, is an ongoing multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized, confirmed COVID-19patients were captured in an electronic data portal from 41 hospitals across India. Patients enrolled during September 1, 2020 to January 31, 2021 and February 1 to May 11, 2021 constituted participants of the two successive waves, respectively. Results: : As on May 11, 2021, 18961 individuals were recruited in the registry, 12059 and 6903 reflecting in-patients from the first and second waves, respectively. Mean age of the patients was significantly lower in the second wave [48.7 (18.1) yr vs. 50.7 (18.0) yr, P< 0.001] with higher proportion of patients in the younger age group intervals of < 20, and 20-39 yr. Approximately 70 per cent of the admitted patients were = 40 yr of age in both waves of the pandemic. The proportion of males were slightly lower in second wave as compared to the first [4400 (63.7%) vs. 7886 (65.4%), P=0.02]. Commonest presenting symptom was fever in both waves. In the second wave, a significantly higher proportion [2625 (48.6%) vs. 4420 (42.8%), P< 0.003] complained of shortness of breath, developed ARDS [422(13%) vs. 880 (7.9%), P< 0.001], required supplemental oxygen [1637 (50.3%) vs. 4771 (42.7%), P< 0.001], and mechanical ventilation [260 (15.9%) vs. 530 (11.1%), P< 0.001]. Mortality also significantly increased in the second wave [OR: 1.35 (95% CI: 1.19, 1.52)] in all age groups except in < 20 yr. Interpretation & conclusions: : The second wave of COVID-19 in India was slightly different in presentation than the first wave, with a younger demography, lesser comorbidities, and presentation with breathlessness in greater frequency.
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