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CC BY-NC-ND 4.0 · Dtsch Med Wochenschr 2023; 148(04): e14-e20
DOI: 10.1055/a-1951-0629
Originalarbeit

COVID 19 – Hospitalisierung in der ersten und zweiten Welle

COVID 19 – Hospital Admission in the First and Second Wave in Germany
Mathias Lehmann
1   Klinik für Pneumologie und Schlafmedizin, HELIOS Klinik, Krefeld
,
Sven Peeters
1   Klinik für Pneumologie und Schlafmedizin, HELIOS Klinik, Krefeld
,
Manuel Streuter
1   Klinik für Pneumologie und Schlafmedizin, HELIOS Klinik, Krefeld
,
Marek Nawrocki
1   Klinik für Pneumologie und Schlafmedizin, HELIOS Klinik, Krefeld
,
Katrin Kösters
2   Klinik für Gastroenterologie und Infektiologie, HELIOS Klinik, Krefeld
,
Knut Kröger
3   Klinik für Gefäßmedizin, HELIOS Klinik, Krefeld
› Author AffiliationsDiese Studie wurde von der Helios Kliniken GmbH gefördert, Grant-ID: 2020_0142.
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Zusammenfassung

Hintergrund Analysiert wurden die Patientencharakteristika und Krankheitsverläufe aller Patienten, die mit COVID-19 in der 1. und 2. Welle im HELIOS-Klinikum Krefeld behandelt wurden.

Methoden Eingeschlossen wurden 84 Patienten aus der 1. Welle (11.03.2020–30.06.2020) und 344 Patienten aus der 2. Welle (01.07.2020–31.01.2021).

Ergebnisse Alter, Geschlecht und Komorbiditäten der Patienten waren ähnlich, mit Ausnahme der venösen Thrombose in der Anamnese. Diese lagen in der 1. Welle häufiger vor als in der 2. Welle (6 % vs. 0,3 %, p = 0,001). Bei der Aufnahme gab es keine Unterschiede in den Ergebnissen der initialen Laborwerte (C-reaktives Protein, Leukozyten) und Blutgasanalysen zwischen beiden Gruppen. Die Behandlung unterschied sich in der Anwendung von Dexamethason und Antikoagulation. In der 1. Welle erhielt niemand Dexamethason, in der 2. Welle jedoch 52,6 % der Patienten für eine durchschnittliche Dauer von 3,6 ± 4,1 Tagen. Eine Antikoagulation mit doppelter Standardprophylaxe (2 × 40 mg niedermolekulares Heparin, subkutan) wurde in der 1. Welle bei 7,1 % und in der 2. Welle bei 30,2 % der Patienten (p = 0,002) durchgeführt. In der 1. Welle wurden mehr thromboembolische Ereignisse nach der Aufnahme diagnostiziert (19,0 % gegenüber 7,0 %, p = 0,001). Die Sterblichkeitsrate im Krankenhaus lag in der 1. Welle bei 26,2 % und in der zweiten Welle bei 15,4 % (p = 0,0234). Die meisten Todesfälle waren auf das akute Atemnotsyndrom (ARDS) zurückzuführen.

Schlussfolgerung Die Patientencharakteristika unterschieden sich in der 1. und 2. COVID-19-Welle nicht, aber Antikoagulation und Dexamethason wurden in der 2. Welle häufiger eingesetzt. Darüber hinaus traten in der 2. Welle weniger thromboembolische Komplikationen auf.

Abstract

Purpose We analyzed patients' characteristics and hospital admission in Germany's first and second COVID 19 wave.

Methods We include all patients hospitalized with the proven diagnosis COVID 19 admitted to the HELIOS Hospital Krefeld, Germany, in the first wave (n = 84; from 11.03.2020–30.06.2020) and the second wave (n = 344; from 01.07.2020–31.01.2021).

Results Patientsʼ age, gender and comorbidities were similar with the exception of venous thrombosis in medical history which was more frequent in the first wave (6 % vs 0.3 %, p = p = 0,001). At admission, there were no differences in the results of the initial lab values (c-reactive protein, leucocytes) and blood gas analyses between both groups. Treatment differed in the application of dexamethasone and anticoagulation. In the first wave, nobody received dexamethasone. However, this changed to 52.6 % of patients in the second wave for a mean length of 3.6 ± 4.1 days. Anticoagulation with double standard prophylaxis (2 × 40 mg low molecular heparin, subcutaneous) was applied in 7.1 % of patients in the first wave but 30.2 % (p = 0.002) in the second wave. In the first wave more thromboembolic events were diagnosed after admission (19.0 % vs 7.0 %, p = 0.001). In-hospital death was 26.2 % in the first wave and 15.4 % in the second wave (p = 0.0234). Most deaths were attributed to acute respiratory distress syndrome (ARDS).

Conclusion Patientsʼ characteristics did not vary in Germanyʼs first and second COVID 19 wave, but anticoagulation and dexamethasone were applied more frequently in the second wave. In addition, there were fewer thromboembolic complications in the second wave.

Schlüsselwörter

COVID 19 - erste Welle - zweite Welle

Key words

COVID 19 - first wave - second wave


Publication History

Article published online:
19 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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