Difference in presentation, outcomes, and hospital epidemiologic trend of COVID-19 among first, second, and third waves in Dhaka Medical College

Background This study aimed to examine the differences in epidemiologic and disease aspects among patients with COVID 19 Methods: We reviewed the hospital records between April 2020 and September 2021 and followed up on the patients for post COVID complications. Findings: Older adult patients were predominantly affected during the first and second waves, followed by middle-aged patients. Men were predominantly admitted, considering the three waves; although more women were admitted in the second wave. Cough was more common in the second and third waves than in the first wave 522 (59.7%). Respiratory distress was the most common in the third wave, 251(67.1%), and least common in the first wave 403 (46.1%). Anosmia was more common in the third wave 116 (31.2%). In the third wave, patients presenting in a critical state 23 (6.2%) and severe disease 152 (40.8%) were more common. The hospital admission median (IQR) was longer in the first wave, 12 (8-20), than in other waves. More patients were admitted in the first wave (52%) than in the other waves, and patients received more oxygen in the third wave (75%) than in the other waves. Death occurred more commonly in the first wave (51%) than in the other waves. Patients were investigated more commonly in the first and third waves than in the second wave. The positivity rate was high in the third wave (22.8%) than in other waves. In the third wave, the positivity rate was higher in women (24.3%) than in men. Post COVID cough increased in the second wave and fatigue was higher in the third wave than in other waves. Tiredness and memory loss was greater during the second wave than in other waves. Conclusion: This study revealed that the presenting symptoms, outcomes, and epidemiologic trends differed during the COVID 19 waves.