COVID-19 patients hospitalized after the fourth wave of the pandemic period in Vietnam: Clinical, laboratory, therapeutic features, and clinical outcomes

• Published in: Journal of the Formosan Medical Association Vol. 123; no. 2; pp. 208 - 217
• Main Authors: Dien, Trinh Cong, Van Nam, Le, Thach, Pham Ngoc, Van Duyet, Le
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 01-02-2024; Elsevier
• Subjects: Acute Kidney Injury; Anticoagulants - therapeutic use; Complications; COVID-19; COVID-19 - epidemiology; COVID-19 Vaccines; Humans; Pandemics; Respiratory Distress Syndrome; SARS-CoV-2; Severe; Variants; Vietnam - epidemiology; Vietnam; COVID-19; Variants; Severe; Complications; Sars-Cov-2
• ISSN: 0929-6646; 1876-0821
• DOI: 10.1016/j.jfma.2023.07.020

Despite having relatively high COVID-19 vaccine coverage in Vietnam, a fraction of COVID-19 patients required hospitalization due to severe symptoms. The purpose of this study was to describe the clinical, laboratory, complications, and treatment of COVID-19 patients hospitalized during the pandemic's fourth wave.
Genome sequencing was performed on COVID-19 patients. Data on clinical characteristics, treatment, complications, and outcomes were consistently collected.
The clinical classifications were mild (37.43%), moderate (24.2%), and severe (38.37%). Patients with co-morbidities, high fever >39 °C, hypertension, tachycardia, tachypnea, and SpO2<90%, had a 1.2–4 folds higher of severe progression than those with mild/moderate. Serious consequences were much more common in the severe patients than in the mild/moderate. The respiratory system of severe patients was generally documented as fine, coarse crackles, and CT scanner shown ground glass, consolidation, and opacity, with Delta variant accounting for 92.6%. Complications were common in the severe patients, including bacteria pneumonia (36.42%), ARDS (61.11%), blood clotting disorder (7.14%), infection (46.92%), and acute kidney injury (12.35%). Antiviral, antifungal, corticosteroid, anticoagulant, and ECMO regimens were utilized. Patients died mostly as a result of co-morbidities, low SpO2, lung injury, and complications such as bacterial + fungal pneumonia (83.9%), ARDS (83.9%), bacteremia (56.5%), injury acute renal failure (27.4%), and coagulopathy (12.9%).
Severe and critical COVID-19 patients frequently have several comorbidities, multiple lung lesions along with a variety of clinical signs. Despite receiving antivirals, antibiotics, corticosteroids, anticoagulants, and even ECMO therapy, the patient encountered multiple complications, with a fatality rate of up to 38.27%.