Mortality in Patients Hospitalized for COVID-19 during the First Wave in a Tertiary Care Institution in Neuquén

Main Article Content

Gustavo Zabert
https://orcid.org/0000-0001-9937-4464
Ignacio Veltri
https://orcid.org/0000-0003-4409-1576
Ignacio Zabert
https://orcid.org/0000-0002-8693-5901
Lucio Espinosa
https://orcid.org/0000-0002-9596-6320
Fabian Mariluan
https://orcid.org/0000-0002-2662-9523
Nelson Fernandez

Abstract

Introduction: In December 2019, an outbreak of disease due to a new coronavirus was detected that evolved into a pandemic with severe respiratory morbidity and mortality. Health systems had to face an unexpected number of patients with respiratory failure. In Argentina, quarantine and health control measures delayed the first peak of the pandemic and offered time to prepare the health system with infrastructure, personnel and protocols based on the best evidence available at the time. In a third level institution of Neuquén, Argentina, a care protocol was developed to confront the pandemic adapted by evolving best evidence and periodic evaluations of hospital mortality.


Methods: Observational cohort study to evaluate the evolution of patients hospitalized for COVID-19 with care protocols in terms of overall hospital mortality and at day 28 at the Pasteur Clinic in Neuquén in 2020.


Results: This report describes the 501 patients diagnosed until December 31, 2020. Mortality was 16.6% (83/501) and 12.2% (61/501) on day 28 of admission. Of the 139 (27.7%) patients with mechanical ventilation, 37.4% (52/139) and 28.1% (38/139) died, respectively. The risk factors identified were age, comorbidities and high oxygen requirements on admission.


Conclusion: The mortality observed in patients hospitalized in our institution during the first wave of COVID-19 pandemic was lower than other publications in Argentina and similar to international reports for the same period.

Downloads

Download data is not yet available.

Article Details

How to Cite
Zabert, G., Veltri, I., Zabert, I., Espinosa, L., Mariluan, F., & Fernandez, N. (2024). Mortality in Patients Hospitalized for COVID-19 during the First Wave in a Tertiary Care Institution in Neuquén. Respirar, 16(2), 113–126. https://doi.org/10.55720/respirar.16.2.2
Section
Artículos Originales

References

Gao Q, Hu Y, Dai Z, Xiao F, Wang J, Wu J. The epidemiological characteristics of 2019 novel coronavirus diseases (COVID-19) in Jingmen, Hubei, China. Med (United States) 2020;99(23):113-122. Doi:10.1097/MD.0000000000020605

Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA - J Am Med Assoc 2020;323(13):1239-1242. Doi:10.1001/jama.2020.2648

Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA 2020;323(16):1545-1546. Doi:10.1001/jama.2020.4031

Grasselli G, Greco M, Zanella A 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. Doi:10.1001/jamainternmed.2020.3539

Redondo-Bravo L, Moros MJS, Sanchez EVM et al. The first wave of the COVID-19 pandemic in Spain: Characterisation of cases and risk factors for sever. Eurosurveillance 2020;25(50):1-13.

Chhibber-Goel J, Malhotra S, Krishnan NMA, Sharma A. The profiles of first and second SARS-CoV-2 waves in the top ten COVID-19 affected countries. J Glob Heal Reports 2021:1-7. Doi:10.29392/001c.27143

World Health Organization. WHO Director-General’s Opening Remarks at the Media Briefing on COVID-19-11 March 2020. Geneva, Switzerland; 2020. [Internet]. [Consultado 3 feb 2024]. Disponible en: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020

Argenzian MG, Bruc SL, Slate CL et al. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: Retrospective case series. BMJ 2020;369. Doi:10.1136/bmj.m1996

Lamfre L, Caro P, Hasdeu S, Horne F. Modelo de Proyección de Casos Esperados COVID-19 en Argentina 2020. Neuquen; 2020. [Internet]. [Consultado 3 feb 2024]. Disponible en: https://1331c255-c873-472c-8edd-6738111a6c38.filesusr.com/ugd/d623b6_007bc0ad0898495882e61367e1d2644d.pdf.

Finelli L, Gupta V, Petigara T, Yu K, Bauer KA, Puzniak LA. Mortality Among US Patients Hospitalized With SARS-CoV-2 Infection in 2020. JAMA Netw Open 2021;4(4):e216556-e216556. Doi:10.1001/jamanetworkopen.2021.6556

Oppenheim B, Gallivan M, Madhav NK et al. Assessing global preparedness for the next pandemic: Development and application of an Epidemic Preparedness Index. BMJ Glob Heal 2019;4(1). Doi:10.1136/bmjgh-2018-001157

Presidencia de la Nación. Decreto 297/20 Aislamiento Social Preventivo y Obligatorio. Argentina, 2020. [Internet]. [Consultado 3 feb 2024]. Disponible en: https://www.boletinoficial.gob.ar/detalleAviso/primera/227042/20200320.

Veltri I, Zabert G, Pelaez J et al. Plan Institucional COVID19. Clinica Pasteur. Neuquén; 2020. [Internet]. [Consultado 3 feb 2024]. Disponible en: https://drive.google.com/file/d/1KOQxPOTZXeiSlqwf6Hr5_RI0e3UGEp-s/view

Zabert G, Veltri I, Goya F et al. Protocolo Tratamiento COVID19 Clinica Pasteur v 1.1. Neuquén; 2020. [Internet]. [Consultado 3 feb 2024]. https://drive.google.com/file/d/1VjxTosouB2WGfLX2rdV-ryHKo2Hk0N7t/view

National Institutes of Health. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. 2020. [Internet]. [Consultado 21 may 2020]. Disponible en: https://covid19treatmentguidelines.nih.gov/.

National Institutes of Health. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. 2020. [Internet]. [Consultado 25 may 2020]. Disponible en: https://www.covid19treatmentguidelines.nih.gov/.

Zabert G, Veltri I, Goya F et al. Protocolo Tratamiento COVID19 Clinica Pasteur v 2. Neuquén; 2021. [Internet]. [Consultado 3 feb 2024]. Disponible en: https://drive.google.com/file/d/1YBR98SJgu2GzSeqfQNoKjEwjIYJdLXr2/view

Espinosa L, Ambort C, Vera M et al. Documento de Comité Asesor de Ética de La Clínica Pasteur Para La Implementación Del Documento de Aspectos Éticos En La Pandemia de COVID19 En El Escenario de Recursos Escasos. Neuquén, 2020. [Internet]. [Consultado 10 may 2021]. Disponible en: https://drive.google.com/drive/u/0/folders/1BK1rSlpCR2KzydRxRp6KKUsqLezIKsAi

Rosenbaum L. Facing Covid-19 in Italy — Ethics, Logistics, and Therapeutics on the Epidemic’s Front Line. N Engl J Med 2020:1-3. Doi:10.1056/nejmp2005492

Emanuel EJ, Persad G, Upshur R et al. Fair Allocation of Scarce Medical Resources in the Time of Covid-19. N Engl J Med 2020:1-7. Doi:10.1056/nejmsb2005114

MSal Neuquén. Aspectos éticos en la atención de las personas durante la pandemia por coronavirus (SARS-CoV-2). Neuquén, 2020. [Internet]. [Consultado 10 feb 2024]. Disponible en: https://bioetica.saludneuquen.gob.ar/wp-content/uploads/2020/05/ASPECTOS-%C3%89TICOS-EN-LA-ATENCI%C3%93N-DE-LAS-PERSONAS-DURANTE-LA-PANDEMIA-POR-CORONAVIRUS-SARS-CoV-2-Versi%C3%B3n-22-4-20-comentado-1.pdf

Carrasco Cézar R, Lavor Lira M, Gama Nogueira M, Araújo de Freitas B, Serra Damasceno L. Trend and dynamics of the COVID-19 pandemic in Latin America during the first wave. Rev Med da UFC 2022;62(1):1-7. Doi:10.20513/2447-6595.2022v62n1e70937p1-7

Manoukian D, Elder M. Mortalidad por COVID-19 y sinergia con enfermedades crónicas coexistentes en la provincia del Neuquén. Rev argentina salud publica 2021;13(Supl COVID19):e32.

Molini W, Gonzalez R, Villalba L et al. Terapia nasal de alto flujo en insuficiencia respiratoria grave por SARS-CoV2. Med 2021;81(21):2-28.

Secretaría de Gobierno de Salud. 4o Encuesta nacional de Factores de riesgo. Principales Resultados. 2019:1-20. [Internet]. [Consultado 25 may 2024]. Disponible en: https://bancos.salud.gob.ar/sites/default/files/2020-01/4ta-encuesta-nacional-factores-riesgo_2019_principales-resultados.pdf

Schönfeld D, Arias S, Bossio JC, Fernández H, Gozal D, Pérez-Chada D. Clinical presentation and outcomes of the first patients with COVID-19 in Argentina: Results of 207079 cases from a national database. PLoS One 2021;16(2):e0246793. Doi:10.1371/journal.pone.0246793

Boietti BR, Mirofsky M, Valentini R et al. Análisis descriptivo de 4776 pacientes internados en servicios de clínica médica por covid-19. Resultados del registro multicéntrico argentino - REMA-COVID-19. Medicina (B Aires) 2021; 81: 703-714.

Estenssoro E, Loudet CI, Ríos FG et al. Clinical characteristics and outcomes of invasively ventilated patients with COVID-19 in Argentina (SATICOVID): a prospective, multicentre cohort study. Lancet Respir Med 2021;9(9):989-998. Doi:10.1016/S2213-2600(21)00229-0

Alhazzani W, Møller MH, Arabi YM et al. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med 2020;46(5):854-887. Doi:10.1007/s00134-020-06022-5

Barrot L, Asfar P, Mauny F et al. Liberal or Conservative Oxygen Therapy for Acute Respiratory Distress Syndrome. N Engl J Med 2020;382(11):999-1008. Doi:10.1056/nejmoa1916431

Horby P, Mafham M, Linsell L; RECOVERY Collaborative Group. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med 2021;384(8):693-704. Doi:10.1056/NEJMoa2021436

Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 2020;18:1094-1099. Doi:10.1111/jth.14817

Nadkarni G, Lala A, Bagiella E et al. Anticoagulation, Bleeding, Mortality, and Pathology in Hospitalized Patients With COVID-19. J Am Coll Cardiol 2020;76:1815-1826. Doi:10.1016/j.jacc.2020.08.041

Roth GA, Emmons-Bell S, Alger HM et al. Trends in Patient Characteristics and COVID-19 In-Hospital Mortality in the United States during the COVID-19 Pandemic. JAMA Netw Open 2021;4(5):1-9. Doi:10.1001/jamanetworkopen.2021.8828

Docherty AB, Mulholland RH, Lone NI et al. Changes in in-hospital mortality in the first wave of COVID-19: a multicentre prospective observational cohort study using the WHO Clinical Characterisation Protocol UK. Lancet Respir Med 2021;9(7):773-785. Doi:10.1016/S2213-2600(21)00175-2