Risk factors for mortality of adult patients with COVID-19 hospitalised in an emerging country: a cohort study.
Alfonso Martin Cueto-ManzanoMaría Claudia Espinel-BermudezSandra O Hernández-GonzálezEnrique Rojas CamposArnulfo Hernan Nava-ZavalaClotilde Fuentes-OrozcoLuz-Ma-Adriana Balderas-PeñaAlejandro Gonzalez-OjedaLaura Cortes-SanabriaMario Alberto Mireles-RamírezJosé J Ramírez-MárquezPorfirio E Martínez-GutiérrezMaribel Ávila-MoránRamón I De-Dios-PérezCarlos Acosta-RamírezHugo R Hernández-GarcíaPublished in: BMJ open (2021)
One thousand ten patients included: 386 (38%) died, 618 (61%) alive at discharge and six (0.6%) remained hospitalised. There was predominance of men (63%) and high frequency of overweight-obesity (71%); hypertension (54%); diabetes (40%); and lung (9%), cardiovascular (8%) and kidney diseases (11%); all of them significantly more frequent in non-survivors. Overweight-obesity was not different between groups, but severity of disease (Manchester Triage System and quick Sequential Organ Failure Assessment) was significantly worse in non-survivors, who were also significantly older (65 vs 45 years, respectively) and had haematological, biochemical, coagulation and inflammatory biomarkers more altered than survivors. Mortality predictors were invasive mechanical ventilation (IMV; OR 3.31, p<0.0001), admission to intensive care unit (ICU; OR 2.18, p<0.0001), age (OR 1.02, p<0.0001), Manchester Triage System (urgent OR 1.44, p=0.02; immediate/very urgent OR 2.02, p=0.004), baseline C reactive protein (CRP; OR 1.002, p=0.009) and antecedent of kidney disease (OR 1.58, p=0.04) CONCLUSIONS: Mortality in hospitalised patients with COVID-19 in this emerging country centre seemed to be higher than in developed countries. Patients displayed a high frequency of risk factors for poor outcome, but the need for IMV, ICU admission, older age, more severe disease at admission, antecedent of kidney disease and higher CRP levels significantly predicted mortality.
Keyphrases
- high frequency
- intensive care unit
- mechanical ventilation
- emergency department
- end stage renal disease
- transcranial magnetic stimulation
- weight loss
- type diabetes
- chronic kidney disease
- newly diagnosed
- cardiovascular events
- ejection fraction
- young adults
- metabolic syndrome
- weight gain
- physical activity
- risk factors
- prognostic factors
- insulin resistance
- peritoneal dialysis
- oxidative stress
- acute respiratory distress syndrome
- coronavirus disease
- sars cov
- respiratory failure
- adipose tissue
- drug induced
- patient reported outcomes
- skeletal muscle
- respiratory syndrome coronavirus
- arterial hypertension