Background and aim: Peru is the country with the highest mortality rate from COVID-19 globally, so the analysis of the characteristics of deaths is of national and international interest. The aim was to determine the epidemiological characteristics of deaths from COVID-19 in Peru from 28 March to 21 May 2020. Methods: Deaths from various sources were investigated, including the COVID-19 Epidemiological Surveillance and the National System of Deaths (SINADEF). In all, 3851 deaths that met the definition of a confirmed case and had a positive result of RT-PCR or rapid test IgM/IgG, were considered for the analysis. We obtained the epidemiological variables and carried out an analysis of time defined as the pre-hospital time from the onset of symptoms to hospitalization, and hospital time from the date of hospitalization to death. Results: Deaths were more frequent in males (72.0%), seniors (68.8%) and residents of the region of Lima (42.7%). In 17.8% of cases, the death occurred out-of-hospital, and 31.4% had some comorbidity. The median of pre-hospital time was 7 days (IQR: 4.0–9.0) and for the hospital time was 5 days (IQR: 3.0–9.0). The multivariable analysis with Poisson regression with robust variance found that the age group, comorbidity diagnosis and the region of origin significantly influenced pre-hospital time; while sex, comorbidity diagnosis, healthcare provider and the region of origin significantly influenced hospital time. Conclusion: Deaths occurred mainly in males, seniors and on the coast, with considerable out-of-hospital deaths. Pre-hospital time was affected by age group, the diagnosis of comorbidities and the region of origin; while, hospital time was influenced by gender, the diagnosis of comorbidities, healthcare provider and the region of origin.
OBJECTIVE: To determine the epidemiological characteristics of deaths from COVID-19 in Peru from March 28 to May 21, 2020, 85 days after the report of the first confirmed case. MATERIAL AND METHODS: Case series type study. Deaths from various sources were investigated, including the COVID-19 Epidemiological Surveillance and the National System of Deaths. Deaths that met the definition of a confirmed case and had a positive (reactive) result of RT-PCR or rapid test were considered for the analysis. From these sources, epidemiological variables were obtained and a time analysis was performed, defining as the pre-hospital time the time from the onset of symptoms to the date of hospitalization and hospital time from the date of hospitalization to the date of death. RESULTS: 3,244 confirmed deaths were included in the study. Deaths were more frequent in males (71.8%), elders (68.3%), residents of the department of Lima (41.8%), and others from the coast (37.7%). In 81.3% of cases, the death occurred in a public hospital, 16.0% died at home, shelter, penitentiary institution, public highway, or in transit to a hospital, and 31.1% had some comorbidity. Statistical difference was observed in pre-hospital time according to age group (p <0.001) and gender (p = 0.037), being significantly higher in adults, elders, and women. There was a statistically significant difference in hospital time according to geographic area, showing a significantly shorter time in the departments of the coast (p <0.001) and Andean region (p = 0.014) compared to Lima. The cases that were seen in private clinics (p = 0.001) survived longer than those seen in public hospitals. CONCLUSION: Deaths from COVID-19 occur mainly in male, elders, on the coast, with considerable deaths at home, in shelters, penitentiaries, public roads, or in transit to a hospital. Pre-hospital time is affected by age group and gender; while, hospital time is also influenced by the region of origin and the health care provider. KEYWORDS: Coronavirus, COVID-19, deaths, epidemiology, Peru.
Introducción. La inflamación es el principal mecanismo propuesto en la génesis fisiopatológica de la trombosis del stent. Una expresión del estado inflamatorio es el índice neutrófilo linfocitario. Objetivo. Evaluar el valor pronóstico del índice neutrófilo linfocitario en la predicción de trombosis temprana del stent. Método. Investigación prospectiva en el Hospital Hermanos Ameijeiras, La Habana, Cuba, entre diciembre de 2018 y junio 2019. Resultados. Se estudiaron 196 pacientes; las variables niveles elevados de neutrófilo (p=0,009) e índice neutrófilo linfocitario (p=0,007) después del proceder se relacionan significativamente con la presencia de trombosis del stent y la curva ROC encontró una sensibilidad de 70% y una especificidad de 62% para un nivel del índice mayor de 6 (0,712; IC95%: 0,610-0,988; p=0,012). Conclusión. El aumento del índice neutrófilo-linfocitario a las 6 horas del intervencionismo coronario percutáneo, tiene alta sensibilidad y alta especificidad en la predicción de trombosis temprana del stent.
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