{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:11:45Z","timestamp":1753877505544,"version":"3.41.2"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T00:00:00Z","timestamp":1738972800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Each coronavirus disease 2019 (COVID-19) wave is unique in its clinical presentation and outcome. In this study, we compared the clinical characteristics and outcomes of COVID waves 2\u20135 in inpatient settings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective study was conducted at the Sindh Infectious Diseases Hospital and Research Center on adult patients who were admitted with a positive COVID polymerase chain reaction from July 2020 to March 2022. SPSS 26 was used to analyze the data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 3190 COVID-19 patients were admitted. Wave 2 had the highest percentage of discharges compared with mortality (81%; P = .0001). Cytokine release syndrome was most common in wave 3 (32.7%; P = .0001). Severe COVID on admission was predominant in wave 4 (79.4%; P = .0001), with the highest rates of intubation (27.1%; P = .0001), septic shock (24.3%; P = .0001), and disease progression (50.8%; P = .0001). In wave 5, the majority were elderly (median age, 68 years) and had mild COVID (22.4%; P = .0001), most had comorbidities (84.6%; P = .0001), and the ratio of acute kidney injury was high (29.2%; P = .0001). Mortality was lowest in wave 2 (18.9%; P = .0001) and highest in wave 4 (42.5%; P = .0001; odds ratio, 3.18; 95% CI, 2.6\u20133.8; compared with wave 2).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Each wave had some unique characteristics compared with other waves, with wave 4, driven by the Delta variant, being the deadliest one in terms of disease severity and outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf072","type":"journal-article","created":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T07:55:01Z","timestamp":1739001301000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical Comparison of COVID Waves 2\u20135. An Inpatient Retrospective Comparative Analysis From Karachi, Pakistan"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4971-295X","authenticated-orcid":false,"given":"Muneeba Ahsan","family":"Sayeed","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisha","family":"Shalim","sequence":"additional","affiliation":[{"name":"Research Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaiza","family":"Farman","sequence":"additional","affiliation":[{"name":"Research Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5016-6701","authenticated-orcid":false,"given":"Fizza","family":"Farooqui","sequence":"additional","affiliation":[{"name":"Microbiology Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6844-5589","authenticated-orcid":false,"given":"Beenish","family":"Syed","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7101-9265","authenticated-orcid":false,"given":"Ishfaque","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anika","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aneel","family":"Kumar","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raniyah","family":"Akhter","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Furkan","family":"Hyder","sequence":"additional","affiliation":[{"name":"Anaesthesiology Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hasan Ali","family":"Shah","sequence":"additional","affiliation":[{"name":"Anaesthesiology Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adeel","family":"Hussain","sequence":"additional","affiliation":[{"name":"Anaesthesiology Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarwat","family":"Rasheed","sequence":"additional","affiliation":[{"name":"Critical Care Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saba","family":"Afshan","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rizwana Salik","family":"Nukrich","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madiha","family":"Raza","sequence":"additional","affiliation":[{"name":"Anaesthesiology Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haseeb U","family":"Rehman","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdul Razzaque","family":"Memon","sequence":"additional","affiliation":[{"name":"Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdul Wahid","family":"Rajput","sequence":"additional","affiliation":[{"name":"Sindh Infectious Diseases Hospital & Research Center, Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Saeed","family":"Quraishy","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences , Karachi ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"2025031112365825000_ofaf072-B1","first-page":"157","article-title":"WHO declares COVID-19 a pandemic","volume":"91","author":"Cucinotta","year":"2020","journal-title":"Acta Biomed"},{"volume-title":"Features, Evaluation, and Treatment of Coronavirus 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