Clinical-epidemiologic variation in patients treated in the first and second wave of COVID-19 in Lambayeque, Peru: A cluster analysis

Mario J. Valladares-Garrido, Virgilio E. Failoc-Rojas, Percy Soto-Becerra, Sandra Zeña-Ñañez, J. Smith Torres-Roman, Jorge L. Fernández-Mogollón, Irina G. Colchado-Palacios, Carlos E. Apolaya-Segura, Jhoni A. Dávila-Gonzales, Laura R. Arce-Villalobos, Roxana del Pilar Neciosup-Puican, Alexander G. Calvay-Requejo, Jorge L. Maguiña, Moisés Apolaya-Segura, Cristian Díaz-Vélez

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives: To identify differences in the clinical and epidemiologic characteristics of patients during the first and second waves of the COVID-19 pandemic at the EsSalud Lambayeque health care network, Peru. Methods: An analytical cross-sectional study of 53,912 patients enrolled during the first and second waves of COVID-19 was conducted. Cluster analysis based on clustering large applications (CLARA) was applied to clinical-epidemiologic data presented at the time of care. The two pandemic waves were compared using clinical-epidemiologic data from epidemiologic surveillance. Results: Cluster analysis identified four COVID-19 groups with a characteristic pattern. Cluster 1 included the largest number of participants in both waves, and the participants were predominantly female. Cluster 2 included patients with gastrointestinal, respiratory, and systemic symptoms. Cluster 3 was the “severe” cluster, characterized by older adults and patients with dyspnea or comorbidities (cardiovascular, diabetes, obesity). Cluster 4 included asymptomatic, pregnant, and less severe patients. We found differences in all clinical-epidemiologic characteristics according to the cluster to which they belonged. Conclusion: Using cluster analysis, we identified characteristic patterns in each group. Respiratory, gastrointestinal, dyspnea, anosmia, and ageusia symptoms were higher in the second COVID-19 wave than the first COVID-19 wave.

Original languageEnglish
Pages (from-to)212-220
Number of pages9
JournalInternational Journal of Infectious Diseases
StatePublished - Oct 2022


  • Cluster analysis
  • Coronavirus infection
  • COVID-19
  • Pandemic wave
  • Peru
  • Symptoms
  • Pandemics
  • Cross-Sectional Studies
  • Humans
  • Male
  • Pregnancy
  • COVID-19/epidemiology
  • Dyspnea
  • Female
  • Aged
  • Peru/epidemiology
  • Cluster Analysis


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