ABSTRACT
There is not in Argentina publications regarding the presentation of patients with COVID-19 requiring hospitalized and emergency care in vulnerable populations (lower incomes and less education tend at greater risk for poor health status and healthcare access), and it has few reports in developing countries. The objective is to determine whether in the care of vulnerable patients, to succeed against COVID-19, multiple public health tools and interventions will be needed to minimize morbidity and mortality. The study is a prospective cohort investigation of patients with lab-confirmed COVID-19, who required to any of the Health Centers response from April 8, 2020, to August 18, 2020. In Buenos Aires Metropolitan Area (AMBA), April 8, 2020 the virus was identified in patients hospitalized in the "Southeast Network" (SN), AMBA. SN covering an area of 661 square kilometers, with 1.8 million inhabitants residing in urban, and rural areas. A total of 14 health centers with different levels of care complexity provide care to patients in the region. The information of each patient with COVID-19 evaluated by SN, was incorporated in an Epidemiological Dashboard. The investigation was designed and reported with consideration of observational studies in epidemiology. We describe the hospitals presentation and care of persons who required SN response and were ultimately diagnosed with COVID-19. From April 8, 2020, to August 18, 2020, were included 1495 patients with lab-confirmed COVID-19 in SN. A total of 58% patients were men, and the mean age (SD) was 48.9 (15.59) years. Eighty one percent patients with pre-existing diseases, most frequent hypertension and diabetes, but hypertension, chronic lung disease, and cardiovascular disease presented higher risk. A total of 13% were hospitalized in Intensive Therapy Unit. The mortality of the cohort was 9.77%. Mortality was higher for patients aged 65 or more (OR 5.09), and for those had some pre-existing disease (OR 2.61). Our observations are consistent with reports demonstrating older persons, and those with comorbidities have the highest risk of mortality related to COVID-19. However, unlike other reports from developed or some developing countries, the mortality in our study is lower. This finding may be related to age of our cohort is younger than other published. Also, the health system was able to respond to the demand.
Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , SARS-CoV-2/isolation & purification , Adult , Aged , Argentina/epidemiology , COVID-19/mortality , Female , Hospitalization , Humans , Male , Middle Aged , Prospective Studies , Public Health , Vulnerable PopulationsABSTRACT
Introduction: The present work describes the clinical characteristics and interventions to minimize morbidity and mortality in hospitalized patients diagnosed with COVID-19. Methods: It is a prospective cohort investigation of patients who received a response from the Health Centers in the southeast region (RS) of the metropolitan area (AMBA) from April 8 to September 30, 2020. A Situation Room was used epidemiological with two monitoring and follow-up boards, one for bed management and the other for patient management. Results: During the analyzed period, 2,588 patients with confirmed COVID-19 diagnosis were admitted, 1,943 with suspected COVID-19 pathology, and 1,464 subjects with other pathologies. 55% of the patients were men and the mean age was 51 years. There were 82.8% patients with pre-existing diseases, hypertension and diabetes were the most frequent. 14% were hospitalized in the Intensive Care Unit. The mortality of the cohort was 15.05%, mortality was higher for men, with a mean age of 60 years, 92.65% had some pre-existing disease. Conclusion: Our cohort is younger than other published works. Older people, men, and people with comorbidities are at increased risk for COVID-19-related mortality. The public health system was able to respond to the demand without collapsing the hospital institutions.
Introducción: En el presente trabajo se describen las características clínicas y las intervenciones para minimizar la morbimortalidad en pacientes hospitalizados con diagnóstico de COVID-19. Métodos: Es una investigación de cohorte prospectiva de pacientes que recibieron respuesta de los Centros de Salud en la región sudeste (RS) del área metropolitana (AMBA) desde el 8 de abril hasta el 30 de septiembre de 2020. Se utilizó una Sala de Situación epidemiológica con dos tableros de monitoreo y seguimiento, uno de gestión de camas y otro de gestión de pacientes. Resultados: Durante el periodo analizado se internaron2.588pacientes con diagnóstico COVID-19 confirmados, 1.943 con sospecha de patología COVID-19, y 1.464sujetos con otras patologías. El 55% de los pacientes eran hombres y la edad media fue de 51 años. Hubo 82,8% pacientes con enfermedades preexistentes, hipertensión y diabetes fueron las más frecuentes. El 14% fue hospitalizado en la Unidad de Terapia Intensiva. La mortalidad de la cohorte fue del 15,05%, la mortalidad fue mayor para los hombres, con una edad media de 60 años, el 92,65% tenía alguna enfermedad preexistente. Conclusión: Nuestra cohorte es más joven que otros trabajos publicados. Las personas mayores, los hombres y las personas con comorbilidades tienen mayor riesgo de mortalidad relacionada con COVID-19. El sistema de salud público pudo responder a la demanda sin llegar a colapsar las instituciones hospitalarias.