Clinical presentation and outcomes of the first patients with COVID-19 in Argentina: Results of 207079 cases from a national database.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2021
Historique:
received: 11 12 2020
accepted: 26 01 2021
entrez: 11 2 2021
pubmed: 12 2 2021
medline: 24 2 2021
Statut: epublish

Résumé

There is limited evidence on the clinical characteristics of SARS-CoV-2 infection in Latin America. We present findings from a nationwide study in Argentina. What is disease severity measures and risk factors are associated with admission to an intensive care unit and mortality? Data were extracted from the COVID-19 database of the Integrated Argentina Health Information System, encompassing the period of March 3rd to October 2nd, 2020, using a standardized case report form that included information on contact history, clinical signs and symptoms, and clinical diagnosis. Information was collected at the initial site of care and follow-up conducted through calls by the regional healthcare authorities. A confirmed case of COVID-19 was defined as having a positive result through sequencing or real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. RT-PCR testing was positive in 738,776 cases. Complete datasets were available for analysis in 207,079 cases. Mean age was 42.9±18.8 years, 50.0% were males. Frequent co-existing conditions included hypertension (19.2%), diabetes (9.7%), asthma (6.1%) and obesity (5.2%). Most common symptoms included fever (58.5%), cough (58.0%), headache (45.4%), and sore throat (42.1%). Death or ICU admission were independently associated with older age, male, coma, dyspnea or tachypnea, and seizures, with underlying co-morbidities such as immunodeficiency, chronic renal failure, and liver disease showing the strongest effects. Most cases of COVID-19 diagnosed in Argentina were mild and had a favorable outcome, but fatality rates were relatively elevated. Risk factors for adverse outcome included older age, male sex, coma and seizures, and the concurrent presence of several morbidities. These data may be useful for healthcare providers and healthcare policy makers of low-middle income and Latin American countries to guide decisions toward optimized care during the pandemic.

Sections du résumé

BACKGROUND
There is limited evidence on the clinical characteristics of SARS-CoV-2 infection in Latin America. We present findings from a nationwide study in Argentina.
RESEARCH QUESTION
What is disease severity measures and risk factors are associated with admission to an intensive care unit and mortality?
STUDY DESIGN AND METHODS
Data were extracted from the COVID-19 database of the Integrated Argentina Health Information System, encompassing the period of March 3rd to October 2nd, 2020, using a standardized case report form that included information on contact history, clinical signs and symptoms, and clinical diagnosis. Information was collected at the initial site of care and follow-up conducted through calls by the regional healthcare authorities. A confirmed case of COVID-19 was defined as having a positive result through sequencing or real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay of nasal and pharyngeal swab specimens.
RESULTS
RT-PCR testing was positive in 738,776 cases. Complete datasets were available for analysis in 207,079 cases. Mean age was 42.9±18.8 years, 50.0% were males. Frequent co-existing conditions included hypertension (19.2%), diabetes (9.7%), asthma (6.1%) and obesity (5.2%). Most common symptoms included fever (58.5%), cough (58.0%), headache (45.4%), and sore throat (42.1%). Death or ICU admission were independently associated with older age, male, coma, dyspnea or tachypnea, and seizures, with underlying co-morbidities such as immunodeficiency, chronic renal failure, and liver disease showing the strongest effects.
INTERPRETATION
Most cases of COVID-19 diagnosed in Argentina were mild and had a favorable outcome, but fatality rates were relatively elevated. Risk factors for adverse outcome included older age, male sex, coma and seizures, and the concurrent presence of several morbidities. These data may be useful for healthcare providers and healthcare policy makers of low-middle income and Latin American countries to guide decisions toward optimized care during the pandemic.

Identifiants

pubmed: 33571300
doi: 10.1371/journal.pone.0246793
pii: PONE-D-20-38991
pmc: PMC7877635
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0246793

Déclaration de conflit d'intérêts

Commercial affiliation: This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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Auteurs

Daniel Schönfeld (D)

Centro Diagnóstico San Jorge, Puerto Madryn, Chubut, Argentina.

Sergio Arias (S)

Instituto Nacional de Enfermedades Respiratorias "Dr. Emilio Coni", Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán", Santa Fe, Argentina.

Juan Carlos Bossio (JC)

Instituto Nacional de Enfermedades Respiratorias "Dr. Emilio Coni", Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán", Santa Fe, Argentina.

Hugo Fernández (H)

Instituto Nacional de Enfermedades Respiratorias "Dr. Emilio Coni", Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán", Santa Fe, Argentina.

David Gozal (D)

Department of Child Health, Women and Children's Hospital, University of Missouri, Columbia, MO, United States of America.

Daniel Pérez-Chada (D)

Servicio de Neumonología, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina.

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