Clinical and Hospital Trajectory of Fatal COVID-19 Cases in Campo Grande, Brazil, During 2021–2022

Understanding the clinical and hospital trajectory of fatal COVID-19 cases is essential to clarify disease progression and support healthcare planning. This study analyzed the temporal trajectory of patients with confirmed COVID-19 who died in Campo Grande, Brazil, during 2021–2022. A retrospective observational study was conducted using secondary data from 3572 fatal cases. Time intervals between symptom onset, hospitalization, intensive care unit (ICU) admission, and death were calculated. Survival analyses were performed using Kaplan–Meier curves and Cox proportional hazards regression. Most patients were aged 61–80 years (48%), male (55%), and had at least one reported risk factor (86%). The most frequent comorbidities were cardiopathy (56%), diabetes mellitus (35%), and obesity (20%). The mean time from symptom onset to hospitalization was 7.70 days, while the mean time from symptom onset to death was 22.87 days. Survival analyses showed significant differences according to age, neurologic disease, pneumopathy, and obesity. In the multivariable Cox model, age remained independently associated with shorter survival time. Fatal COVID-19 cases were characterized by a relatively short interval from symptom onset to hospitalization and a prolonged in-hospital course until death. By characterizing the timing of clinical deterioration, ICU admission, and death, these findings may inform regional assessments of critical care demand, expected ICU bed occupancy, and capacity planning during periods of increased healthcare demand.