COVID-19 en adultos en el Hospital de Puerto Montt en la primera etapa de la pandemia

Abstract

The COVID-19 pandemic posed a great strain in health services. To describe the epidemiological and clinical features of patients with SARS-CoV-2 admitted to a regional hospital in southern Chile between April and August 2020. Clinical records of all hospitalized patients with RT-PCR (+) for SARS-CoV-2 were retrospectively analyzed. During the study period 226 patients aged 55 ± 18 years (55% men) were admitted. The main comorbidities were high blood pressure in 45%, diabetes in 31% and obesity in 21%. The main symptoms were dyspnea in 70%, cough in 69%, fever in 62% and myalgia in 47%. Pneumonia was the main cause of admission in 66%. Images on admission were compatible with pneumonia in 81%, and with a typical COVID-19 pattern in 84%. In 76% there was five-lobe involvement. Eighty-seven cases (39%) were admitted to critical care, with an APACHE score of 10.9 ± 7.1. Invasive mechanical ventilation was used in 16%, 30% required prone position and 13%, a high-flow nasal cannula. The mean stay in critical care was 13.3 days. The mean duration of invasive mechanical ventilation was 14.1 days. Antimicrobials were used in 55% and dexamethasone in 36%. Twenty-two (9.7%) patients aged 71.7 ± 14 died. A Charlson comorbidity index > 3, heart failure and connection to invasive mechanical ventilation were independent risk factors for death. An age > 65 years alone and other comorbidities were not risk factors. Viral pneumonia is the main cause of hospitalization for COVID-19, usually extensive and bilateral. The greater severity and poor prognosis of these patients are mainly related to comorbidities.