NEW DELHI: A registry-based ICMR study from 41 government and private hospitals in India has shown that a significantly higher number of Covid patients had shortness of breath, developed acute respiratory disease, needed oxygen and ventilation in the devastating second wave of the pandemic as compared to the first wave.
Importantly, the study has also shown that mortality due to the infectious disease also went up in all age groups, except in those under 20 and 13.3 % of the admitted patients died in the second wave in comparison to 10.2% in the first wave.
These figures mark, in absolute terms, a 3.1% rise in mortality and a 30% rise in relative terms and confirm fears that the second wave, beginning March this year, was far more lethal than the first wave last year.
A more granular analysis showed that while 6.5% of those admitted patients aged 20-39 years died in the second wave, this percentage was 3.5 % in the first wave, for 40-60 year olds, the mortality went up from 9.2% to 12.1% and for those above 60 the death rate increased from 17% to 22.2%. However, for those under 20 years, mortality was down from 6.1% to 4.7% between the two waves.
The significant data is based on comparing the clinical outcomes of 18,961 patients -- 12059 of whom were hospitalised in the first wave and 6,903 in the second.
It has been published under the title “Clinical profile of hospitalized Covid-19 patients in first & second wave of the pandemic: Insights from an Indian registry-based observational study” in the Indian Journal of Medical Research.
The comparison showed that the mean age of the patients was significantly lower in the second wave 48.7 years versus 50.7 years even as over 70% of the hospitalised patients were over 40 years in both the waves.
However, a significantly higher proportion of the admitted patients in the second wave (48. 6% vs 42.8 %) complained of shortness of breath, developed acute respiratory distress (13 % vs 7.9 %), required oxygen support (50.3% vs 42.7%) and mechanical ventilation (15.9% vs 11.1%).
A lesser proportion of admitted patients had one or more comorbidities, highlighted the study, and showed that 50% of the patients presented to the hospital for admission within three days of onset of symptoms during the second wave as compared to four days in the first wave—showing that the deterioration may have been more rapid.
Also, the proportion of asymptomatic patients at the time of admission had considerably increased during the second wave, the data analysed from the National Covid19 Clinical Registry showed and amongst the symptoms noted, shortness of breath in the second wave increased by 6%.
“In conclusion, the second wave that is being experienced in our country seems to be slightly different in presentation than the first wave,” the researchers noted.
“Besides the steep rise of the cases, there has been more involvement of the younger demographic. However, the elderly above 60 years of age remained the most vulnerable,” they added.
The symptomatology has remained focussed primarily on respiratory systems with breathlessness reported in higher proportions during the second wave of Covid-19 in India, the paper said adding that higher utilization of health care systems has underlined the need for meticulous pandemic preparedness for future surges.
The findings in the latest paper are consistent with another study independently carried out by the Max group of hospitals which has shown that the second wave of Covid in India was far more fatal than the previous wave.