Clinical aspects of importance in suspected or confirmed patients with COVID-19 hospitalized at Centro Médico Docente la Trinidad: Case review

Abstract

The objective of this study was to describe the clinical characteristics of patients with suspected or confirmed COVID-19 hospitalized at the Centro Médico Docente La Trinidad (CMDLT) between August and September 2020. Methodology: observational, case series study. The sample was obtained by random sampling and consisted of 144 patients. Results: the majority were patients between 60-79 years (42.1%) with a predominance of males (69%). Diagnostic confirmation of COVID-19 was obtained only in 13.2% of cases. Sixty-four percent of patients had comorbidities, mainly cardiovascular and metabolic diseases. The main consulting symptoms were dyspnea (53.5%), fever (15.9%) and cough (12.5%). A 62.5% received outpatient treatment; during hospitalization 89.5% received steroids, 91.6% anticoagulants, and 36.8% antivirals; 11.1% of the patients were admitted to the Intensive Care Unit (ICU), of which 56% required mechanical ventilation. The mortality found was 10.4%, lower than reported in literature, mostly in the ICU (6.3%). Elevation of D-dimer was evidenced between 7-9 days of disease while acute phase reactants showed a progressive increase during the disease, with a peak between 13-15 days after the onset of symptoms. Conclusions: in this study dyspnea was the main manifestation associated to late visit to healthcare centers. Importance should be given to the biochemical parameters associated with liver disease and possible implications of hypoalbuminemia in the pathophysiology of interstitial edema. Monitoring of acute phase reactants can predict the appearance of cytokine storm between days 13-15 of illness.