Clinical-epidemiological profile of patients with Covid-19 treated Clinical-epidemiological profile of patients with Covid-19 treated at a peruvian jungle hospital 2020 at a peruvian jungle hospital 2020

Introduction: The epidemic that had its beginning in the city of Wuhan in December 2019, has become a public health problem that is advancing at dizzying steps. Objective: To determine the clinical and epidemiological prole in Covid-19 patients attended at the HASA-I - Utcubamba, 2020. Methods: The type of research was observational, descriptive and retrospective cross-sectional. The population consisted of 312 patients from which a sample of 173 patients was extracted that met the conditions of being representative and adequate. All data processing and statistical calculations were performed using Microsoft Excel 2019 software. Results: Regarding the results, it was determined that the epidemiological prole: male gender a total of 102 and female gender 71, representing 59,0% and 41,0% respectively; average age of 45 years; most aﬀected place of origin, the city of Bagua Grande, with a frequency of 162, which represents 93,6%. Regarding the clinical prole: diabetes mellitus presented a total of 7 cases, representing 4,1%; cardiovascular diseases with a frequency of 6, representing 3,5%; general malaise with a total of 75 cases, representing 43,4%; fever with a frequency of 66 cases, representing 38,2%; cough with a frequency of 56 cases, representing 32,4%; headaches with a frequency of 50 cases, representing 28,9%; and dyspnea with a frequency of 34, representing 19,7%. Conclusion: The male gender was predominant with comorbidities such as diabetes mellitus, general malaise and elevated CRP.


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The epidemic that began in the city of Wuhan in December 2019 has become a problem of public health that advances at vertiginous steps. Its progress was so overwhelming that, as of March 2020, 114 countries were affected. Its arrival in the American continent was reported on January 23, 2020, con rming the rst case in Argentina, while in Peru, the rst infection was registered on March 6, 2020 in the city of Lima.
Taking all this into account, it is understood that contagion by this disease involves all the medical aspects of which it is pertinent to investigate: clinical, laboratory, and epidemiologica characteristics, to reach a better understanding of the condition for the sake of greater and more effective scienti c treatment. Especially in places that do not have research related to this current and vital problem, as is the case in Hospital Apoyo I Santiago Apóstol in the province of Utcubamba (HSA), which has a large rate of cases that are progressively increasing, of which The clinical pro le that would contribute to studying the main comorbidities that are related to arterial hypertension, obesity and diabetes mellitus is not yet available; diseases that could accelerate the progression of the (5) disease and therefore premature death .
The objective of this study was to determine the clinical and epidemiological pro le in Covid-19 patients treated at the HSA -Utcubamba, 2020.
Likewise, the HSA of the province of Utcubamba does not have an epidemiological pro le that allows for studying morbidity, that is, the evolution of the disease and its prevalence according to gender, place of origin, and age. Important data that allow a better knowledge (6) of the virus and its differential impact according to these demographic characteristics.
The main problematic reality of underdeveloped countries such as Peru is related to the fact that not all departments have standardized reverse transcriptasepolymerase chain reaction (rRT-PCR) tests, which help in the diagnosis of molecular. Likewise, the poorest departments and provinces, such as the province of Utcubamba, did not have vaccines that serve the speci c antiviral treatment against Covid 19, having as their only resource non-exposure as a means of prevention the rational use of equipment. Individual protection.
An observational, descriptive and cross-sectional study was carried out. The study area was in Utcubamba, Amazonas, Perú, the hospital is located in an area called Bagua Grande.

Type of design and area
The population consisted of 312 patients, of which 173 were selected with a con dence level of 95% and 5% error, of patients diagnosed with Covid-19 treated at the HSA -Utcubamba during August -December of 2020. Patients who had positive results using a serological test or radiological criteria were chosen. Patients with incomplete or ineligible medical records were excluded. The sampling was for convenience and the diagnosis was given by a positive result of the IGG/IGM rapid test and according to the clinical-radiological criteria.

Procedure
To execute said investigation, we resorted to the use of an elaborated technical chart with which the data was extracted from the conventional clinical histories of each patient, which speci es the main epidemiological and clinical characteristics of the patients diagnosed with Covid-19 treated at the HSA during the months of August -December 2020. Sociodemographic data such as age, gender and origin were evaluated. In the clinical pro le, comorbidities (type II diabetes mellitus, cardiovascular diseases (heart attack, angina, stroke, among others), chronic lung disease, ar terial hypertension, others), clinical signs and symptoms (general malaise, fever, cough, headache) were evaluated. , dyspnea, among others) and the laboratory ndings, the following were considered: High CRP if it was greater than 10 mg/L, Elevated leukocytes if it was greater than 4,5 to 11 × 109/L; Lymphopenia if it was less than 1,5 (5) × 109/L.

Variables and instruments
Permission was requested from the ethics committee of the university, once its approval was given, permission was requested from the hospital, which granted permission to review the hospital le, where data from the medical records of patients with con rmed diagnosis of COVID-19 by serological test or PCR. The data collected was entered into the database at the end of each day.

RESULTS
The study was approved by the ethics committee of the Universidad Señor de Sipán and with authorization from the HSA management. The data collection forms were coded to avoid the identi cation of the patients.

Ethical aspects
A total of 173 patients were reported, most of whom were male Table 1, with a mean age of 44,7 years (SD 5,8).

Statistical analysis
A database was created in the Microsoft Excel 2019 program, the statistical analysis was carried out in the STATA 16 program. For the analysis of normality distribution, the Kolmogorov Smirnov Test was used, according to this analysis, the variables The qualitative variables were presented in absolute frequencies and percentages, the quantitative variables were presented according to the measures of central tendency (mean, standard deviation (SD)). Subsequently, all the quantitative variables were categorized according to the literature to make them qualitative. 22 patients with comorbidities were found, of these the highest frequency was diabetes mellitus, the rest of the patients did not presented comorbidities (Table 2). The most frequent signs or symptoms were general malaise and fever, the least frequent were nausea or vomiting.   Currently, Covid-19 is considered one of the most dismal pandemics in history, not only because of the abrupt increases in mortality rates throughout the world but also because of the symptoms and comorbidities that it can trigger, these being painful and lethal. Epidemiological and clinical studies are still an open eld due to the variants that this disease has developed, which continue to mutate and continue to express themselves in different clinical manifestations and laboratory ndings.

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In the present investigation, it was possible to identify the epidemiological characteristics that include the gender, age, and place of origin of the AHS patients. (3,5,7,8) Regarding gender, the highest prevalence in the male gender since they have a greater genetic (9,10) predisposition to contract this type of disease. The average age in general, was 44,7 years, with adults and older adults being the most affected. These results were partially similar in other studies, indicating that the disease tends to have a greater impact on these people (8,12) because the immune system deteriorates over time.

DISCUSSION
Regarding the place of origin, 93,6% resided in the city of Bagua Grande, the capital of Utcubamba, which (5,12) represents a greater centralization of people and an .
a higher risk of contagion. The limitations of the research were the small sample compared to the studies carried out at a national and international level. Likewise, the study was only carried out at a retrospective and descriptive level. However, it represents the rst study carried out in the HSA and in the province of Utcubamba. Another limitation arose in the equipment of the laboratory instruments that were required to carry out more speci c tests; however, the most basic and necessary ones could be carried out with the help of the medical and administrative personnel who provided the required information at all times.

CONCLUSIONS
Regarding the main comorbidities presented in HSA Covid-19 patients, diabetes mellitus, cardiovascular (5,12) diseases, and high blood pressure stood out, which generated an unfavorable clinical course due to the (8) weakening of the immune and circulatory system.
Consequently, it was possible to identify the symptoms and signs presented by SAH patients, the main one (13) being general malaise, characterized by fatigue and (9,14) diffuse pain were also present. Fever and cough Covid-19. Likewise, dyspnea and headaches can occur (15) due to a lack of oxygen and blood supply.
Regarding the identi cation of the rst laboratory ndings, which have been the study material of many investigations, elevated CRP, elevated leukocytosis, and (16) lymphopenia were found, ndings that are shared by other investigations because they are samples that represent the presence of infections at the blood level and product of the deformation of antibodies that help (17) ght this microorganism.

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Authorship contributions: The authors participated in the genesis of the idea, project design, data collection and interpretation, analysis of results, and preparation of the manuscript of this research work.

Con icts of interest:
The authors declare no con ict of interest.