Covid-19: new profile of inpatients has older people with more comorbidities

A change in the profile of hospitalized patients with Covid-19 this year is the highlight of the latest epidemiological bulletin made by the Medical Intelligence Nucleus of HCor (former Hospital do Coração), obtained exclusively by the Estadão.

The analysis compared the total of 2,277 hospitalized between 2020 and 2021 with the 423 hospitalized patients in 2022. The result points to an increase in the average age and in the proportion of comorbidities presented by patients.

From the beginning of the pandemic until last year, the average age of hospitalized patients was 61.7. In 2022, there was an addition of a decade (71 years). At the same time, the vast majority (91.9%) of hospitalized patients have three or more comorbidities. Until last year, this rate was 64.4%.

“We can infer that the vaccine fulfilled the role of reducing severe cases of covid-19 because people with fewer comorbidities practically disappeared from the hospital”, says epidemiologist Suzana Alves da Silva, coordinator of the Medical Intelligence Center at HCor.

Despite the higher risk profile of most hospitalized patients in 2022, the need for ICUs decreased from 37.1% to 29.1%, while the need for mechanical ventilation dropped from 8.3% to 5.2%.

“This trend shows that vaccines continue to have a good protective effect against covid-19, even in the Ômicron wave”, says Esper Kallás, professor at the Faculty of Medicine of the University of São Paulo (USP). “Recent studies indicate that vaccines also reduce sequelae of infection with the current variant.”

no vaccine

Among those hospitalized at HCor this year, 31.8% had not received a single dose of the vaccine. The case fatality rate was 5.5% among the vaccinated and 9.9% among the unvaccinated. “My personal perception is that a large part of the population still has great distrust in relation to adverse events”, says the doctor.

“People need to understand that mortality and hospitalization rates plummeted after vaccination. This is great news. The benefit of immunization far outweighs any risk it may bring”, emphasizes Suzana.

Also according to the doctor, it is essential that risk patients and their families understand the importance of vaccination. An example of the protection conferred by doses is that deaths in the hospital practically zero among patients over 40 years of age with one or two comorbidities.

Currently, deaths in the institution occur in patients with multiple diseases and over 80 years. “In 2022, we had a significant increase in deaths of people who were in palliative care. Until last year, this group represented 12% of deaths. Now it is 19%”, emphasizes the doctor.

Emergency Room

In the last two weeks, covid-19 and other respiratory diseases have increased demand for urgent and emergency services in the capital and in the interior of São Paulo. At HCor it was no different. The Covid-19 positivity rate of people tested at the hospital increased from 32% in April to 62% in June. Of the patients seen at the flu emergency room in April, 7% needed to be hospitalized. In June, the index rose to 9%.

Although Omicron appears to cause less severe illness in people, transmissibility is high. The doctor, in this way, advises that people do not neglect preventive measures: hand washing and use of a mask in closed environments and also in open places, in case of agglomeration.

About Abhishek Pratap

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