Navigating the waves in Colombia: a cohort study of inpatient care during four COVID-19 waves
Introduction: Understanding the intricate dynamics between different waves of the COVID-19 pandemic and the corresponding variations in clinical outcomes is essential for informed public health decision-making. Comprehensive insights into these fluctuations can guide resource allocation, healthcare...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Brazilian Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867024000205 |
| _version_ | 1797260390982221824 |
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| author | David E. Rebellón-Sánchez Tania M. Guzmán Sarita Rodriguez Julio Llanos-Torres Daniela Vinueza Eric Tafurt Estefanía Beltrán Álvaro Martínez Fernando Rosso |
| author_facet | David E. Rebellón-Sánchez Tania M. Guzmán Sarita Rodriguez Julio Llanos-Torres Daniela Vinueza Eric Tafurt Estefanía Beltrán Álvaro Martínez Fernando Rosso |
| author_sort | David E. Rebellón-Sánchez |
| collection | DOAJ |
| description | Introduction: Understanding the intricate dynamics between different waves of the COVID-19 pandemic and the corresponding variations in clinical outcomes is essential for informed public health decision-making. Comprehensive insights into these fluctuations can guide resource allocation, healthcare policies, and the development of effective interventions. This study aimed to compare the characteristics and clinical outcomes of COVID-19 at peak transmission points by including all patients attended during the first four pandemic waves in a referral center in Colombia. Material and methods: In a prospective observational study of 2733 patients, clinical and demographic data were extracted from the Fundacion Valle de Lili's COVID-19 Registry, focusing on ICU admission, Invasive Mechanical Ventilation (IMV), length of hospital stay, and mortality. Results: Our analysis unveiled substantial shifts in patient care patterns. Notably, the proportion of patients receiving glucocorticoid therapy and experiencing secondary infections exhibited a pronounced decrease across waves (p < 0.001). Remarkably, there was a significant reduction in ICU admissions (62.83% vs. 51.23% vs. 58.23% vs. 46.70 %, p < 0.001), Invasive Mechanical Ventilation (IMV) usage (39.25% vs. 32.22% vs. 31.22% vs. 21.55 %, p < 0.001), and Length of Hospital Stay (LOS) (9 vs. 8 vs. 8 vs. 8 days, p < 0.001) over the successive waves. Surprisingly, hospital mortality remained stable at approximately 18‒20 % (p > 0.05). Notably, vaccination coverage with one or more doses surged from 0 % during the initial waves to 66.71 % in the fourth wave. Conclusions: Our findings emphasize the critical importance of adapting healthcare strategies to the evolving dynamics of the pandemic. The reduction in ICU admissions, IMV utilization, and LOS, coupled with the rise in vaccination rates, underscores the adaptability of healthcare systems. Hospital mortality's persistence may warrant further exploration of treatment strategies. These insights can inform public health responses, helping policymakers allocate resources effectively and tailor interventions to specific phases of the pandemic. |
| first_indexed | 2024-04-24T23:24:34Z |
| format | Article |
| id | doaj.art-1503e191e0ad47fa9f99ffb6a92ed4d7 |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-04-24T23:24:34Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-1503e191e0ad47fa9f99ffb6a92ed4d72024-03-16T05:08:09ZengElsevierBrazilian Journal of Infectious Diseases1413-86702024-03-01282103737Navigating the waves in Colombia: a cohort study of inpatient care during four COVID-19 wavesDavid E. Rebellón-Sánchez0Tania M. Guzmán1Sarita Rodriguez2Julio Llanos-Torres3Daniela Vinueza4Eric Tafurt5Estefanía Beltrán6Álvaro Martínez7Fernando Rosso8Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia; Corresponding author.Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, ColombiaFundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, ColombiaFundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, ColombiaFundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, ColombiaFundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia; Universidad Icesi, Facultad de Ciencias de la Salud, Cali, ColombiaFundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, ColombiaFundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia; Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia; Fundación Valle del Lili, Servicio de Enfermedades Infecciosas, Cali, ColombiaFundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia; Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia; Fundación Valle del Lili, Servicio de Enfermedades Infecciosas, Cali, ColombiaIntroduction: Understanding the intricate dynamics between different waves of the COVID-19 pandemic and the corresponding variations in clinical outcomes is essential for informed public health decision-making. Comprehensive insights into these fluctuations can guide resource allocation, healthcare policies, and the development of effective interventions. This study aimed to compare the characteristics and clinical outcomes of COVID-19 at peak transmission points by including all patients attended during the first four pandemic waves in a referral center in Colombia. Material and methods: In a prospective observational study of 2733 patients, clinical and demographic data were extracted from the Fundacion Valle de Lili's COVID-19 Registry, focusing on ICU admission, Invasive Mechanical Ventilation (IMV), length of hospital stay, and mortality. Results: Our analysis unveiled substantial shifts in patient care patterns. Notably, the proportion of patients receiving glucocorticoid therapy and experiencing secondary infections exhibited a pronounced decrease across waves (p < 0.001). Remarkably, there was a significant reduction in ICU admissions (62.83% vs. 51.23% vs. 58.23% vs. 46.70 %, p < 0.001), Invasive Mechanical Ventilation (IMV) usage (39.25% vs. 32.22% vs. 31.22% vs. 21.55 %, p < 0.001), and Length of Hospital Stay (LOS) (9 vs. 8 vs. 8 vs. 8 days, p < 0.001) over the successive waves. Surprisingly, hospital mortality remained stable at approximately 18‒20 % (p > 0.05). Notably, vaccination coverage with one or more doses surged from 0 % during the initial waves to 66.71 % in the fourth wave. Conclusions: Our findings emphasize the critical importance of adapting healthcare strategies to the evolving dynamics of the pandemic. The reduction in ICU admissions, IMV utilization, and LOS, coupled with the rise in vaccination rates, underscores the adaptability of healthcare systems. Hospital mortality's persistence may warrant further exploration of treatment strategies. These insights can inform public health responses, helping policymakers allocate resources effectively and tailor interventions to specific phases of the pandemic.http://www.sciencedirect.com/science/article/pii/S1413867024000205COVID-19SARS-COV-2PandemicCOVID-19 vaccinesClinical presentationsAll-cause mortality |
| spellingShingle | David E. Rebellón-Sánchez Tania M. Guzmán Sarita Rodriguez Julio Llanos-Torres Daniela Vinueza Eric Tafurt Estefanía Beltrán Álvaro Martínez Fernando Rosso Navigating the waves in Colombia: a cohort study of inpatient care during four COVID-19 waves Brazilian Journal of Infectious Diseases COVID-19 SARS-COV-2 Pandemic COVID-19 vaccines Clinical presentations All-cause mortality |
| title | Navigating the waves in Colombia: a cohort study of inpatient care during four COVID-19 waves |
| title_full | Navigating the waves in Colombia: a cohort study of inpatient care during four COVID-19 waves |
| title_fullStr | Navigating the waves in Colombia: a cohort study of inpatient care during four COVID-19 waves |
| title_full_unstemmed | Navigating the waves in Colombia: a cohort study of inpatient care during four COVID-19 waves |
| title_short | Navigating the waves in Colombia: a cohort study of inpatient care during four COVID-19 waves |
| title_sort | navigating the waves in colombia a cohort study of inpatient care during four covid 19 waves |
| topic | COVID-19 SARS-COV-2 Pandemic COVID-19 vaccines Clinical presentations All-cause mortality |
| url | http://www.sciencedirect.com/science/article/pii/S1413867024000205 |
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