Cambios en las características clínicas y desenlaces de pacientes hospitalizados por COVID-19 durante dos años de pandemia: experiencia en un hospital venezolano

María C. Arvelo; María Montes de oca; Laura Sánchez-Traslaviña; Flor H. Pujol; Rossana C. Jaspe; Isabel C. Silva; Irene Stulin; Gabriela Blanco; Jennireth Quevedo; Nathalia Valera; Irene Papa; Santiago Bacci; Fátima de Abreu; Héctor Villaroel; Juan C. Catari; José L. Lopez; Brigitte Moran; Claudio Cárdenas; Saverio Santucci; José L. Viloria; Eleonora García; Jerry Gómez; Antonio Martinelli; Manuel Guzmán

doi:10.17843/rpmesp.2022.393.11195

Authors

María C. Arvelo Hospital Centro Médico de Caracas, Caracas, Venezuela; Universidad Central de Venezuela (UCV), Facultad de Medicina, Caracas, Venezuela https://orcid.org/0000-0002-6412-0357
María Montes de oca Hospital Centro Médico de Caracas, Caracas, Venezuela; Universidad Central de Venezuela (UCV), Facultad de Medicina, Caracas, Venezuela https://orcid.org/0000-0002-5274-7574
Laura Sánchez-Traslaviña Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0003-1975-6257
Flor H. Pujol Laboratorio de Virología Molecular, Centro de Microbiología y Biología Celular (CMBC), Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela https://orcid.org/0000-0001-6086-6883
Rossana C. Jaspe Laboratorio de Virología Molecular, Centro de Microbiología y Biología Celular (CMBC), Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela https://orcid.org/0000-0002-4816-1378
Isabel C. Silva Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0001-8963-8980
Stulin Stulin Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0002-3408-8552
Gabriela Blanco Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0003-4110-4482
Jennireth Quevedo Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0003-0467-2181
Nathalia Valera Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0003-0242-2824
Irene Papa Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0001-9981-9638
Santiago Bacci Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0003-1733-6793
Fátima de Abreu Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0002-5780-4064
Héctor Villaroel Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0002-0183-0167
Juan C. Catari Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0002-9224-244X
José L. Lopez Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0002-6860-9002
Brigitte Moran Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0002-0402-4419
Cárdenas Cárdenas Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0003-1008-0369
Saverio Santucci Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0001-9397-2455
Santucci Viloria Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0001-5654-3010
Eleonora García Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0003-1239-6965
Jerry Gómez Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0002-0958-9777
Antonio Martinelli Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0002-8841-7577
Manuel Guzmán Hospital Centro Médico de Caracas, Caracas, Venezuela https://orcid.org/0000-0003-1965-1826

DOI:

https://doi.org/10.17843/rpmesp.2022.393.11195

Keywords:

COVID-19, SARS-CoV-2, SARS-CoV-2 variants, Intensive Care Units, Mortality, In-Hospital

Abstract

Objectives. To determine changes in the clinical characteristics and in-hospital outcomes of patients hospitalized for COVID-19 in a private hospital in Caracas during two years of the pandemic. Materials and Methods. Retrospective, observational study of patients hospitalized for COVID-19. We evaluated the correspondence between waves of hospital admissions and circulating variants of SARS-CoV-2 in the general population of the Capital District and Miranda state. Results. A total of 1025 patients (569 men and 456 women) were included, with a mean age of 62.9 SD: 16.2 years. Four waves of hospital admissions were identified: first (March-November 2020) 150/1025 (14.6%) cases; second (December 2020 to May 2021) 415/1025 (40.5%) cases; third (June-December 2021) 344/1025 (33.6%) cases; fourth (January-February 2022) 116/1025 (11.3%) cases. The mean age was higher in the fourth wave (first: 64.0±15.7, second: 61.4±15.8, third: 62.1±16.5, and fourth wave: 68.5±16.4), while the proportion of male patients (first: 66.7%, second: 58.8%, third: 50.3%, and fourth wave: 44.8%), patients with severe-critical illness (first: 65.3%, second: 57%, third: 51.7%, and fourth wave: 44.8%), in-hospital stay (first: 9.1±6.0, second: 9.0±7.3, third: 8.8±7.7, and fourth wave: 6.9±5.0 days), ICU admissions (first: 23.3%, second: 15.7%, third: 14.0%, and fourth wave: 11.2%; p=0.027) and mortality (first: 21. 8%, second: 10.7%, third: 9.1%, and fourth wave: 7.1%; p<0.001) progressively decreased over time. Conclusions. The results show lower frequency of severe cases and improvement of in-hospital outcomes in two years of the pandemic. Changes in circulating variants, improvements in disease management and vaccination are likely to have influenced these results.

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