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Brazil is one of the countries most affected by the COVID-19 pandemic, with more than 16 million confirmed cases and 454 429 confirmed deaths by May 26, 2021 (according to the Johns Hopkins Coronavirus Resource Center). The beginning of 2021 was marked by a second wave of COVID-19, which had different features to the first wave, 1 with simultaneous, explosive surges of COVID-19 cases across different regions of the country that added enormous pressure to a health system already under strain after a year of the pandemic. This second wave was contemporary with the discovery, expansion, and dominance of variants of interest (VoI) and variants of concern (VoC) in Brazil. 2 We previously characterised the first 250 000 hospital admissions for COVID-19 in Brazil, including resource use and in-hospital mortality of patients. 1 We now compare the burden, severity (number of patients with hypoxaemia …