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      Clinical presentation and outcomes of the first patients with COVID-19 in Argentina: Results of 207079 cases from a national database

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          Abstract

          Background

          There is limited evidence on the clinical characteristics of SARS-CoV-2 infection in Latin America. We present findings from a nationwide study in Argentina.

          Research question

          What is disease severity measures and risk factors are associated with admission to an intensive care unit and mortality?

          Study design and methods

          Data were extracted from the COVID-19 database of the Integrated Argentina Health Information System, encompassing the period of March 3rd to October 2nd, 2020, using a standardized case report form that included information on contact history, clinical signs and symptoms, and clinical diagnosis. Information was collected at the initial site of care and follow-up conducted through calls by the regional healthcare authorities. A confirmed case of COVID-19 was defined as having a positive result through sequencing or real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay of nasal and pharyngeal swab specimens.

          Results

          RT-PCR testing was positive in 738,776 cases. Complete datasets were available for analysis in 207,079 cases. Mean age was 42.9±18.8 years, 50.0% were males. Frequent co-existing conditions included hypertension (19.2%), diabetes (9.7%), asthma (6.1%) and obesity (5.2%). Most common symptoms included fever (58.5%), cough (58.0%), headache (45.4%), and sore throat (42.1%). Death or ICU admission were independently associated with older age, male, coma, dyspnea or tachypnea, and seizures, with underlying co-morbidities such as immunodeficiency, chronic renal failure, and liver disease showing the strongest effects.

          Interpretation

          Most cases of COVID-19 diagnosed in Argentina were mild and had a favorable outcome, but fatality rates were relatively elevated. Risk factors for adverse outcome included older age, male sex, coma and seizures, and the concurrent presence of several morbidities. These data may be useful for healthcare providers and healthcare policy makers of low-middle income and Latin American countries to guide decisions toward optimized care during the pandemic.

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          Most cited references38

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            A pneumonia outbreak associated with a new coronavirus of probable bat origin

            Since the outbreak of severe acute respiratory syndrome (SARS) 18 years ago, a large number of SARS-related coronaviruses (SARSr-CoVs) have been discovered in their natural reservoir host, bats 1–4 . Previous studies have shown that some bat SARSr-CoVs have the potential to infect humans 5–7 . Here we report the identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, which started on 12 December 2019, had caused 2,794 laboratory-confirmed infections including 80 deaths by 26 January 2020. Full-length genome sequences were obtained from five patients at an early stage of the outbreak. The sequences are almost identical and share 79.6% sequence identity to SARS-CoV. Furthermore, we show that 2019-nCoV is 96% identical at the whole-genome level to a bat coronavirus. Pairwise protein sequence analysis of seven conserved non-structural proteins domains show that this virus belongs to the species of SARSr-CoV. In addition, 2019-nCoV virus isolated from the bronchoalveolar lavage fluid of a critically ill patient could be neutralized by sera from several patients. Notably, we confirmed that 2019-nCoV uses the same cell entry receptor—angiotensin converting enzyme II (ACE2)—as SARS-CoV.
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              Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: Visualization
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: SupervisionRole: ValidationRole: Visualization
                Role: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                11 February 2021
                2021
                11 February 2021
                : 16
                : 2
                Affiliations
                [1 ] Centro Diagnóstico San Jorge, Puerto Madryn, Chubut, Argentina
                [2 ] Instituto Nacional de Enfermedades Respiratorias “Dr. Emilio Coni”, Administración Nacional de Laboratorios e Institutos de Salud “Dr. Carlos G. Malbrán”, Santa Fe, Argentina
                [3 ] Department of Child Health, Women and Children’s Hospital, University of Missouri, Columbia, MO, United States of America
                [4 ] Servicio de Neumonología, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
                National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, ITALY
                Author notes

                Competing Interests: Commercial affiliation: This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                Article
                PONE-D-20-38991
                10.1371/journal.pone.0246793
                7877635
                33571300
                714340c3-fcd3-4ea9-96ac-f313fdba422a
                © 2021 Schönfeld et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 2, Tables: 4, Pages: 16
                Product
                Funding
                Funded by: Instituto Nacional de Enfermedades Respiratorias, Administración Nacional de Laboratorios e Institutos de Salud
                Award Recipient :
                Funded by: Centro Diagnóstico San Jorge
                Award Recipient :
                Funded by: Instituto Nacional de Enfermedades Respiratorias, Administración Nacional de Laboratorios e Institutos de Salud
                Award Recipient :
                Funded by: Instituto Nacional de Enfermedades Respiratorias, Administración Nacional de Laboratorios e Institutos de Salud
                Award Recipient :
                Funded by: Hospital Universitario Austral
                Award Recipient :
                Funded by: University of Missouri
                Award Recipient :
                “Centro Diagnóstico San Jorge. Puerto Madryn” did not play a role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript and only provided financial support in the form of one of authors' salaries. The author contributions roles were reviewed and accurately indicated. The funder provided support in the form of salaries for authors: a. Centro Diagnóstico San Jorge pay salary to Daniel Schönfeld. b. Instituto Nacional de Enfermedades Respiratorias "Dr. Emilio Coni", Administración Nacional de Laboratorios e Institutos de Salud “Dr. Carlos G. Malbrán” pay salaries to Sergio Arias, Juan Carlos Bossio and Hugo Fernández. c. Hospital Universitario Austral pay salaries to Daniel Pérez-Chada. d. Department of Child Health, Women and Children’s Hospital, University of Missouri, pay salary to David Gozal. The funders did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.
                Categories
                Research Article
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Covid 19
                Medicine and Health Sciences
                Pulmonology
                Pneumonia
                Medicine and Health Sciences
                Health Care
                Health Care Facilities
                Hospitals
                Intensive Care Units
                People and places
                Geographical locations
                South America
                Argentina
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Obesity
                Medicine and Health Sciences
                Endocrinology
                Endocrine Disorders
                Diabetes Mellitus
                Medicine and Health Sciences
                Medical Conditions
                Metabolic Disorders
                Diabetes Mellitus
                Medicine and Health Sciences
                Medical Conditions
                Respiratory Disorders
                Asthma
                Medicine and Health Sciences
                Pulmonology
                Respiratory Disorders
                Asthma
                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                Cancer Risk Factors
                Medicine and Health Sciences
                Oncology
                Cancer Risk Factors
                Custom metadata
                There are legal restrictions on sharing the dataset. The dataset is an official database of COVID 19 pandemic in Argentina and authorization about use, analysis and public diffusion of this date, can only be approved by the Argentinian government. The contact information of a data access is the “Dirección Nacional de Epidemiología e Información Estratégica” – email: nuevosnvs2@ 123456gmail.com . Information Access might be requested from the Instituto Nacional de Enfermedades Respiratorias Emilio Coni – email: direccionconi@ 123456gmail.com .
                COVID-19

                Uncategorized

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