A comparison between alpha and delta waves of COVID-19, in Tunisia

##plugins.themes.academic_pro.article.sidebar##

Published Mar 30, 2025
https://doi.org/10.62438/tunismed.v103i4.5199
Download
pdf
Vol. 103 No. 4 (2025): Tunis Med Apr 2025

##plugins.themes.academic_pro.article.main##

Bouthaina Trabelsi
Infection Prevention and Control department, Farhat Hached university hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse,Tunisia
Souhir Chelly
Infection Prevention and Control department, Farhat Hached university hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse,Tunisia
Syrine Chelly
Gynecology department, Farhat Hached University Hospital, Sousse. Faculty of Medicine of Sousse, University of Sousse, Tunisia
Houda Ben Soltane
Emergency Department, Farhat Hached University Hospital, Sousse. Faculty of Medicine of Sousse; University of Sousse, Tunisia
Mohamed Mahjoub
Infection Prevention and Control department, Farhat Hached university hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse,Tunisia

Abstract

Introduction: Several nations have seen an increase in COVID-19 cases in 2020, exhibiting a wave pattern. Different COVID-19 variants caused these waves. In this perspective, the aim of the study was  to compare epidemiological, clinical and evolutive profile of COVID-19 infection during two waves of COVID-19.


Methods: Data collection was carried out using a questionnaire self-administered in French and Arabic developed with Google Forms and shared online via social media with weekly reminders. Duration of one month was enough to get the necessary number of participants calculated. The study included all Tunisians who were infected with COVID-19 at least once and agreed to participate in the study.


 Results: In total, 1328 COVID-19 patients were included. Eight hundred eighty-three patients were infected during the Alpha wave (66.5%) and 445 were infected during the Delta wave (33.5%). The median age was 37 years (interquartile range (IQR): 30–41 years). Clinically, during delta wave, these symptoms were more frequent; fever (57.8% versus 51.9%, p= 0.042), loss of smell (75.1% versus 65.1%, p On the other hand, aches were more frequent during Alpha wave (65.2% versus 56.2%, p = 0.001) and the impact of health professionals was greater (27.6% versus 15.7%, p≤10-3).


Conclusion:The Alpha variant had more pronounced clinical symptoms than the Delta variant. This can be explained by the high vaccination coverage during the pandemic by the Delta variant.


 


 


 


 

Keywords:

COVID-19 infection, Variants, COVID-19 waves

##plugins.themes.academic_pro.article.details##

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Soriano V, Ganado-Pinilla P, Sanchez-Santos M, Gómez-Gallego F, Barreiro P, de Mendoza C, et al. Main differences between the first and second waves of COVID-19 in Madrid, Spain. International Journal of Infectious Diseases. 2021 Apr 1;105:374–6.
  2. Vahidy FS, Drews AL, Masud FN, Schwartz RL, Askary BB, Boom ML, et al. Characteristics and Outcomes of COVID-19 Patients During Initial Peak and Resurgence in the Houston Metropolitan Area. JAMA. 2020 Sep 8;324(10):998–1000.
  3. Decreased Case Fatality Rate of COVID‐19 in the Second Wave: A study in 53 countries or regions - Fan - 2021 - Transboundary and Emerging Diseases - Wiley Online Library [Internet]. [cited 2024 Mar 19]. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/tbed.13819
  4. First and second COVID-19 waves in Japan: A comparison of disease severity and characteristics - PMC [Internet]. [cited 2024 Mar 19]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605825/
  5. COVID-19 cases | WHO COVID-19 dashboard [Internet]. [cited 2024 Mar 19]. Available from: https://data.who.int/dashboards/covid19/cases?n=c
  6. BenMiled S, Borgi C, Hsairi M, Somrani N, Kebir A. Hospital bed capacity across in Tunisia hospital during the first 4 waves of the COVID-19 pandemic: A descriptive analysis. Infectious Medicine. 2023 Jun 1;2(2):112–21.
  7. Griffin DO, Brennan-Rieder D, Ngo B, Kory P, Confalonieri M, Shapiro L, et al. The Importance of Understanding the Stages of COVID-19 in Treatment and Trials. AIDS Rev. 2021 Feb 8;23(1):40–7.
  8. Haddad-Boubaker S, Arbi M, Souiai O, Chouikha A, Fares W, Edington K, et al. The Delta variant wave in Tunisia: Genetic diversity, spatio-temporal distribution and evidence of the spread of a divergent AY.122 sub-lineage. Front Public Health [Internet]. 2023 Jan 4 [cited 2024 Mar 19];10. Available from: https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.990832/full
  9. Mlcochova P, Kemp SA, Dhar MS, Papa G, Meng B, Ferreira IATM, et al. SARS-CoV-2 B.1.617.2 Delta variant replication and immune evasion. Nature. 2021 Nov;599(7883):114–9.
  10. Tunisie/Covid-19 : Neuf gouvernorats ont dépassé le seuil d’alerte [Internet]. [cited 2024 Mar 20]. Available from: https://www.aa.com.tr/fr/sante/tunisie-covid-19-neuf-gouvernorats-ont-dépassé-le-seuil-d-alerte/1964951
  11. Kharroubi G, Cherif I, Ghawar W, Dhaouadi N, Yazidi R, Chaabane S, et al. Incidence and risk factors of SARS-CoV-2 infection among workers in a public health laboratory in Tunisia. Archives of Virology. 2023 Jan 20;168(2):69.
  12. StatCounter Global Stats [Internet]. [cited 2024 Mar 25]. Social Media Stats Worldwide. Available from: https://gs.statcounter.com/social-media-stats
  13. Mollinedo-Gajate I, Villar-Álvarez F, Zambrano-Chacón M de LÁ, Núñez-García L, de la Dueña-Muñoz L, López-Chang C, et al. First and Second Waves of Coronavirus Disease 2019 in Madrid, Spain: Clinical Characteristics and Hematological Risk Factors Associated With Critical/Fatal Illness. Crit Care Explor. 2021 Feb;3(2):e0346.
  14. Iftimie S, López-Azcona AF, Vallverdú I, Hernández-Flix S, de Febrer G, Parra S, et al. First and second waves of coronavirus disease-19: A comparative study in hospitalized patients in Reus, Spain. PLoS One. 2021 Mar 31;16(3):e0248029.
  15. Saito S, Asai Y, Matsunaga N, Hayakawa K, Terada M, Ohtsu H, et al. First and second COVID-19 waves in Japan: A comparison of disease severity and characteristics. J Infect. 2021 Apr;82(4):84–123.
  16. Buttenschøn HN, Lynggaard V, Sandbøl SG, Glassou EN, Haagerup A. Comparison of the clinical presentation across two waves of COVID-19: a retrospective cohort study. BMC Infect Dis. 2022 May 3;22(1):423.
  17. RACHDI R, HANNACHI S, ZRIBI S, AYED O, ABID R, MOATEMRI Z, et al. Étude comparative de patients hospitalisés pour une infection SARS-CoV-2 au cours de deux vagues consécutives en Tunisie. Med Trop Sante Int. 2022 Aug 18;2(3):mtsi.v2i3.2022.207.
  18. Nandy K, Salunke A, Pathak SK, Pandey A, Doctor C, Puj K, et al. Coronavirus disease (COVID-19): A systematic review and meta-analysis to evaluate the impact of various comorbidities on serious events. Diabetes Metab Syndr. 2020;14(5):1017–25.
  19. Jalali SF, Ghassemzadeh M, Mouodi S, Javanian M, Akbari Kani M, Ghadimi R, et al. Epidemiologic comparison of the first and second waves of coronavirus disease in Babol, North of Iran. Caspian J Intern Med. 2020;11(Suppl 1):544–50.
  20. Wenham C, Smith J, Morgan R, Gender and COVID-19 Working Group. COVID-19: the gendered impacts of the outbreak. Lancet. 2020 Mar 14;395(10227):846–8.
  21. Rozenberg S, Vandromme J, Martin C. Are we equal in adversity? Does Covid-19 affect women and men differently? Maturitas. 2020 Aug;138:62–8.
  22. Gu J, Han B, Wang J. COVID-19: Gastrointestinal Manifestations and Potential Fecal-Oral Transmission. Gastroenterology. 2020 May;158(6):1518–9.
  23. Mandal A, Konala VM, Adapa S, Naramala S, Gayam V. Gastrointestinal Manifestations in COVID-19 Infection and Its Practical Applications. Cureus. 2020 Jun 21;12(6):e8750.
  24. Villapol S. Gastrointestinal symptoms associated with COVID-19: impact on the gut microbiome. Transl Res. 2020 Dec;226:57–69.
  25. Mihajlovic S, Nikolic D, Santric-Milicevic M, Milicic B, Rovcanin M, Acimovic A, et al. Four Waves of the COVID-19 Pandemic: Comparison of Clinical and Pregnancy Outcomes. Viruses. 2022 Dec;14(12):2648.
  26. Blanca D, Nicolosi S, Bandera A, Blasi F, Mantero M, Hu C, et al. Comparison between the first and second COVID-19 waves in Internal Medicine wards in Milan, Italy: a retrospective observational study. Intern Emerg Med. 2022 Nov 1;17(8):2219–28.
  27. Contou D, Fraissé M, Pajot O, Tirolien JA, Mentec H, Plantefève G. Comparison between first and second wave among critically ill COVID-19 patients admitted to a French ICU: no prognostic improvement during the second wave? Critical Care. 2021 Jan 4;25(1):3.
  28. Siemieniuk RA, Bartoszko JJ, Zeraatkar D, Kum E, Qasim A, Martinez JPD, et al. Drug treatments for covid-19: living systematic review and network meta-analysis. BMJ. 2020 Jul 30;370:m2980.
  29. Seyfi S, Amri P, Mouodi S. New modalities for non-invasive positive pressure ventilation: A review article. Caspian J Intern Med. 2019;10(1):1–6.
  30. Guérin C, Lévy P. Easier access to mechanical ventilation worldwide: an urgent need for low income countries, especially in face of the growing COVID-19 crisis. Eur Respir J. 2020 Jun 4;55(6):2001271.
  31. Khalili M, Karamouzian M, Nasiri N, Javadi S, Mirzazadeh A, Sharifi H. Epidemiological characteristics of COVID-19: a systematic review and meta-analysis. Epidemiol Infect. 2020 Jun 29;148:e130.
  32. Javanian M, Bayani M, Shokri M, Sadeghi-Haddad-Zavareh M, Babazadeh A, Yeganeh B, et al. Clinical and laboratory findings from patients with COVID-19 pneumonia in Babol North of Iran: a retrospective cohort study. Rom J Intern Med. 2020 Sep 1;58(3):161–7.
  33. Shahid Z, Kalayanamitra R, McClafferty B, Kepko D, Ramgobin D, Patel R, et al. COVID-19 and Older Adults: What We Know. J Am Geriatr Soc. 2020 May;68(5):926–9.
  34. Mueller AL, McNamara MS, Sinclair DA. Why does COVID-19 disproportionately affect older people? Aging (Albany NY). 2020 May 29;12(10):9959–81.
  35. Second wave COVID-19 pandemics in Europe: a temporal playbook - PubMed [Internet]. [cited 2024 Mar 27]. Available from: https://pubmed.ncbi.nlm.nih.gov/32968181/