269. Outcomes comparison of hospitalized patients with COVID-19 during the first three pandemic waves. Experience in Colombia, South America.

Abstract

Background Differences in access to specialized medical care services and their overcrowding due to the pandemic could impact clinical outcomes. Availability of newer treatments, vaccination, and emergence of newer SARS-CoV-2 variants could also explain these differences. Methods We performed a single-centered, observational study comparing clinical outcomes of COVID-19 admitted to the emergency department among the first three waves of the pandemic defined as June to August 2020, November 2020 to January 2021, and May to July 2021, respectively. The primary outcomes included intensive care unit admission, invasive mechanical ventilation requirement, hospital length of stay, and hospital mortality categorized by age groups. Effective COVID 19 antiviral therapy and monoclonal antibodies are not available in Colombia. Vaccination was available after March 2021. Results Out of a total of 2264 patients were admitted. Fifty-six percent were male, with a median age of 58 years [IQR, 45-70]. A significant increase of patients was seen after each wave: 530 in the first, 568 in the second, and 1166 in the third-wave worsening hospital overcrowding. Patients from the third wave were significantly younger (59 vs. 62 vs. 56 years, p < 0.01). Patients from the first wave had higher proportion of intensive care unit admission (62.83% vs. 51.23% vs. 52.23%, p< 0.01), invasive mechanical ventilation (39.25% vs. 32.22% vs. 31.22%, p< 0.01), and length of hospital stay (9 vs 7 vs 7 days, p< 0.01). Overall, no difference was found in mortality among waves (18.4% vs 19% 18.8%, p = 0.974). However, patients of 70-79 and ≥ 80 had a lower mortality during the third wave (24.4% vs 33.3% vs 19%, p=0.018), (30.6% vs 29.6% vs 23.6%, p=0.018). Vaccination was very low in all the age groups but was higher in elderly patients. Figure 1 Conclusion Overall mortality did not increase between infection waves, although there was an increase in cases during the third wave. We found a significant decrease in mortality among the elderly. Major efforts of medical teams succeed in containing COVID 19 mortality. Figure 4 Disclosures All Authors: No reported disclosures.