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Clinical and survival differences during separate COVID-19 surges: Investigating the impact of the Sars-CoV-2 alpha variant in critical care patients

A number of studies have highlighted physiological data from the first surge in critically unwell Covid-19 patients but there is a paucity of data describing emerging variants of SARS-CoV-2, such as B.1.1.7. We compared ventilatory parameters, biochemical and physiological data and mortality between...

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Autores principales: Ritchie, Andrew I., Kadwani, Owais, Saleh, Dina, Baharlo, Behrad, Broomhead, Lesley R., Randell, Paul, Waheed, Umeer, Templeton, Maie, Brown, Elizabeth, Stümpfle, Richard, Patel, Parind, Brett, Stephen J., Soni, Sanooj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249170/
https://www.ncbi.nlm.nih.gov/pubmed/35776718
http://dx.doi.org/10.1371/journal.pone.0269244
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author Ritchie, Andrew I.
Kadwani, Owais
Saleh, Dina
Baharlo, Behrad
Broomhead, Lesley R.
Randell, Paul
Waheed, Umeer
Templeton, Maie
Brown, Elizabeth
Stümpfle, Richard
Patel, Parind
Brett, Stephen J.
Soni, Sanooj
author_facet Ritchie, Andrew I.
Kadwani, Owais
Saleh, Dina
Baharlo, Behrad
Broomhead, Lesley R.
Randell, Paul
Waheed, Umeer
Templeton, Maie
Brown, Elizabeth
Stümpfle, Richard
Patel, Parind
Brett, Stephen J.
Soni, Sanooj
author_sort Ritchie, Andrew I.
collection PubMed
description A number of studies have highlighted physiological data from the first surge in critically unwell Covid-19 patients but there is a paucity of data describing emerging variants of SARS-CoV-2, such as B.1.1.7. We compared ventilatory parameters, biochemical and physiological data and mortality between the first and second COVID-19 surges in the United Kingdom, where distinct variants of SARS-CoV-2 were the dominant stain. We performed a retrospective cohort study investigating critically unwell patients admitted with COVID-19 across three tertiary regional ICUs in London, UK. Of 1782 adult ICU patients screened, 330 intubated and ventilated patients diagnosed with COVID-19 were included. In the second wave where B.1.1.7 variant was the dominant strain, patients were had increased severity of ARDS whilst compliance was greater (p<0.05) and d-dimer lower. The 28-day mortality was not statistically significant (1st wave: 42.2% vs 2nd wave: 39.8%). However, when adjusted for key covariates, the hazard ratio for 28-day mortality in those patients with B.1.1.7 was 3.79 (CI 1.04–13.8; p = 0.043) compared to the original strain. During the second surge in the UK, where the COVID-19 variant B.1.1.7 was most prevalent, significantly more patients presented to critical care with severe ARDS. Furthermore, mortality risk was significantly greater in our ICU population during the second wave of the pandemic in those patients with B.1.1.7. As ICUs are experiencing further waves (particularly by the delta (B.1.617.2) variant), we highlight the urgent need for prospective studies describing immunological and pathophysiological differences across novel emerging variants.
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spelling pubmed-92491702022-07-02 Clinical and survival differences during separate COVID-19 surges: Investigating the impact of the Sars-CoV-2 alpha variant in critical care patients Ritchie, Andrew I. Kadwani, Owais Saleh, Dina Baharlo, Behrad Broomhead, Lesley R. Randell, Paul Waheed, Umeer Templeton, Maie Brown, Elizabeth Stümpfle, Richard Patel, Parind Brett, Stephen J. Soni, Sanooj PLoS One Research Article A number of studies have highlighted physiological data from the first surge in critically unwell Covid-19 patients but there is a paucity of data describing emerging variants of SARS-CoV-2, such as B.1.1.7. We compared ventilatory parameters, biochemical and physiological data and mortality between the first and second COVID-19 surges in the United Kingdom, where distinct variants of SARS-CoV-2 were the dominant stain. We performed a retrospective cohort study investigating critically unwell patients admitted with COVID-19 across three tertiary regional ICUs in London, UK. Of 1782 adult ICU patients screened, 330 intubated and ventilated patients diagnosed with COVID-19 were included. In the second wave where B.1.1.7 variant was the dominant strain, patients were had increased severity of ARDS whilst compliance was greater (p<0.05) and d-dimer lower. The 28-day mortality was not statistically significant (1st wave: 42.2% vs 2nd wave: 39.8%). However, when adjusted for key covariates, the hazard ratio for 28-day mortality in those patients with B.1.1.7 was 3.79 (CI 1.04–13.8; p = 0.043) compared to the original strain. During the second surge in the UK, where the COVID-19 variant B.1.1.7 was most prevalent, significantly more patients presented to critical care with severe ARDS. Furthermore, mortality risk was significantly greater in our ICU population during the second wave of the pandemic in those patients with B.1.1.7. As ICUs are experiencing further waves (particularly by the delta (B.1.617.2) variant), we highlight the urgent need for prospective studies describing immunological and pathophysiological differences across novel emerging variants. Public Library of Science 2022-07-01 /pmc/articles/PMC9249170/ /pubmed/35776718 http://dx.doi.org/10.1371/journal.pone.0269244 Text en © 2022 Ritchie et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ritchie, Andrew I.
Kadwani, Owais
Saleh, Dina
Baharlo, Behrad
Broomhead, Lesley R.
Randell, Paul
Waheed, Umeer
Templeton, Maie
Brown, Elizabeth
Stümpfle, Richard
Patel, Parind
Brett, Stephen J.
Soni, Sanooj
Clinical and survival differences during separate COVID-19 surges: Investigating the impact of the Sars-CoV-2 alpha variant in critical care patients
title Clinical and survival differences during separate COVID-19 surges: Investigating the impact of the Sars-CoV-2 alpha variant in critical care patients
title_full Clinical and survival differences during separate COVID-19 surges: Investigating the impact of the Sars-CoV-2 alpha variant in critical care patients
title_fullStr Clinical and survival differences during separate COVID-19 surges: Investigating the impact of the Sars-CoV-2 alpha variant in critical care patients
title_full_unstemmed Clinical and survival differences during separate COVID-19 surges: Investigating the impact of the Sars-CoV-2 alpha variant in critical care patients
title_short Clinical and survival differences during separate COVID-19 surges: Investigating the impact of the Sars-CoV-2 alpha variant in critical care patients
title_sort clinical and survival differences during separate covid-19 surges: investigating the impact of the sars-cov-2 alpha variant in critical care patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249170/
https://www.ncbi.nlm.nih.gov/pubmed/35776718
http://dx.doi.org/10.1371/journal.pone.0269244
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