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秘鲁兰巴耶克省 COVID-19 第一波和第二波治疗患者的临床流行病学差异:聚类分析。

Clinical-epidemiologic variation in patients treated in the first and second wave of COVID-19 in Lambayeque, Peru: A cluster analysis.

机构信息

Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru; South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru.

Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru; Universidad San Ignacio de Loyola, Lima, Peru.

出版信息

Int J Infect Dis. 2022 Oct;123:212-220. doi: 10.1016/j.ijid.2022.07.045. Epub 2022 Jul 22.

Abstract

OBJECTIVES

To identify differences in the clinical and epidemiologic characteristics of patients during the first and second waves of the COVID-19 pandemic at the EsSalud Lambayeque health care network, Peru.

METHODS

An analytical cross-sectional study of 53,912 patients enrolled during the first and second waves of COVID-19 was conducted. Cluster analysis based on clustering large applications (CLARA) was applied to clinical-epidemiologic data presented at the time of care. The two pandemic waves were compared using clinical-epidemiologic data from epidemiologic surveillance.

RESULTS

Cluster analysis identified four COVID-19 groups with a characteristic pattern. Cluster 1 included the largest number of participants in both waves, and the participants were predominantly female. Cluster 2 included patients with gastrointestinal, respiratory, and systemic symptoms. Cluster 3 was the "severe" cluster, characterized by older adults and patients with dyspnea or comorbidities (cardiovascular, diabetes, obesity). Cluster 4 included asymptomatic, pregnant, and less severe patients. We found differences in all clinical-epidemiologic characteristics according to the cluster to which they belonged.

CONCLUSION

Using cluster analysis, we identified characteristic patterns in each group. Respiratory, gastrointestinal, dyspnea, anosmia, and ageusia symptoms were higher in the second COVID-19 wave than the first COVID-19 wave.

摘要

目的

在秘鲁埃斯萨尔瓦德兰巴耶克医疗保健网络中,确定 COVID-19 大流行第一波和第二波期间患者的临床和流行病学特征差异。

方法

对 COVID-19 第一波和第二波期间纳入的 53912 名患者进行了分析性横断面研究。应用聚类大应用程序的聚类分析(CLARA)对就诊时呈现的临床流行病学数据进行分析。使用流行病学监测的临床流行病学数据比较两个大流行波。

结果

聚类分析确定了具有特征模式的四个 COVID-19 组。第 1 组在两个波中都包含最多的参与者,参与者主要是女性。第 2 组包括有胃肠道、呼吸道和全身症状的患者。第 3 组是“严重”组,其特征是老年人和有呼吸困难或合并症(心血管、糖尿病、肥胖)的患者。第 4 组包括无症状、孕妇和病情较轻的患者。根据所属的聚类,我们发现所有临床流行病学特征均存在差异。

结论

使用聚类分析,我们确定了每个组的特征模式。与第一波 COVID-19 相比,第二波 COVID-19 的呼吸道、胃肠道、呼吸困难、嗅觉丧失和味觉丧失症状更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a712/9303067/9deb55eec827/gr1_lrg.jpg

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