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Clinical Profile and Risk Factors for Severe COVID-19 in Hospitalized Patients from Rio de Janeiro, Brazil: Comparison between the First and Second Pandemic Waves

2023; Multidisciplinary Digital Publishing Institute; Volume: 12; Issue: 7 Linguagem: Inglês

10.3390/jcm12072568

2077-0383

Luciane Almeida Amado Leon, Wagner Luís da Costa Nunes Pimentel Coelho, Arthur Daniel Rocha Alves, Vanessa Cristine de Souza Carneiro, Otacílio C. Moreira, Vanessa Salete de Paula, Andreza Lemos Salvio, Larissa Araújo Duarte, Elisa Gouvea Gutman, Fabrícia Lima Fontes-Dantas, João Paulo da Costa Gonçalves, Carlos Henrique Ferreira Ramos, Carlos Henrique Ferreira Ramos Filho, Marta Guimarães Cavalcanti, Marisa Pimentel Amaro, Rafael Lopes Kader, Roberto de Andrade Medronho, Dmitry José de Santana Sarmento, Soniza Vieira Alves‐Leon,

Long-Term Effects of COVID-19

Since COVID-19 was declared a pandemic, Brazil has become one of the countries most affected by this disease. A year into the pandemic, a second wave of COVID-19 emerged, with a rapid spread of a new SARS-CoV-2 lineage of concern. Several vaccines have been granted emergency-use authorization, leading to a decrease in mortality and severe cases in many countries. However, the emergence of SARS-CoV-2 variants raises the alert for potential new waves of transmission and an increase in pathogenicity. We compared the demographic and clinical data of critically ill patients infected with COVID-19 hospitalized in Rio de Janeiro during the first and second waves between July 2020 and October 2021. In total, 106 participants were included in this study; among them, 88% had at least one comorbidity, and 37% developed severe disease. Disease severity was associated with older age, pre-existing neurological comorbidities, higher viral load, and dyspnea. Laboratory biomarkers related to white blood cells, coagulation, cellular injury, inflammation, renal, and liver injuries were significantly associated with severe COVID-19. During the second wave of the pandemic, the necessity of invasive respiratory support was higher, and more individuals with COVID-19 developed acute hepatitis, suggesting that the progression of the second wave resulted in an increase in severe cases. These results can contribute to understanding the behavior of the COVID-19 pandemic in Brazil and may be helpful in predicting disease severity, which is a pivotal for guiding clinical care, improving patient outcomes, and defining public policies.