Impact of the Gamma Variant on the ICU Admission in a Hospital of the Autonomous City of Buenos Aires (CABA), Argentina

Abstract

Verónica Mandich35068*, Daniel Chiacchiara35069, Antonio Pilipec35070, Santiago Grimaldi35071, Johnny Cotez35072, Víctor Paniouk35073, Oswaldo Escobar35074, Henry Arévalo35076, Sebastián Pérez Flach35077, Amílcar Herbas Pozo35078, Alejandro Aimar35079 and Marcelo Bravo35081

Objectives: Comparison between patients admitted to the Intensive Care Unit (ICU) with ventilatory support during the first and second wave (Gamma variant) of COVID-19 in a tertiary hospital in the City of Buenos Aires.

Design: Descriptive, observational, prospective cohort study.

Setting: ICU of an acute general hospital in Argentina. Patients: Adult patients with COVID-19 admitted consecutively to the ICU.

Intervention: Admission to ICU. Main variables of interest: Demographic and laboratory data, history, duration of MV (Mechanical Ventilation), mortality.

Results: 44 patients were recruited during the first wave, and 80 in the second. Significant differences were observed in the second wave for age (60, [SD (Standard Deviation) 11]; vs. 68 [SD 11]; p<0.01), days with symptoms (9 [SD 5]; vs. 4.5 [SD 3]; p<0.01), duration of MV (10 days [SD 7]; vs. 16 [SD 13]; p<0.01), Ferritin (1450 mcg/l [SD 547]; vs. 941 mcg/l [SD 593]; p=0.04) and use of antibiotics (97% vs. 45% p<0.01). There was no difference in mortality (66% vs. 78% p 0.14) but there was in its primary causes; being more frequent hypoxemia associated with sepsis in the second wave (40% vs. 3.4% p<0.01) and hypoxemia and multiorgan failure in the first (28% vs. 4% p<0.01).

Conclusions: During the second wave of the pandemic, due to Gamma variant, more patients were admitted to our unit, younger, with a longer evolution time, a shorter time on MV (Mechanical Ventilation) and a greater inflammatory response, with no difference in mortality, although there was a difference in its causes.