Mortality in Two Waves of COVID-19: A Comparative Analysis of a Tertiary Care Hospital in India

Background COVID-19 has spread as two distinct surges of cases in many countries. Several countries have reported differences in disease severity and mortality in the two waves. Objective Compare the in-hospital mortality in the two COVID-19 waves at a tertiary care hospital in India. Methods We conducted a retrospective data collection. Distinct periods of surges in cases and admissions were defined as the first wave spanning from March 2020 to December 2020 and the second wave from April 2021 to June 21, 2021. The primary outcome of this study was to compare mortality rates in terms of total hospital mortality rate (TMR) and case fatality rate (CFR). Results Mortality rates of wave 2 were approximately 10 times that of wave 1 (TMR of 20.3% in wave 2 versus 2.4% in wave 1 and CFR of 1.5% versus 17.7% in wave 1 and 2, respectively). Mortalities in wave 2 had a larger proportion of severe disease at presentation, faster progression of symptoms to death, and more patients without any chronic comorbid condition dying due to the direct effect of COVID-19 acute respiratory distress syndrome (ARDS). Conclusion Our data matches the worldwide reported pooled hospital mortality figures and shows the comparative difference in disease severity between the two waves.

[The analysis of dynamics and structure of mortality of female and male population of reproductive age in the Republic of Chuvashia]

Reducing mortality of working-age population is a potential reserve for preserving Russia's population and its labor force. In addition, the task of analyzing health of economically active citizens of our country is inextricably linked with the challenge of developing strategy of development of reproductive potential at the regional level. As reproductive or generative woman's age is defined precisely enough, and such unambiguous definition for men is lacking, the study used mortality rates, calculated for men and women of working age (16 - 59 years and 16 - 54 years respectively) and officially published by the Russian Federal State Statistics Service (Rosstat) as characteristics of reproductive health. The analysis of mortality rate for working age men and women in the Republic of Chuvashia as well as the structure of main causes of death are presented for 2002-2016 in comparison with average indicators for the Russian Federation. The mortality rate of the mentioned population category in Republic of Chuvashia since 2002 has decreased by 17.5% in all age groups except women aged 30-39 years. At this, the rate of mortality decreased in men during the analyzed period is higher than in women i.e. 20.5% and 19.3% respectively. As compared with 2002, the percentage of circulatory system diseases, neoplasms, digestive system diseases increased with a simultaneous decrease in the proportion of "external" causes in mortality structure of able-bodied population of the Republic of Chuvashia in 2016. Throughout the analyzed period relative mortality rates of able-bodied men are four times and higher than those of women. The analysis of dynamics characteristics in mortality level and structure among working age women and men as well as risk factors that contribute to its growth, can become the basis for developing an organizational improvement program of rendering medical care to economically active population as a component of regional strategy of increasing the level of reproductive potential.