Características clínico-epidemiológicas de pacientes fallecidos por COVID-19 en un hospital de referencia en Paraguay entre enero de 2021 a julio de 2022

Dora Montiel Jarolin; Margarita Samudio; Estela Torres; Magali Jarolin; Verónica Taboada; Luis Sánchez

doi:10.53732/rccsalud/2023.e5101

Authors

Dora Montiel Jarolin Hospital Nacional, Departamento de Medicina Interna. Itauguá, Paraguay https://orcid.org/0000-0003-1587-7836
Margarita Samudio Universidad del Pacífico. Dirección de Investigación. Asunción, Paraguay https://orcid.org/0000-0003-2813-218X
Estela Torres Hospital Nacional, Departamento de Medicina Interna. Itauguá, Paraguay https://orcid.org/0000-0002-9601-7274
Magali Jarolin Hospital Nacional, Departamento de Medicina Interna. Itauguá, Paraguay https://orcid.org/0000-0001-7839-858X
Verónica Taboada Hospital Nacional, Departamento de Medicina Interna. Itauguá, Paraguay https://orcid.org/0000-0001-8272-4499
Luis Sánchez Hospital Nacional, Departamento de Medicina Interna. Itauguá, Paraguay https://orcid.org/0000-0001-6665-7126

DOI:

https://doi.org/10.53732/rccsalud/2023.e5101

Abstract

Introduction. The COVID-19 pandemic from its beginning until August 13, 2022, has caused 19,478 deaths in Paraguay with a fatality rate of 2.78%. The objective of the study is to compare the characteristics of patients who died from COVID-19 in two years, January-December 2021 and January-July 2022. Material and Method. A retrospective cross-sectional analytical study of adult and pediatric patients who died from COVID-19 hospitalized in the respiratory area of the hospital. The patients were confirmed by RT-PCR in nasopharyngeal swabs. Results. Out of 5265 patients hospitalized with COVID-19, 1512 died, yielding an overall lethality rate of 28.7%, in 2021 was 26.3% (1164/4423) and 41.3% (348/842) in 2022. There was a higher percentage of men (53, 6%) among the deceased, significantly higher (p=0.045) in 2022 (58.3%) than in 2021 (52.2%); 69% of the deceased were over 60 years of age in 2022 and 48.3% in 2021; 79.2% of the patients had some risk factor, significantly higher in 2022 (84.3%) than in 2021 (77.7%), especially in AHT (54.3% vs 42.2%), heart disease (15.8% vs 9.7%), CKD (14.4% vs 5.4%), COPD (11.5% vs 5.4%), immunodeficiency (6.3% vs 2.5%) and neurological disease (3.4% vs 1.5%). The need for MRA was significantly (p <0.001) higher in 2022 (50.3%) than in 2021 (31.1%). Conclusion. A high global lethality rate was observed in a reference hospital in Paraguay with mortality predictors similar to those reported worldwide.

References

Sala de Situación Epidemiológica COVID-19 – DGVS. https://dgvs.mspbs.gov.py/files/boletines_covid19/SE45_2021_Boletin_Covid19.pdf

Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G,et al.Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Intern Med. 2020;180(10):1345-1355. 10.1001/jamainternmed.2020.3539

Kim L, Garg S, O'Halloran A, Whitaker M, Pham H, Anderson EJ, et al. Risk Factors for Intensive Care Unit Admission and In-hospital Mortality Among Hospitalized Adults Identified through the US Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET). Clin Infect Dis. 2021;72(9):e206-e214. 10.1093/cid/ciaa1012

Arulanandam B, Beladi H, ChakrGraabarti A. COVID-19 mortality and the overweight: Cross-Country Evidence. Public Health Pract (Oxf). 2021;2(2100179):1-4.10.1016/j.puhip.2021.100179

Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes MetabSyndr. 2020;14(4):535-545.10.1016/j.dsx.2020.04.044

Landstra CP, de Koning EJP. COVID-19 and Diabetes: Understanding the Interrelationship and Risks for a Severe Course. Front Endocrinol (Lausanne). 2021;12:649525. 10.3389/fendo.2021.649525

Zhou Y, Chi J, Lv W, Wang Y. Obesity and diabetes as high-risk factors for severe coronavirus disease 2019 (Covid-19). Diabetes Metab Res Rev. 2021;37(2):e3377. 10.1002/dmrr.3377

Franchini M, Bongiovanni G, Cruciani M. Mortality from COVID-19. Ann Ig. 2021;33(5):521-523. 10.7416/ai.2021.2451

Elliott J, Bodinier B, Whitaker M, Delpierre C, Vermeulen R, et al.COVID-19 mortality in the UK Biobank cohort: revisiting and evaluating risk factors. Eur J Epidemiol. 2021;36(3):299-309.10.1007/s10654-021-00722-y

Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, Salazar-Mather TP, Dumenco L, Savaria MC, Aung SN, Flanigan T, Michelow IC. Predictors of COVID-19 severity: A literature review. Rev Med Virol. 2021 Jan;31(1):1-10.: 10.1002/rmv.2146.

Lauring AS, Tenforde MW, Chappell JD, Gaglani M, Ginde AA, et al. Clinical severity of, and effectiveness of mRNA vaccines against, covid-19 from omicron, delta, and alpha SARS-CoV-2 variants in the United States: prospective observational study. BMJ. 2022;376:e069761. 10.1136/bmj-2021-069761

Ministerio de Salud Pública y Bienestar Social. Muertes maternas a causa de COVID-19 disminuyen 30%. 2022, abril; Paraguay. https://www.mspbs.gov.py/portal/25199/muertes-maternas-a-causa-de-covid-19-disminuyen-30-.html

Gurzenda S, Castro MC. COVID-19 poses alarming pregnancy and postpartum mortality risk in Brazil. EClinicalMedicine. 2021;36:100917.10.1016/j.eclinm.2021.100917

López-Rodríguez G, Galván M, Valencia ÓG. Comorbidities associated with maternal mortality from COVID-19 in Mexico. Gac Med Mex. 2021;157(6):599-603. 10.24875/GMM.M21000623

Frenkel LD, Gomez F, Bellanti JA. COVID-19 in children: Pathogenesis and current status. Allergy Asthma Proc. 2021;42(1):8-15. 10.2500/aap.2021.42.200104

Zhang QY, Xu BW, Du JB. Similarities and differences between multiple inflammatory syndrome in children associated with COVID-19 and Kawasaki disease: clinical presentations, diagnosis, and treatment. World J Pediatr. 2021; 17(4): 335-340. 10.1007/s12519-021-00435-y

Mouffak S, Shubbar Q, Saleh E, El-Awady R. Recent advances in management of COVID-19: A review. Biomed Pharmacother. 2021; 143: 112107. 10.1016/j.biopha.2021.112107

Fathizadeh H, Afshar S, Masoudi MR, et al. SARS-CoV-2 (Covid-19) vaccines structure, mechanisms and effectiveness: A review. Int J Biol Macromol. 2021; 188: 740-750. 10.1016/j.ijbiomac.2021.08.076

Ministerio de Salud Pública y Bienestar Social. Plan de Vacunacion - COVID-19. https://www.mspbs.gov.py/portal/26719/el-plan-de-vacunacion-contra-covid-19-en-el-2023.html