Caracterización clínica y manejo de pacientes covid-19, hospital amazónico, Yarinacocha – Región de Ucayali, 2020

Abstract

Introduction: The objective was to determine the clinical characteristics and management of COVID-19 patients at the Amazon Hospital, Yarinacocha, Ucayali Region, from April to December 2020.
Materials and methods: Non-experimental, cross-sectional, quantitative, descriptive, observational, and retrospective design, with convenience sampling. The sample consisted of 113 medical records of patients with confirmed COVID-19 from the Department of Medicine. The instrument was a registration form (binomial P = 0.439). Results: 63.7 % were female, 61.1 % were between 18 and 59 years of age, x̅ = 46.5 years, minimum age = 18, maximum age = 76 years, and originated in Callería and Yarinacocha. Clinical classification: 52.2 % were moderate, 41.6 % severe. The hospital stay was 1 to 6 days in 62.8 % of the patients, and 1 to 2 weeks in 27.4 %. Clinical characteristics: 69 % had 1 to 7 days of illness, rapid test: 44.2 % IgM IgG, 41.6 % reactive IgG, 60.2 % chest X-ray with bilateral involvement. 89.4 % and 96.5% presented cough and fever respectively and 100 % general malaise. 82.3% respiratory difficulty, 50.4 % headache; a lower percentage ageusia, anosmia. Warning signs: dyspnea 86.7%, tachypnea 93.8%, Sat.O2 (<92%) 71.7 %, muscle fatigue 46.9 %. Clinical management: moderate-severe case (MINSA protocol), 84.1% administered Methylprednisolone every 12 hours, Dexamethasone 8 mg/EV every 24 hours for hyperinflammation; 73.4% Ceftriaxone every 24 hours + Clindamycin every 8 hours, 20.4 % Ceftriaxone 2 mg/24 hours; prophylactic anticoagulation: 54% Enoxaparin 40 mg subcutaneous injection, 31.9 % 60 mg, and 93.8 % oxygen therapy. Complications: respiratory failure, comorbid hypertension, and BMD.
Results: Clinical progression was 3 to 6 days; 38.9 % recovered, 36.3 % died, 19.5 % were discharged voluntarily, and 5.3% were transferred to the ICU.
Conclusions: Clinical characteristics are similar to those reported in the international and national literature; clinical management was protocolized.