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Sustainable Development Goals
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CLINICAL PROFILE AND RISK FACTORS FOR SEVERE COVID-19 IN HOSPITALIZED PATIENTS FROM RIO DE JANEIRO, BRAZIL: COMPARISON BETWEEN THE FIRST AND SECOND PANDEMIC WAVES
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Abstract
Since COVID-19 was declared a pandemic, Brazil has become one of the countries most affected
by this disease. A year into the pandemic, a second wave of COVID-19 emerged, with a rapid spread of a
new SARS-CoV-2 lineage of concern. Several vaccines have been granted emergency-use authorization,
leading to a decrease inmortality and severe cases inmany countries. However, the emergence of SARSCoV-
2 variants raises the alert for potential newwaves of transmission and an increase in pathogenicity. We
compared the demographic and clinical data of critically ill patients infected with COVID-19 hospitalized
in Rio de Janeiro during the first and second waves between July 2020 and October 2021. In total,
106 participants were included in this study; among them, 88% had at least one comorbidity, and 37%
developed severe disease. Disease severity was associated with older age, pre-existing neurological
comorbidities, higher viral load, and dyspnea. Laboratory biomarkers related to white blood cells,
coagulation, cellular injury, inflammation, renal, and liver injuries were significantly associated with severe
COVID-19. During the second wave of the pandemic, the necessity of invasive respiratory support was
higher, andmore individuals with COVID-19 developed acute hepatitis, suggesting that the progression
of the second wave resulted in an increase in severe cases. These results can contribute to understanding
the behavior of the COVID-19 pandemic in Brazil and may be helpful in predicting disease severity, which
is a pivotal for guiding clinical care, improving patient outcomes, and defining public policies.
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