Risk factors associated with COVID-19 ICU admission or death in Argentina

A nationwide analysis of data from the first 6 months of the COVID-19 pandemic in Argentina has identified factors associated with increased risk of death or admission to an intensive care unit (ICU) due to the disease, including older age, male sex, coma, seizures, and underlying comorbidities. Daniel Schoenfeld of Centro Diagnostico San Jorge in Puerto Madryn, Argentina, and colleagues present these findings in the open-access journal PLOS ONE on February 11.

Argentina reported its first case of COVID-19 on March 3, 2020, and a national lockdown has been in place since March 20, 2020. As of January 10, 2021, a total of 1,714,409 cases and 44,417 deaths had been reported. However, few studies have examined the clinical characteristics of COVID-19 in Latin America.

To address that knowledge gap, Schoenfeld and colleagues examined COVID-19 patient characteristics and outcomes reported across Argentina in health records from March 3 to October 2, 2020. Out of over 700,000 total confirmed cases, 207,079 patients' health records contained enough follow-up information for analysis. Half of these patients were male, and 80.7 percent were younger than 60.

Most of the 207,079 COVID-19 patients had mild cases and favorable outcomes, but 5,652 were admitted to an ICU and 10,913 died. Increased risk of ICU admission or death was most strongly associated with underlying comorbidities, such as immunodeficiency, chronic renal failure, and liver disease. Other risk factors for ICU admission or death were older age, male sex, coma, dyspnea or tachypnea, and seizures.

The analysis also identified the most common initial symptoms experienced by the patients, including fever, cough, headache, and sore throat. Common co-existing conditions among the patients included hypertension, diabetes, asthma, and obesity.

This analysis was limited to positive cases with complete records, and there may be many additional cases of COVID-19 that were never officially registered. Still, the authors note, the new findings could help inform public health measures to optimize COVID-19 care in low-to-middle income and Latin American countries.

The authors add: "Our study of more than 200,000 people shows the risk of hospitalization in ICU and dying by age, sex and comorbidities in Argentina. Severe cases can be identified based on the predictors we described in the study, and may be useful for setting priorities in the Healthcare process and allocate resources."