{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T02:08:26Z","timestamp":1771294106700,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T00:00:00Z","timestamp":1722384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Coordenac\u0327\u00e3o de Aperfeic\u0327oamento de Pessoal de Ni\u0301vel Superior (CAPES)","award":["001"],"award-info":[{"award-number":["001"]}]},{"name":"Coordenac\u0327\u00e3o de Aperfeic\u0327oamento de Pessoal de Ni\u0301vel Superior (CAPES)","award":["#314209\/2021-2"],"award-info":[{"award-number":["#314209\/2021-2"]}]},{"name":"CNPq Grantee","award":["001"],"award-info":[{"award-number":["001"]}]},{"name":"CNPq Grantee","award":["#314209\/2021-2"],"award-info":[{"award-number":["#314209\/2021-2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: Coronavirus disease 2019 (COVID-19) is a disease with a broad clinical spectrum, which may result in hospitalization in healthcare units, intensive care, and progression to death. This study aimed to describe and compare the clinical and epidemiological profile of COVID-19 during the three waves of the disease, in patients admitted to a public hospital in the city of Bel\u00e9m, Par\u00e1, in the Amazon region of Brazil. Methods: This descriptive, observational, and cross-sectional study was population-based on individuals who were hospitalized with a diagnosis of COVID-19, confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR), and who were interviewed and monitored at the public hospital, from February 2020 to April 2022. Results: The prevalence was male patients, older than 60 years. The most frequent symptoms were dyspnea, cough, and fever. Systemic arterial hypertension was the most prevalent comorbidity followed by diabetes mellitus. Less than 15% of patients were vaccinated. The nasal oxygen cannula was the most used oxygen therapy interface followed by the non-rebreathing reservoir mask. Invasive mechanical ventilation predominated and the median time of invasive mechanical ventilation ranged from 2 to 6 days among waves. As for the hospital outcome, transfers prevailed, followed by deaths and discharges. Conclusion: The presence of comorbidities, advanced age, and male sex were important factors in the severity and need for hospitalization of these patients, and the implementation of the vaccination policy was an essential factor in reducing the number of hospital admissions.<\/jats:p>","DOI":"10.3390\/v16081233","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T17:16:49Z","timestamp":1722446209000},"page":"1233","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical\u2013Epidemiological Profile of COVID-19 Patients Admitted during Three Waves of the Pandemic in a Tertiary Care Center, in Bel\u00e9m, Par\u00e1, Amazon Region of Brazil"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0782-6994","authenticated-orcid":false,"given":"Ana Beatriz Nunes","family":"Pereira","sequence":"first","affiliation":[{"name":"Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Para\u0301, Bele\u0301m 66075-110, PA, Brazil"},{"name":"Virology Laboratory, Institute of Biological Sciences, Federal University of Para\u0301, Bele\u0301m 66075-110, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3257-5699","authenticated-orcid":false,"given":"Fernando S\u00e9rgio Henriques","family":"Pereira","sequence":"additional","affiliation":[{"name":"Bel\u00e9m Health Department, Humberto Maradei Pereira Municipal and Emergency Hospital, Bele\u0301m 66075-259, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1739-2572","authenticated-orcid":false,"given":"J\u00falio \u00c9den Davi Lopes","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Bel\u00e9m Health Department, Humberto Maradei Pereira Municipal and Emergency Hospital, Bele\u0301m 66075-259, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6916-1561","authenticated-orcid":false,"given":"Rangel Pereira","family":"Brasil","sequence":"additional","affiliation":[{"name":"Bel\u00e9m Health Department, Humberto Maradei Pereira Municipal and Emergency Hospital, Bele\u0301m 66075-259, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ang\u00e9lica Menezes Bessa","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Bel\u00e9m Health Department, Humberto Maradei Pereira Municipal and Emergency Hospital, Bele\u0301m 66075-259, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra Souza","family":"Lima","sequence":"additional","affiliation":[{"name":"Virology Laboratory, Institute of Biological Sciences, Federal University of Para\u0301, Bele\u0301m 66075-110, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0312-0553","authenticated-orcid":false,"given":"Ricardo Roberto de Souza","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Virology Laboratory, Institute of Biological Sciences, Federal University of Para\u0301, Bele\u0301m 66075-110, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6986-1309","authenticated-orcid":false,"given":"Rog\u00e9rio Valois","family":"Laurentino","sequence":"additional","affiliation":[{"name":"Virology Laboratory, Institute of Biological Sciences, Federal University of Para\u0301, Bele\u0301m 66075-110, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4888-3530","authenticated-orcid":false,"given":"Aldemir Branco","family":"Oliveira-Filho","sequence":"additional","affiliation":[{"name":"Study and Research Group on Vulnerable Populations, Institute for Coastal Studies, Federal University of Par\u00e1, Bragan\u00e7a 68600-000, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4571-4715","authenticated-orcid":false,"given":"Luiz Fernando Almeida","family":"Machado","sequence":"additional","affiliation":[{"name":"Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Para\u0301, Bele\u0301m 66075-110, PA, Brazil"},{"name":"Virology Laboratory, Institute of Biological Sciences, Federal University of Para\u0301, Bele\u0301m 66075-110, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.ajem.2020.03.036","article-title":"Coronavirus Disease (COVID-19): A primer for emergency physicians","volume":"44","author":"Chavez","year":"2021","journal-title":"Am. J. Emerg. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/978-3-030-63761-3_5","article-title":"The Incubation Period of COVID-19: Current Understanding and Modeling Technique","volume":"1318","author":"Leung","year":"2021","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Chilamakuri, R., and Agarwal, S. (2021). COVID-19: Characteristics and Therapeutics. Cells, 10.","DOI":"10.3390\/cells10020206"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ajem.2022.01.028","article-title":"Clinical update on COVID-19 for the emergency clinician: Presentation and evaluation","volume":"54","author":"Long","year":"2022","journal-title":"Am. J. Emerg. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e00228-20","DOI":"10.1128\/CMR.00228-20","article-title":"Tools and Techniques for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)\/COVID-19 Detection","volume":"34","author":"LeBlanc","year":"2021","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/s41579-022-00713-0","article-title":"SARS-CoV-2 pathogenesis","volume":"20","author":"Lamers","year":"2022","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.jmii.2020.05.001","article-title":"A systematic review of asymptomatic infections with COVID-19","volume":"54","author":"Gao","year":"2021","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.radi.2020.09.010","article-title":"Effectiveness of COVID-19 diagnosis and management tools: A review","volume":"27","author":"Alsharif","year":"2021","journal-title":"Radiography"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s12016-022-08921-5","article-title":"Risk and Protective Factors for COVID-19 Morbidity, Severity, and Mortality","volume":"64","author":"Zhang","year":"2023","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_10","unstructured":"World Health Organization (2024, January 07). COVID-19 Dashboard. Available online: https:\/\/data.who.int\/dashboards\/covid19\/cases?n=c."},{"key":"ref_11","unstructured":"Brazilian Ministry of Health (2024, February 15). New Coronavirus Disease\u2014COVID-19 Epidemiological Bulletin, Available online: https:\/\/www.gov.br\/saude\/pt-br\/centrais-de-conteudo\/publicacoes\/boletins\/epidemiologicos\/covid-19\/2023\/boletim-epidemiologico-no-148-boletim-coe-coronavirus."},{"key":"ref_12","unstructured":"Brazilian Ministry of Health (2024, March 01). Coronavirus Panel, Available online: https:\/\/covid.saude.gov.br."},{"key":"ref_13","unstructured":"Par\u00e1 state Health Department (2024, March 05). COVID-19 in Par\u00e1 State Panel, Available online: https:\/\/www.covid-19.pa.gov.br\/public\/dashboard\/41777953-93bf-4a46-b9c2-3cf4ccefb3c9."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Jorda, A., Kussmann, M., Kolenchery, N., Siller-Matula, J.M., Zeitlinger, M., Jilma, B., and Gelbenegger, G. (2022). Convalescent Plasma Treatment in Patients with Covid-19: A Systematic Review and Meta-Analysis. Front. Immunol., 7.","DOI":"10.3389\/fimmu.2022.817829"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e36","DOI":"10.1017\/S0950268821000224","article-title":"Epidemiology of COVID-19 in Northern Ireland, 26 February 2020\u201326 April 2020","volume":"29","author":"Pett","year":"2021","journal-title":"Epidemiol. Infect."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.7326\/M20-7003","article-title":"COVID-19 Case Age Distribution: Correction for Differential Testing by Age","volume":"174","author":"Fisman","year":"2021","journal-title":"Ann. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1056\/NEJMoa2004500","article-title":"COVID-19 in Critically Ill Patients in the Seattle Region\u2014Case Series","volume":"382","author":"Bhatraju","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1002\/jmv.25722","article-title":"Understanding of COVID-19 based on current evidence","volume":"92","author":"Sun","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3000605221129543","DOI":"10.1177\/03000605221129543","article-title":"COVID-19 induces gastrointestinal symptoms and affects patients\u2019 prognosis","volume":"50","author":"Jin","year":"2022","journal-title":"J. Int. Med. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1001\/jamaneurol.2020.1127","article-title":"Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China","volume":"77","author":"Mao","year":"2020","journal-title":"JAMA Neurol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1055\/s-0043-1761433","article-title":"Neurological symptoms and comorbidity profile of hospitalized patients with COVID-19","volume":"81","author":"Cremaschi","year":"2023","journal-title":"Arq. Neuro-Psiquiatr."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Arevalos, V., Ortega-Paz, L., Rodriguez-Arias, J.J., Calvo Lopez, M., Castrillo-Golvano, L., Salazar-Rodriguez, A., Sabate-Tormos, M., Spione, F., Sabate, M., and Brugaletta, S. (2021). Acute and Chronic Effects of COVID-19 on the Cardiovascular System. J. Cardiovasc. Dev. Dis., 8.","DOI":"10.3390\/jcdd8100128"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/CP9.0000000000000046","article-title":"Understanding COVID-19-related myocarditis: Pathophysiology, diagnosis, and treatment strategies","volume":"8","author":"Shu","year":"2023","journal-title":"Cardiol. Plus"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2441","DOI":"10.1056\/NEJMoa2008975","article-title":"Renin-Angiotensin-Aldosterone System Inhibitors and Risk of COVID-19","volume":"382","author":"Reynolds","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1016\/j.cjco.2021.03.001","article-title":"Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors in COVID-19: Meta-analysis\/Meta-regression Adjusted for Confounding Factors","volume":"3","author":"Lee","year":"2021","journal-title":"CJC Open"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/s41581-019-0244-2","article-title":"The global epidemiology of hypertension","volume":"16","author":"Mills","year":"2020","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1111\/all.14840","article-title":"Vaccines and allergic reactions: The past, the current COVID-19 pandemic, and future perspectives","volume":"76","author":"Sampath","year":"2021","journal-title":"Allergy"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1093\/intimm\/dxab107","article-title":"The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19","volume":"34","author":"Gao","year":"2022","journal-title":"Int. Immunol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1002\/jmv.26050","article-title":"Predictors of mortality in hospitalized COVID-19 patients: A systematic review and meta-analysis","volume":"92","author":"Tian","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"338","DOI":"10.3390\/epidemiologia2030026","article-title":"The COVID-19 Vaccination Strategy in Brazil-A Case Study","volume":"2","author":"Sponagel","year":"2021","journal-title":"Epidemiologia"},{"key":"ref_31","unstructured":"(2024, March 20). Our World in Data. Share of People Who Completed the Initial COVID-19 Vaccination Protocol. Available online: https:\/\/ourworldindata.org\/grapher\/share-people-fully-vaccinated-covid."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Alatrany, S.S., Falaiyah, A.M., Zuhairawi, R.H.M., Ogden, R., ALi Sayyid ALdrraji, H., Alatrany, A.S., and Al-Jumeily, D. (2023). A cross-sectional analysis of the predictors of COVID-19 vaccine uptake and vaccine hesitancy in Iraq. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0282523"},{"key":"ref_33","first-page":"e41126","article-title":"COVID-19 Vaccine Hesitancy Among Pregnant Women","volume":"15","author":"Alkhalifah","year":"2023","journal-title":"Cureus"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/ijgo.14794","article-title":"COVID-19 vaccine hesitancy among pregnant women attending tertiary care centre: A cross-sectional study","volume":"162","author":"Gupta","year":"2023","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e063632","DOI":"10.1136\/bmjopen-2022-063632","article-title":"Vaccine intention and hesitancy among Australian women who are currently pregnant or have recently given birth: The Birth in the Time of COVID-19 (BITTOC) national online survey","volume":"13","author":"Dahlen","year":"2023","journal-title":"BMJ Open."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.arcmed.2020.04.016","article-title":"Ongoing Challenges Faced in the Global Control of COVID-19 Pandemic","volume":"51","year":"2020","journal-title":"Arch. Med. Res."},{"key":"ref_37","first-page":"4","article-title":"COVID-19: Lost opportunities and lessons for the future","volume":"14","author":"Saqr","year":"2020","journal-title":"Int. J. Health Sci."},{"key":"ref_38","first-page":"e200450","article-title":"Considerations on COVID-19 impact on the individual-society relationship: From vaccine hesitancy to the clamor for a vaccine","volume":"30","author":"Couto","year":"2021","journal-title":"Sa\u00fade Soc. S\u00e3o Paulo"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1164\/rccm.202004-1076ED","article-title":"Basing Respiratory Management of COVID-19 on Physiological Principles","volume":"201","author":"Tobin","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"487","DOI":"10.5935\/0103-507X.20200082","article-title":"Clinical characteristics and predictors of mechanical ventilation in patients with COVID-19 hospitalized in Southern Brazil","volume":"32","author":"Bastos","year":"2020","journal-title":"Rev. Bras. Ter. Intensiv."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.ijid.2023.02.012","article-title":"Clinical characteristics and outcomes of hospital-manifested COVID-19 among Brazilians","volume":"130","author":"Pires","year":"2023","journal-title":"Int. J. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e009489","DOI":"10.1136\/bmjgh-2022-009489","article-title":"Profile of COVID-19 in Brazil-risk factors and socioeconomic vulnerability associated with disease outcome: Retrospective analysis of population-based registers","volume":"7","author":"Pereira","year":"2022","journal-title":"BMJ Glob. Health"},{"key":"ref_43","first-page":"e106","article-title":"Profile of Brazilian inpatients with COVID-19 vaccine breakthrough infection and risk factors for unfavorable outcome","volume":"18","author":"Guidoni","year":"2022","journal-title":"Rev. Panam. Salud Publica"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/16\/8\/1233\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:27:25Z","timestamp":1760110045000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/16\/8\/1233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,31]]},"references-count":43,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["v16081233"],"URL":"https:\/\/doi.org\/10.3390\/v16081233","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,31]]}}}