Factores Asociados a Mortalidad en Pacientes Hospitalizados Con Covid-19: Cohorte Prospectiva en El Hospital Nacional Edgardo Rebagliati Martins. Lima, Perú

Abstract

Objetivos. Determinar los factores asociados a mortalidad de los pacientes adultos hospitalizados con COVID-19 en un hospital de referencia de la seguridad social. Materiales y métodos. Se realizó un estudio de cohorte prospectivo. Se incluyó a pacientes mayores de 18 años hospitalizados con el diagnostico de infección por SARS-CoV-2 y se excluyó a quienes ingresaron asintomáticos respiratorios, con prueba rápida serológica positiva al ingreso y sin imágenes compatibles. Los datos se recolectaron a partir de la historia clínica. Resultados. Se incluyó un total de 813 adultos, 544 (66.9%) tuvieron COVID-19 confirmado. La media de la edad fue de 61.2 años (DE: 15.0) y 575 (70.5%) fueron de sexo masculino. Las comorbilidades más frecuentes fueron hipertensión arterial (34.1%) y obesidad (25.9%). Los síntomas más frecuentes al ingreso fueron disnea (82.2%) y tos (53.9%). Un total de 114 (14.0%) pacientes recibieron ventilación mecánica, 38 (4.7%) ingresaron a UCI y 377 (46.4%) fallecieron. El requerimiento de soporte ventilatorio, el mayor compromiso pulmonar, las comorbilidades y los marcadores inflamatorios se asociaron a la mortalidad. Se halló que por cada 10 años que aumenta la edad, el riesgo de morir se incrementa en 32% (RR: 1.32 IC95%: 1.25 a 1.38). Aquellos que requirieron ingreso a UCI y ventilación mecánica tuvieron 1.39 (IC95%: 1.13 a 1.69) y 1.97 (IC95%: 1.69 a 2.29) veces el riesgo de morir, respectivamente. Conclusión. La mortalidad encontrada en nuestro estudio fue alta y estuvo asociada a la edad, marcadores inflamatorios y compromiso respiratorio.

“Epidemiological profile of patients with stage 5 chronic kidney disease on dialysis with Covid 19 infection in a Public Hospital-Perú”

“…Regarding laboratory markers, there are reports of the relationship between increased leukocytes, CRP, LDH, ferritin, D-dimer and decreased lymphocytes with mortality, data that relate the exaggerated inflammatory response in patients with Covid-19 with increased mortality, such findings are congruent with our findings [30][31][32][33] , in relation to the gasometrical characteristics it is described that SatO2<90% persistent despite increased oxygen support, pO2 < 68 mmHg and decreased pO2/FiO2 are related to higher mortality in the context of the severity of respiratory compromise 34 , in this series it was found that most patients needed oxygen support and showed a significantly decreased PaO2/FiO2.…”

“…Mortality in CKD secondary to pulmonary infections in general is 51.9% and this varies according to increasing age 18,24,27-30 , there is evidence of reports such as that of Yang et al 19 on mortality in CKD infected by COVID19 which ranges between 6% and 22.7%; also in Perú a study reports up to 46% mortality 31 ; in our research a mortality of 20% was obtained, which correlates with the aforementioned.…”

“…There is evidence that the factors related to greater mortality are age, male sex, comorbidities such as arterial hypertension, diabetes mellitus and obesity, inflammatory markers, and respiratory compromise [25][26][27][28][29][30][31][32] , in the present investigation as well as in a Spanish study, no relationship was found with age, sex and comorbidities 33 .…”

Clustering K-Means Algorithms and Econometric Lethality Model by Covid-19, Peru 2020

“…Age was associated with higher mortality, in our series, the highest proportion of deaths were in the age groups over 60 years, besides, that for every 10 years that the age increased, the risk of dying increased by 32%, This was described in [15], a large series of Chinese population data, in which the age groups 60 to 69, 70 to 79 and over 80 years had 3.6%, 8%, and 14.8% mortality respectively.…”

“…In conclusion, the largest series of patients hospitalized with COVID-19 in the country was reported; the population tested presented high mortality and was associated with age, comorbidities, [16] inflammatory markers, and respiratory involvement. These results could serve us to propose strategies for reorganizing the care system and to direct management differentiating in [15] patients with higher risk factors for mortality.…”