Prognosis of patients with COVID-19 admitted to a tertiary center in Chile: A cohort study

Abstract

Introduction Since the beginning of the COVID-19 pandemic, extensive research has been done on the prognosis of patients with SARS-CoV-2 associated with age, biodemographic conditions, comorbidities, social factors, clinical parameters, inflammatory blood markers, coagulation, biochemical and blood gas parameters, among others. Few studies have addressed this problem in Latin America, so it is of interest to know how the disease plays out in this region. Objective The purpose of our study is to evaluate the course of COVID-19 in patients admitted to a tertiary center in Chile and to assess factors measured close to hospital admission that may be associated with death and the need for invasive mechanical ventilation. Methods We did a retrospective cohort study at Indisa Clinic in Santiago, Chile. We included all patients aged 15 years and older hospitalized between March 11 and July 25, 2020. Hospital mortality and severity of the cases were analyzed, and logistic regression models were applied to identify predictors of outcome variables. Results The sample included 785 subjects. The mean age was 59 years, 59% were men, and 61.3% had comorbidities. Forty five per cent required intensive care, and 24% invasive mechanical ventilation. The overall hospital fatality rate was 18.7%. In intensive care patients, the case fatality was 32.1%, and in those who received invasive mechanical ventilation, it was 59.4%. Independent risk factors for death included age (odds ratio 1.09; 95% confidence interval: 1.07 to 1.12), diabetes (1.68; 1.06 to 2.67), chronic lung disease (2.80; 1.48 to 5.28), increased C-reactive protein, creatinine, and ferritin. No association with sex, public health insurance, history of heart disease, oxygen saturation upon admission, or D-dimer was found. Similar factors were predictors of invasive mechanical ventilation. Discussion The prognosis and predictive factors in this cohort of patients hospitalized in Chile for COVID-19 were comparable to those reported in similar studies from higher-income countries. Male sex was not associated with a poor prognosis in this group of patients.

Risk Assessment and Rationalization of Health Resource Allocation: Lessons From the Brazilian COVID-19 Cohort in 2020

“…A similar pattern also manifested itself among the older patients, but less pronouncedly, possibly due to the prevalent accumulation of comorbidities among individuals in these strata. Our results confirmed the association of aging with the demand for healthcare resources and COVID-19-related deaths reported in different Brazilian states, (Sousa et al, 2020;Macedo et al, 2020;Cobre et al, 2020;Escosteguy et al, 2020;Moura et al, 2020;Leal et al, 2021;Policarpo et al, 2021;Bastos et al, 2020) in population restricted to a clinical condition or not, or even in national population studies, (Santos et al, 2021;de Souza et al, 2020;Nascimento et al, 2020;Marcolino et al, 2021;Castro et al, 2021) but also reported in studies in Latin America, Araujo et al, 2020;Elizondo et al, 2021;Galindo et al, 2021;Yacobitti et al, 2021;Ortiz-Prado et al, 2021) and in international cohorts (Pepe et al, 2021). Overall, frailty and the high prevalence of comorbidities made the elderly more susceptible to severe infection by COVID-19.…”

Predictors of Mortality in Hospitalized Patients with COVID-19: A One-Year Case-Control Study

“…A few published papers have previously characterized the risk factors associated with COVID-19 mortality in Latin American patients (17,18) Therefore, the present study highlights multiple variables, including laboratory abnormalities and clinical features associated with COVID-19 mortality. The main findings in our study were significant associations between TBIL, ferritin, D-Dimer levels, dyspnea, GERD, and increased risk of mortality in COVID-19 patients.…”

Predictors of mortality in hospitalised patients with COVID-19: a 1-year case–control study

“…A few published studies have characterised the risk factors associated with COVID-19 mortality in Latin American patients 18 19 ; therefore, the present study highlights multiple variables, including laboratory abnormalities and clinical features associated with COVID-19 mortality. The main findings in our study were significant associations between respiratory distress, haemoglobin, LDH, PaO 2 /FiO 2 , CKD, ferritin, creatinine and leucocytes on admission, providing the landscape of multiple complex interactions associated with mortality in COVID-19.…”