Covid-19 in South America: Clinical and epidemiological characteristics among 381 patients during the early phase of the pandemic in Santiago, Chile

  1. Macarena R. Vial
  2. Anne Peters
  3. Inia Perez
  4. Maria Spencer
  5. Mario Barbe
  6. Lorena Porte
  7. Thomas Weitzel
  8. Mabel Aylwin
  9. Pablo Vial
  10. Rafael Araos
  11. Jose M Munita

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Abstract

Background: Understanding the characteristics of the Covid-19 pandemic in different geographical regions, ethnic and socioeconomic settings are of emerging importance. This study presents the demographic and clinical features of SARS-CoV-2 infected patients in a large private healthcare center in Santiago, Chile, during the first month of the pandemic. Methods: We analyzed the demographics, laboratory and clinical characteristics including severity and outcome of all patients diagnosed with Covid-19 during the first month of the pandemic. SARS-2-CoV infection was confirmed by RT-PCR in nosopharyngeal samples. The primary outcome was a composite of ICU admission or all-cause, in-hospital mortality. Clinical and laboratory parameters of hospitalized patients were analyzed regarding their association with the primary outcome. Results: From March 3 to April 4, 2020, 3679 individuals were tested for SARS-CoV-2 in our hospital. Of those, 381 had Covid-19 and were included into this analysis. Most patients (99.2%) were Chileans, 12% returning from recent travel. The median age was 39 years (IQR 31-49) and 52% were female. A total of 88 patients (23.1%) were hospitalized; 18 (3.7%) required ICU and/or died. The overall mortality was 0.7%. Increased body mass index (BMI) and elevated C-reactive protein (CRP) were independently associated with ICU care or death. Conclusion: During the first weeks of the pandemic in Chile, most Covid-19 patients were young, with low rates of hospitalization, ICU requirement, and fatality. BMI and CRP on admission were predictors for severity. Our data provide important information on the clinical course and outcome of Covid-19 in a Latin American setting.

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  1. Version published to 10.21203/rs.3.rs-64458/v3 on Research Square
  2. Version published to 10.1186/s12879-020-05665-5
  3. Version published to 10.21203/rs.3.rs-64458/v2 on Research Square
  4. Version published to 10.21203/rs.3.rs-64458/v1 on Research Square
  5. ScreenIT

    SciScore for 10.1101/2020.08.11.20171975: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the Institutional Review Board, with a waiver of informed consent given that data was collected as part of routine clinical practice and used in a de-identified manner.
    Consent: The study was approved by the Institutional Review Board, with a waiver of informed consent given that data was collected as part of routine clinical practice and used in a de-identified manner.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data was extracted from the electronic medical records and entered into a REDCap database by a team of researchers, after a training session led by the senior data manager investigator (AP).
    REDCap
    suggested: (REDCap, RRID:SCR_003445)
    College Station, TX: StataCorp LLC).
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    In addition, other relevant limitations of our study include that it is a single center effort and its observational nature. Due to the latter, we did not explore treatment effects given our limited ability to appropriately correct for potential confounders. However, our data were prospectively collected with high quality standards and provide one of the few studies contributing information from developing areas of the world, in this case South America. As mentioned above, the data of this cohort mainly represent the initially affected high-income population of Chile and a time of the pandemic were the healthcare system was not yet overwhelmed. Therefore, future studies analyzing the general population attending to a wider range of hospital centers and reflecting a systemic stress created by the large number of patients infected with SARS-CoV-2 will be important to help understand the possible influence of social and health disparities, and of the system overload in the outcomes of Covid-19 patients. In conclusion, among patients in our study, SARS-CoV-2 generally caused mild illness with a case fatality rate of 0.7%. On admission, variables associated with the need of ICU care and/or in-hospital mortality included BMI, CRP and SaTO2/FiO2, all of which are widely available in low and middle resource settings such as Latin America.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  6. Version published to 10.1101/2020.08.11.20171975v1 on medRxiv