Características clínicas y factores asociados a mortalidad en pacientes adultos hospitalizados por COVID-19 en un hospital público de Lima, Perú.
The COVID-19 pandemic has deeply affected the national health system in Peru, and despite the many strategies implemented to control the epidemic, the collapse of the sanitary system was imminent. We performed a retrospective cohort from the clinical records of adult patients with COVID-19 admitted...
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| Formato: | Preprint |
| Lenguaje: | español |
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2020
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| author | Fernando Mejía Carlos Medina Enrique Cornejo Cisneros Enrique Morello Sergio Vásquez Jorge Alave Alvaro Schwalb Germán Málaga |
| author_browse | Alvaro Schwalb Carlos Medina Enrique Cornejo Cisneros Enrique Morello Fernando Mejía Germán Málaga Jorge Alave Sergio Vásquez |
| author_facet | Fernando Mejía Carlos Medina Enrique Cornejo Cisneros Enrique Morello Sergio Vásquez Jorge Alave Alvaro Schwalb Germán Málaga |
| author_sort | Fernando Mejía |
| collection | Producción científica |
| description | The COVID-19 pandemic has deeply affected the national health system in Peru, and despite the many strategies implemented to control the epidemic, the collapse of the sanitary system was imminent. We performed a retrospective cohort from the clinical records of adult patients with COVID-19 admitted in Hospital Cayetano Heredia (Lima, Peru), between March and June 2020. A total of 369 patient charts were included for analysis; 241 (65.31%) were male and the median age was 59 years (IQR: 49-68). Most patients (68.56%) reported at least one comorbidity; more frequently: obesity (42.55%), diabetes mellitus (21.95%), and hypertension (21.68%). The median duration of symptoms prior to hospital admission was 7 days (IQR: 5-10). Reported in-hospital mortality was 49.59%. By multiple Cox regression, oxygen saturation (SaO2) level at admission was the main predictor of patient mortality, with SaO2 levels of 84-80% and <80% had 4.44 (95%CI 2.46-8.02) and 7.74 (95%CI 4.54-13.19) times greater risk of death, respectively, when compared to patients with SaO2 >90%. Additionally, older age (>60 years old) was associated with 1.9 times greater mortality. Our study finds SaO2 at admission and older age to be independent predictors of in-hospital mortality. These findings suggest a delay in early detection of hypoxemia in the community, therefore, we propose the implementation of monitoring for hypoxemia among outpatients with COVID-19 as well as appropriate and timely oxygen therapy in admission. |
| format | Preprint |
| id | oai:cris.upeu.edu.pe:20.500.15037/179 |
| institution | UPeU |
| language | Spanish |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| record_format | dspace |
| spelling | oai:cris.upeu.edu.pe:20.500.15037/1792026-10-30T16:14:32ZCaracterísticas clínicas y factores asociados a mortalidad en pacientes adultos hospitalizados por COVID-19 en un hospital público de Lima, Perú.Fernando MejíaCarlos MedinaEnrique Cornejo CisnerosEnrique MorelloSergio VásquezJorge AlaveAlvaro SchwalbGermán MálagaMedicineComorbidityHypoxemiaDiabetes mellitusCoronavirus disease 2019 (COVID-19)Retrospective cohort studyPediatricsProportional hazards modelHospital admissionCohortEmergency medicineInternal medicineDiseaseInfectious disease (medical specialty)EndocrinologyMedicineComorbidityHypoxemiaDiabetes mellitusCoronavirus disease 2019 (COVID-19)Retrospective cohort studyPediatricsProportional hazards modelHospital admissionCohortEmergency medicineInternal medicineDiseaseInfectious disease (medical specialty)Health Sciences Medicine Infectious Diseases COVID-19 Clinical Research StudiesPhysical Sciences Environmental Science Health, Toxicology and Mutagenesis Public Health and Environmental IssuesHealth Sciences Medicine Neurology Long-Term Effects of COVID-19The COVID-19 pandemic has deeply affected the national health system in Peru, and despite the many strategies implemented to control the epidemic, the collapse of the sanitary system was imminent. We performed a retrospective cohort from the clinical records of adult patients with COVID-19 admitted in Hospital Cayetano Heredia (Lima, Peru), between March and June 2020. A total of 369 patient charts were included for analysis; 241 (65.31%) were male and the median age was 59 years (IQR: 49-68). Most patients (68.56%) reported at least one comorbidity; more frequently: obesity (42.55%), diabetes mellitus (21.95%), and hypertension (21.68%). The median duration of symptoms prior to hospital admission was 7 days (IQR: 5-10). Reported in-hospital mortality was 49.59%. By multiple Cox regression, oxygen saturation (SaO2) level at admission was the main predictor of patient mortality, with SaO2 levels of 84-80% and <80% had 4.44 (95%CI 2.46-8.02) and 7.74 (95%CI 4.54-13.19) times greater risk of death, respectively, when compared to patients with SaO2 >90%. Additionally, older age (>60 years old) was associated with 1.9 times greater mortality. Our study finds SaO2 at admission and older age to be independent predictors of in-hospital mortality. These findings suggest a delay in early detection of hypoxemia in the community, therefore, we propose the implementation of monitoring for hypoxemia among outpatients with COVID-19 as well as appropriate and timely oxygen therapy in admission.Preprinthttps://doi.org/10.1590/scielopreprints.85810.1590/scielopreprints.858https://hdl.handle.net/20.500.15037/179W4206128051es2020-06-292026-06-13T07:49:03Z2026-06-13T07:49:03Z |
| spellingShingle | Medicine Comorbidity Hypoxemia Diabetes mellitus Coronavirus disease 2019 (COVID-19) Retrospective cohort study Pediatrics Proportional hazards model Hospital admission Cohort Emergency medicine Internal medicine Disease Infectious disease (medical specialty) Endocrinology Medicine Comorbidity Hypoxemia Diabetes mellitus Coronavirus disease 2019 (COVID-19) Retrospective cohort study Pediatrics Proportional hazards model Hospital admission Cohort Emergency medicine Internal medicine Disease Infectious disease (medical specialty) Health Sciences Medicine Infectious Diseases COVID-19 Clinical Research Studies Physical Sciences Environmental Science Health, Toxicology and Mutagenesis Public Health and Environmental Issues Health Sciences Medicine Neurology Long-Term Effects of COVID-19 Fernando Mejía Carlos Medina Enrique Cornejo Cisneros Enrique Morello Sergio Vásquez Jorge Alave Alvaro Schwalb Germán Málaga Características clínicas y factores asociados a mortalidad en pacientes adultos hospitalizados por COVID-19 en un hospital público de Lima, Perú. |
| title | Características clínicas y factores asociados a mortalidad en pacientes adultos hospitalizados por COVID-19 en un hospital público de Lima, Perú. |
| title_full | Características clínicas y factores asociados a mortalidad en pacientes adultos hospitalizados por COVID-19 en un hospital público de Lima, Perú. |
| title_fullStr | Características clínicas y factores asociados a mortalidad en pacientes adultos hospitalizados por COVID-19 en un hospital público de Lima, Perú. |
| title_full_unstemmed | Características clínicas y factores asociados a mortalidad en pacientes adultos hospitalizados por COVID-19 en un hospital público de Lima, Perú. |
| title_short | Características clínicas y factores asociados a mortalidad en pacientes adultos hospitalizados por COVID-19 en un hospital público de Lima, Perú. |
| title_sort | caracteristicas clinicas y factores asociados a mortalidad en pacientes adultos hospitalizados por covid 19 en un hospital publico de lima peru |
| topic | Medicine Comorbidity Hypoxemia Diabetes mellitus Coronavirus disease 2019 (COVID-19) Retrospective cohort study Pediatrics Proportional hazards model Hospital admission Cohort Emergency medicine Internal medicine Disease Infectious disease (medical specialty) Endocrinology Medicine Comorbidity Hypoxemia Diabetes mellitus Coronavirus disease 2019 (COVID-19) Retrospective cohort study Pediatrics Proportional hazards model Hospital admission Cohort Emergency medicine Internal medicine Disease Infectious disease (medical specialty) Health Sciences Medicine Infectious Diseases COVID-19 Clinical Research Studies Physical Sciences Environmental Science Health, Toxicology and Mutagenesis Public Health and Environmental Issues Health Sciences Medicine Neurology Long-Term Effects of COVID-19 |
| topic_facet | Medicine Comorbidity Hypoxemia Diabetes mellitus Coronavirus disease 2019 (COVID-19) Retrospective cohort study Pediatrics Proportional hazards model Hospital admission Cohort Emergency medicine Internal medicine Disease Infectious disease (medical specialty) Endocrinology Medicine Comorbidity Hypoxemia Diabetes mellitus Coronavirus disease 2019 (COVID-19) Retrospective cohort study Pediatrics Proportional hazards model Hospital admission Cohort Emergency medicine Internal medicine Disease Infectious disease (medical specialty) Health Sciences Medicine Infectious Diseases COVID-19 Clinical Research Studies Physical Sciences Environmental Science Health, Toxicology and Mutagenesis Public Health and Environmental Issues Health Sciences Medicine Neurology Long-Term Effects of COVID-19 |
| url | https://doi.org/10.1590/scielopreprints.858 https://hdl.handle.net/20.500.15037/179 |
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