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Étude comparative de patients hospitalisés pour une infection SARS-CoV-2 au cours de deux vagues consécutives en Tunisie

INTRODUCTION: Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a global pandemic with a heavy medical and societal-economic toll. The health consequences were not similar during the successive waves that affected several countries. The aim of our study was to compare the sociodemo...

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Autores principales: RACHDI, Rim, HANNACHI, Souha, ZRIBI, Sabrine, AYED, Oumaima, ABID, Rim, MOATEMRI, Zied, MHAMDI, Samira, DABBOUSSI, Salsabil, GHARSALLAH, Hédi, SELLAMI, Walid, SAMMOUD, Walid, MASSOUDI, Hakim, LAMINE, Khaled, DJEBBI, Olfa, HAMMAMI, Rim, BEN MOUSSA, Mohamed, BELLAAJ, Ridha, BATTIKH, Riadh, RACHDI, Mohamed Radhouane, FERJANI, Mustapha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MTSI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9557822/
https://www.ncbi.nlm.nih.gov/pubmed/36284562
http://dx.doi.org/10.48327/mtsi.v2i3.2022.207
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author RACHDI, Rim
HANNACHI, Souha
ZRIBI, Sabrine
AYED, Oumaima
ABID, Rim
MOATEMRI, Zied
MHAMDI, Samira
DABBOUSSI, Salsabil
GHARSALLAH, Hédi
SELLAMI, Walid
SAMMOUD, Walid
MASSOUDI, Hakim
LAMINE, Khaled
DJEBBI, Olfa
HAMMAMI, Rim
BEN MOUSSA, Mohamed
BELLAAJ, Ridha
BATTIKH, Riadh
RACHDI, Mohamed Radhouane
FERJANI, Mustapha
author_facet RACHDI, Rim
HANNACHI, Souha
ZRIBI, Sabrine
AYED, Oumaima
ABID, Rim
MOATEMRI, Zied
MHAMDI, Samira
DABBOUSSI, Salsabil
GHARSALLAH, Hédi
SELLAMI, Walid
SAMMOUD, Walid
MASSOUDI, Hakim
LAMINE, Khaled
DJEBBI, Olfa
HAMMAMI, Rim
BEN MOUSSA, Mohamed
BELLAAJ, Ridha
BATTIKH, Riadh
RACHDI, Mohamed Radhouane
FERJANI, Mustapha
author_sort RACHDI, Rim
collection PubMed
description INTRODUCTION: Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a global pandemic with a heavy medical and societal-economic toll. The health consequences were not similar during the successive waves that affected several countries. The aim of our study was to compare the sociodemographic, clinical and evolutionary features of COVID-19 patients hospitalized at the Military Hospital of Tunis (HMPIT) during the 2(nd) and 3(rd) waves that affected the country. PATIENTS AND METHODS: Observational prospective study involving 1,527 COVID-19 patients hospitalized at HMPIT over 11 months, divided into two periods: from July 2020 to December 2020 called the second wave (V2) and from January 2021 to May 2021 called the third wave (V3). We compared the epidemiological data, the clinical form and the evolution of the patients for each period. RESULTS: The number of hospitalized patients was 636 during V2 compared to 891 during V3. Average age was 63.5 ± 15.3 years during V2 versus 65.8 ± 17.8 years during V3 (P = not significant [NS]). The percentage of young adults [18-40 years] was 6.5% during V2 compared to 6.7% during V3 (P = NS). The gender ratio (M/F) was 1.59 for V2 and 1.42 for V3 (P = NS). Comorbidities were present in 65% of V2 patients and 66.3% of V3 patients (P = NS), with hypertension being the most prevalent one in both groups (47.2% for V2 versus 44.9% for V3; P = NS), followed by overweight, dyslipidemia and diabetes (33% for V2 versus 39.3% for V3; P = 0.012). The median duration between symptoms onset and hospitalization was 7 days [5-10] during V2 versus 8.5 days during V3 [5-12] (P = 0.0004). The severe clinical form was present in 49% of patients admitted during V2 compared to 34.8% during V3 (P < 10(-3)). The critical form represented 18.6% of cases during V2 against 16.8% during V3 (P = NS). The average hospital length of stay in COVID units (outside of intensive care unit) was 8.4 ± 5.4 days during V2 and 9.8 ± 5.7 days during V3. The average length of stay was significantly longer for the intensive care unit (11.3 ± 3.4 days for V2 versus 13.8 ± 3.9 days for V3; P = 0.01). The case fatality rate was 24.5% during V2 and 20.7% during V3 (P = NS). Median age of death was 70.2 years [42-88] during V2 and 70.4 years [22-96] during V3 with 2 patients less than 40 years of age (1%) for the latter period. The gender ratio (M/F) of deceased patients was 3.21 for V2 and 1.5 for V3 (P = 0.001). The case fatality rate was higher in the intensive care unit (65.4% for V2 versus 69.7% for V3; P = NS). Causes of death were dominated by ARDS (acute respiratory distress syndrome) for both periods (55.1% for V2 versus 70.8% for V3; P = 0.002), followed by septic shock (12.8% for V2 versus 10.8% for V3; P = NS) and multi-organ failure (9.6% for V2 versus 7.0% for V3; P = NS). CONCLUSION: This study revealed a decrease in severe and critical clinical forms during the 3rd wave, as well as a decrease in the case fatality rate compared to the previous wave, due to improved management and vaccination. On the other hand, the percentage of ARDS was significantly higher during this wave probably related to the beginning of circulation in our country of the Delta variant causing more severe clinical cases.
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spelling pubmed-95578222022-10-24 Étude comparative de patients hospitalisés pour une infection SARS-CoV-2 au cours de deux vagues consécutives en Tunisie RACHDI, Rim HANNACHI, Souha ZRIBI, Sabrine AYED, Oumaima ABID, Rim MOATEMRI, Zied MHAMDI, Samira DABBOUSSI, Salsabil GHARSALLAH, Hédi SELLAMI, Walid SAMMOUD, Walid MASSOUDI, Hakim LAMINE, Khaled DJEBBI, Olfa HAMMAMI, Rim BEN MOUSSA, Mohamed BELLAAJ, Ridha BATTIKH, Riadh RACHDI, Mohamed Radhouane FERJANI, Mustapha Med Trop Sante Int Clinique INTRODUCTION: Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a global pandemic with a heavy medical and societal-economic toll. The health consequences were not similar during the successive waves that affected several countries. The aim of our study was to compare the sociodemographic, clinical and evolutionary features of COVID-19 patients hospitalized at the Military Hospital of Tunis (HMPIT) during the 2(nd) and 3(rd) waves that affected the country. PATIENTS AND METHODS: Observational prospective study involving 1,527 COVID-19 patients hospitalized at HMPIT over 11 months, divided into two periods: from July 2020 to December 2020 called the second wave (V2) and from January 2021 to May 2021 called the third wave (V3). We compared the epidemiological data, the clinical form and the evolution of the patients for each period. RESULTS: The number of hospitalized patients was 636 during V2 compared to 891 during V3. Average age was 63.5 ± 15.3 years during V2 versus 65.8 ± 17.8 years during V3 (P = not significant [NS]). The percentage of young adults [18-40 years] was 6.5% during V2 compared to 6.7% during V3 (P = NS). The gender ratio (M/F) was 1.59 for V2 and 1.42 for V3 (P = NS). Comorbidities were present in 65% of V2 patients and 66.3% of V3 patients (P = NS), with hypertension being the most prevalent one in both groups (47.2% for V2 versus 44.9% for V3; P = NS), followed by overweight, dyslipidemia and diabetes (33% for V2 versus 39.3% for V3; P = 0.012). The median duration between symptoms onset and hospitalization was 7 days [5-10] during V2 versus 8.5 days during V3 [5-12] (P = 0.0004). The severe clinical form was present in 49% of patients admitted during V2 compared to 34.8% during V3 (P < 10(-3)). The critical form represented 18.6% of cases during V2 against 16.8% during V3 (P = NS). The average hospital length of stay in COVID units (outside of intensive care unit) was 8.4 ± 5.4 days during V2 and 9.8 ± 5.7 days during V3. The average length of stay was significantly longer for the intensive care unit (11.3 ± 3.4 days for V2 versus 13.8 ± 3.9 days for V3; P = 0.01). The case fatality rate was 24.5% during V2 and 20.7% during V3 (P = NS). Median age of death was 70.2 years [42-88] during V2 and 70.4 years [22-96] during V3 with 2 patients less than 40 years of age (1%) for the latter period. The gender ratio (M/F) of deceased patients was 3.21 for V2 and 1.5 for V3 (P = 0.001). The case fatality rate was higher in the intensive care unit (65.4% for V2 versus 69.7% for V3; P = NS). Causes of death were dominated by ARDS (acute respiratory distress syndrome) for both periods (55.1% for V2 versus 70.8% for V3; P = 0.002), followed by septic shock (12.8% for V2 versus 10.8% for V3; P = NS) and multi-organ failure (9.6% for V2 versus 7.0% for V3; P = NS). CONCLUSION: This study revealed a decrease in severe and critical clinical forms during the 3rd wave, as well as a decrease in the case fatality rate compared to the previous wave, due to improved management and vaccination. On the other hand, the percentage of ARDS was significantly higher during this wave probably related to the beginning of circulation in our country of the Delta variant causing more severe clinical cases. MTSI 2022-08-18 /pmc/articles/PMC9557822/ /pubmed/36284562 http://dx.doi.org/10.48327/mtsi.v2i3.2022.207 Text en Copyright © 2022 SFMTSI https://creativecommons.org/licenses/by/4.0/Cet article en libre accès est distribué selon les termes de la licence Creative Commons CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Clinique
RACHDI, Rim
HANNACHI, Souha
ZRIBI, Sabrine
AYED, Oumaima
ABID, Rim
MOATEMRI, Zied
MHAMDI, Samira
DABBOUSSI, Salsabil
GHARSALLAH, Hédi
SELLAMI, Walid
SAMMOUD, Walid
MASSOUDI, Hakim
LAMINE, Khaled
DJEBBI, Olfa
HAMMAMI, Rim
BEN MOUSSA, Mohamed
BELLAAJ, Ridha
BATTIKH, Riadh
RACHDI, Mohamed Radhouane
FERJANI, Mustapha
Étude comparative de patients hospitalisés pour une infection SARS-CoV-2 au cours de deux vagues consécutives en Tunisie
title Étude comparative de patients hospitalisés pour une infection SARS-CoV-2 au cours de deux vagues consécutives en Tunisie
title_full Étude comparative de patients hospitalisés pour une infection SARS-CoV-2 au cours de deux vagues consécutives en Tunisie
title_fullStr Étude comparative de patients hospitalisés pour une infection SARS-CoV-2 au cours de deux vagues consécutives en Tunisie
title_full_unstemmed Étude comparative de patients hospitalisés pour une infection SARS-CoV-2 au cours de deux vagues consécutives en Tunisie
title_short Étude comparative de patients hospitalisés pour une infection SARS-CoV-2 au cours de deux vagues consécutives en Tunisie
title_sort étude comparative de patients hospitalisés pour une infection sars-cov-2 au cours de deux vagues consécutives en tunisie
topic Clinique
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9557822/
https://www.ncbi.nlm.nih.gov/pubmed/36284562
http://dx.doi.org/10.48327/mtsi.v2i3.2022.207
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