COVID-19 pandemic in Southern Brazil: Hospitalizations, intensive care unit admissions, lethality rates, and length of stay between March 2020 and April 2022

Abstract

Coronavirus disease 2019 (COVID-19) pandemic spread rapidly with more than 515 million cases and 6.2 million deaths. Epidemiological factors are important for understanding the state of the pandemic. This study aims to evaluate the hospitalizations, intensive care unit (ICU) admissions, and lethality from March 2020 to April 2022. Data were collected from a hospital in Porto Alegre city, southern Brazil. The Mann-Whitney, analysis of variance, and Kruskal-Wallis tests were used to compare quantitative variables. Categorical variables were compared by Pearson's χ² test. p values <0.05 for all tests were considered significant. Were observed 3784 hospitalizations. Males were 51.4% and the age was 60.4± 20.3. Intensive care unit (ICU) patients were 31.2%, the median length of stay (LOS) was 9.0 and lethality was 13.3%. ICU lethality was 34.5% versus 4.6% in other inpatients (p < 0.01). The LOS of ICU patients was 22.0 versus 7.0 in other inpatients (p < 0.01). The first peak (July-Novemebr 2020) showed ICU occupancy of 79.1%. The second peak (December 2020-June 2021) with 91.6% occupancy. The third peak January-March 2022 with 81.0% occupancy (p < 0.01). Lethality rates were 10.3% in 2020, 14.9% in 2021 and 15.4% in 2022 (p < 0.01). In conclusion, the ICU occupancy rate was higher in 2021 and the lethality rates of ICU patients were high during pandemic years (10.3% in 2020, 14.9% in 2021, and 15.2% in 2022). The lethality of these patients ranged from 25.0% in March to 21.8% in December 2020, from 20.9% in January 22.2% in Decemebr 2021, and 35.7% in January 2022 to 21.4% in April 2022. These data demonstrate that COVID-19 is a critical illness, even in a private hospital setting.

Keywords: COVID-19; intensive care unit; length of stay; lethality.

Figure 1

Map of South America, highlighting the Rio Grande do Sul (Porto Alegre city), Brazil.

Figure 2

Distribution of COVID‐19 inpatient cases and deaths between March 2020 and April 2022. The columns represent the number of patients who survived (primary axis) and the row is the total deaths for each month (secondary axis). COVID‐19, coronavirus disease‐2019; ICU, intensive care unit

Figure 3

Lethality rates (%) for COVID‐19 for total inpatients (not admitted to the ICU + ICU), not admitted to the ICU, and admitted to the ICU. COVID‐19, coronavirus disease‐2019; ICU, intensive care unit

Figure 4 (A)

Correlation between cases of hospitalization and deaths. (B) Correlation between patients admitted to the ICU and deaths. (C) Correlation between patients not admitted to the ICU and deaths. ICU, intensive care unit

Figure 5

Movement rate of the Brazilian population during the pandemic period. Available: https://ourworldindata.org/covid-google-mobility-trends Accessed June 06, 2022.

Figure 6

(A) Molecular evolution of SARS‐COV‐2 variants in Brazil. (B) Phylogeography of SARS‐CoV‐2 variants in Brazil. Data extracted from GISAID (Global Initiative on Sharing All Influenza Data). Available: https://www.gisaid.org/phylodynamics/brazil/ Accessed June 06, 2022. SARS‐CoV‐2, severe acute respiratory syndrome coronavirus 2