COVID-19 in hospitalized patients in 4 hospitals in San Isidro, Buenos Aires, Argentina

Abstract

In December 2019, a novel illness called coronavirus disease 2019 (COVID 19) was described in China and became pandemic in a few months. The first case was detected in Argentina on March 3, 2020. A multicentre prospective observational cohort study on hospitalized patients with COVID 19 was conducted in 4 hospitals in San Isidro district from March 1, 2020 to October 31. Data was obtained by the attendant physician. 668 patients were included, the median age was 54 years, and 42.7% were female. Male sex and older age were associated with COVID 19 disease and more strongly with severity. Most frequent symptoms were fever and cough followed by dyspnoea, myalgia, odynophagia, headache, anosmia, and diarrhoea. Nonsevere patients had more upper respiratory symptoms while severe patients had mainly lower respiratory symptoms on admission. Most common comorbidities were arterial hypertension, diabetes, and cardiovascular disease. A great proportion of patients had normal thorax X ray and ground-glass opacity in tomography. In severe patients, radiography and tomography had a predominant ground glass pattern, but normal radiography and tomography on presentation were present in 22% and 5.9%, respectively. The absence of fever and normal radiology on admission neither excluded the disease nor further severity. PCR elevation was related with COVID 19 disease and with severity, while lymphopenia was more related with the disease and leukocytosis and thrombocytopenia with severity. 8, 4% of patients were health care workers. The mortality rate was 12.4%, 32.7% in severe patients and 61.2% in ventilated patients. Mortality was higher in the public hospital, probably associated with patients with older age and more comorbidities. All these observations can contribute to the knowledge of this disease in terms of diagnosis and prognosis.

Risk factors for COVID-19 in-hospital mortality in Argentina: A competing risk survival analysis

“…An overall inhospital mortality rate of 18.1% is lower than those reported in previous studies carried both in HICs and LMICs, ranging from 24.5% [26] to 30.1% [30]. Still, 18.1% mortality rate is above those found by other studies on hospitalized patients carried in Argentina (9.8% [29], 11.0% [27] and 12.4% [31]) reported in S1 Table . These findings highlight the relevance of analysis based on multi-center data. We observed substantial heterogeneity in mortality rates across healthcare centers (with the lowest mortality rate at 4.7% and the highest at 46.2%).…”

“…Demographic factors included age (in years) and sex. Following the Centers for Disease Control and Prevention guidelines [31,33] we extracted information on the following comorbidities: hypertension, smoking, diabetes, obesity, pulmonary diseases, other cardiovascular diseases, cancer and chronic kidney disease. Oximetry information included oxygen saturation (in percentage terms) and respiratory rate (in breaths per minute) at admission.…”

“…Evidence on role of these risk factors for LICs is still limited. Prior studies [24][25][26] in Argentina and other Latin American countries have mostly focused on the clinical features of COVID-19 based on a small number of patients [27][28][29], of unicentric nature [30], or mostly based on descriptive statistical analyses [31]. In the present study, we analyze data on COVID-19 patients from 11 centers spread across 10 cities in Argentina, which constitutes one of the largest multi-centric retrospective observational descriptive studies in low-and middleincome countries (S1 Table ).…”