P217 Table 1A comparison of first and second wave characteristics, treatment and outcome data First wave Second wave Mean difference (95%CI) X2 (df) P value Age (years) 69.0 (52.0, 80.0) 62.0 (52.0, 71.0) -3.4 (-7.8 to +1.1) - 0.14 Sex: - Male - Female 49 (69.0%) 22 (31.0%) 180 (65.0%) 97 (35.0%) - 0.4 (1) 0.52 BMI (kg/m2) 28.5 (24.9, 33.6) 29.6 (24.8, 34.9) +0.6 (-1.7 to +2.9) - 0.63 Clinical Frailty Score: - 1 to 2 (fit) 18 (25.4%) 132 (47.7%) - 15.6 (5) 0.008 CT severity score - Moderate/severe - Severe 11 (29.7%) 23 (62.2%) 131 (52.2%) 113 (45.0%) - 16.0 (3) 0.0012 CRP prior to rHDU admission (mg/L) 180.6 (118.0, 210.0) 124.1 (78.1, 175.6) -44.1 (-66.9 to -21.3) - 0.0002 Spike gene testing - VOC B.1.1.7 variant - Wild-type - Ambiguous - - - 143 (67.1%) 57 (26.8%) 13 (6.1%) - - - Dexamethasone 3 (4.2%) 266 (96.0%) - 271.4 (1) <0.0001 Remdesivir 4 (5.6%) 198 (71.5%) - 100.6 (1) <0.0001 CPAP as primary respiratory support 32 (45.1%) 248 (89.5%) - 71.1 (1) <0.0001 Able to adopt semi- or full- prone position 42 (59.2%) 237 (85.6%) - 24.8 (1) <0.0001 Admission outcome (all) - Died - Discharged 36 (50.7%) 35 (49.3%) 74 (26.7%) 201 (72.5%) - 14.7 (1) 0.0001 rHDU outcome (‘For Intubation’) - Died - Off respiratory support - Intubated 0 (0.0%) 14 (41.2%) 20 (58.8%) 7 (3.3%) 152 (72.4%) 51 (24.3%) - 17.3 (2) 0.0002 ConclusionOur single centre experience shows that rHDU mortality and intubation rates have improved over time in spite of the emergence of new variants. Improvements in outcome are likely to be multi-factorial. Our data support the benefit of pharmacological COVID-19 therapies in a rHDU population as well as the use of CPAP and awake proning. Other potential causes for improved outcomes are lower serological and radiological COVID-19 severity in our wave two cohort as well as reduced rates of frailty.Referencehttps://medrxiv.org/content/10.1101/2021.03.11.21253364v1
Improved COVID-19 outcomes in a large non-invasive respiratory support cohort despite new variants