Risk Factors and Clinical Phenotypes Associated with Severity in Patients with COVID-19 in Northeast Mexico

Abstract

Objective: The aim of this study is to describe the main clinical phenotypes, laboratory findings, and severity of coronavirus disease 2019 in patients hospitalized at the High Specialty Medical Unit # 71 of the Mexican Social Security Institute. Methods: Prospective observational cohort study with a total of 105 patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at the High Specialty Medical Unit # 71 (Torreón, Coahuila, Mexico), from May 15th to August 15th, 2020. The cases were confirmed to be COVID-19 positive through an RT-qPCR test. Clinical phenotypes and laboratory tests were evaluated to determine the degree of severity of the disease and the most frequent comorbidities. Results: The clinical characteristics of a total of 105 hospitalized patients (47 females and 58 males; median age being 52 years) with confirmed COVID-19 diagnoses were studied. The severity of the disease was classified as moderate grade (62.7%), severe grade (21.5%), and critical grade (15.6%). Among the most frequent underlying pathologies coexisted overweight (n = 75, 78.12%), obesity (n = 21, 21.87%), diabetes (n = 10, 9.52%), and hypertension (n = 6, 5.71%), some of these patients present more than one pathology. This association was found with diabetes (odds ratio [OR]: 1.42; 95% confidence interval [CI]: 1.23-1.97; p = 0.021) and high levels of D-dimer (OR: 1.01; 95% CI: 1.00-1.08; p = 0.001). Conclusion:In this retrospective cohort study of patients with COVID-19 from a specialty hospital in the northeast region of Mexico, it was observed that clinical phenotypes and D-dimer elevation were compatible with an inflammatory state by degree of severity; it was found that the hospitalized patients with underlying chronic medical conditions such as diabetes and elevated D-dimer levels were significantly associated with increased mortality from COVID-19. Age and sex (males) were two factors highly associated with mortality.

Association Between D-Dimer Level with Clinical Severity and Radiological Imaging of Confirmed COVID-19 Patients at RSUP Dr. M. Djamil Padang

“…Garcia-Alvarado et al in their study obtained similar results which stated that the most clinical severity was moderate (62.7%), followed by severe (21.5%), and critical (15.6%). 15 Long et al observed that the most clinical severity was severe (41.7%), followed by moderate (33.9%) and critical clinical severity (24.3%). 12 A higher proportion of moderate symptoms in this study was also associated with exclusion criteria which excluded the comorbidities of stroke and malignancy, pregnancy, as well as younger age.…”