Comparative study of COVID-19 patients admitted during the first and second waves in a tertiary care hospital in Eastern India: a retrospective observational study.

A novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to coronavirus disease 2019 (COVID-19), which is a global health problem that occurred in waves and resulted in high mortality globally. This is a single-center retrospective study conducted in a Medical College's dedicated COVID-19 hospital in India during the first wave (March-November 2020) and second wave (March-May 2021) of the COVID-19 pandemic on 104 children below 18 years of age to compare the clinical characteristics and outcome of COVID-19 patients during the first and second waves. During the first wave (n = 57, 54.8%), the majority of children (n = 36, 63.16%) were between 5-18 years, but during the second wave (n = 47, 62.09%), the majority of children (n = 29, 61.70%) were below 5 years. Neonates outnumbered during the second wave (n = 11, 23.4% vs. n = 1, 1.8%). Asymptomatic patients (n = 24, 42.1%) were common during the first wave, while severe-grade patients (n = 19, 40.4%) were common during the second wave. During both waves, fever and respiratory distress were the common symptoms followed by cough. Respiratory distress (p = 0.0003), C-reactive protein (p = 0.008), peripheral oxygen saturation <94% (p = 0.00002), and acidosis (p = 0.001) were significantly higher during the second wave. Use of steroids and low-molecular-weight heparin was similar in two waves, but intensive care unit (ICU) admission (p = 0.0031), oxygen via nasal prongs (p = 0.0003), use of CPAP/BIPAP (p = 0.031), blood and blood products (p = 0.044), comorbidity (p = 0.017), and mortality (p = 0.008) were significantly higher during second wave. ICU admission, use of blood and blood products, mechanical ventilation, comorbidity, and mortality were found to be higher during the second wave.