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Colegio de Medicina Interna de México.

2022, Number 3

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Med Int Mex 2022; 38 (3)

Clinical, biochemical and tomographic patterns in COVID-19 patients associated with requirement of invasive ventilation and mortality in a tertiary care center in Mexico City

De la Peña-Sosa G, Gulías-Herrero A, Almeda-Valdés P

Language: Spanish
References: 28
Page: 550-559
PDF size: 234.20 Kb.


ABSTRACT

Objective: To describe the factors associated with the requirement of invasive mechanical ventilation (IMV) and mortality in COVID-19 patients diagnosed in a tertiarycare center in Mexico City.
Materials and Methods: A cross-sectional study was done including consecutive patients with COVID-19 from March 18 to July 30, 2020.
Results: Nine hundred forty-six patients were analyzed. The median age was 53 years (interquartile range, 44-53), 64% men, and 22.2% received invasive mechanical ventilation. The overall mortality was 23.3%, and 50% in the intensive care unit. In the logistic regression analysis, a severe tomographic pattern (STP) (odds ratio [OR] 23.8, 95% confidence interval [95% CI] 6.9-81.3), troponin I › 20 pg/mL (OR 7.1, 95% CI 3.9-12.9) and hyperglycemia (› 180 mg/dL) at admission (OR 2.8, 95% CI 1.6-4.8) were associated with requirement of IMV (p ‹ 0.001). A severe tomographic pattern (OR 18.6, 95% CI 2.5-138.7), troponin I › 20 pg/mL (OR 4.9, 95% CI 3.2-7.4), age between 44-64 years (OR 2.7, 95% CI 1.7-4.1), age ≥ 65 years (OR 2.9, 95% CI 1.7- 5.0), hyperglycemia (OR 1.9, 95% CI 1.2-3.2) and male sex (OR 1.6, 95% CI 1.1-2.4) increased mortality (p ‹ 0.001).
Conclusions: A severe tomographic pattern, high troponin I, and hyperglycemia at admission were associated with invasive mechanical ventilation requirement and increased mortality due to COVID-19.


REFERENCES

  1. Costa FF, Rosário WR, Ribeiro-Farias AC, Guimaraes R, etal. Metabolic syndrome and COVID-19: An update on theassociated comorbidities and proposed therapies. DiabetesMetab Syndr 2020; 14 (5): 809-814. DOI: 10.1016/j.dsx.2020.06.016.

  2. Suárez V, Suarez-Quezada M, Oros-Ruiz S, Ronquillo E.Epidemiology of COVID-19 in Mexico: from the 27th ofFebruary to the 30th of April 2020. Rev Clin Esp 2020; 220(8): 463-471. DOI: 10.1016/j.rce.2020.05.007.

  3. Ge H, Wang X, Yuan X, Xiao G, et al. The epidemiology andclinical information about COVID-19. Eur J Clin MicrobiolInfect Dis 2020; 39 (6): 1011-1019. DOI: 10.1007/s10096-020-03874-z.

  4. Rothan HA, Byrareddy SN. The epidemiology and pathogenesisof coronavirus disease (COVID-19) outbreak. J Autoimmun2020; 109: 102433. DOI: 10.1016/j.jaut.2020.102433.

  5. Carrillo-Vega MF, Salinas-Escudero G, García-Peña C,Gutiérrez-Robledo LM, et al. Early estimation of the riskfactors for hospitalization and mortality by COVID-19 inMexico. PLoS One 2020; 15 (9): e0238905. DOI: https://doi.org/10.1371/journal.pone.0238905.

  6. Bello-Chavolla OY, Bahena-López JP, Antonio-Villa NE, etal. Predicting mortality due to sars-cov-2: a mechanisticscore relating obesity and diabetes to COVID-19 outcomesin Mexico. J Clin Endocrinol Metab 2020;105 (8): dgaa346.DOI: 10.1210/clinem/dgaa346.

  7. Hur K, Price CPE, Gray EL, Gulati R, et al. Factors associatedwith intubation and prolonged intubation in hospitalizedpatients with COVID-19. Otolaryngol Head Neck Surg 2020;163 (1): 170-178. DOI: 10.1177/0194599820929640.

  8. Richardson S, Hirsch JS, Narasimhan M, Crawford J, et al.Presenting characteristics, comorbidities, and outcomesamong 5700 patients hospitalized with COVID-19 in theNew York city area. JAMA 2020; 323 (20): 2052-2059. DOI:10.1001/jama.2020.6775.

  9. Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalenceof underlying diseases in hospitalized patients with covid-19: a systematic review and meta-analysis. Arch AcadEmerg Med 2020; 8 (1): e35.*

  10. Nie S, Zhao X, Zhao K, Zhang Z, et al. Metabolic disturbancesand inflammatory dysfunction predict severityof coronavirus disease 2019 (COVID-19): A retrospectivestudy. MedRxiv 2020. DOI: https://doi.org/10.1101/2020.03.24.20042283.

  11. Bornstein SR, Dalan R, Hopkins D, Mingrone G, et al.Endocrine and metabolic link to coronavirus infection.Nat Rev Endocrinol 2020; 16 (6): 297-298. DOI:10.1038/s41574-020-0353-9.

  12. Pal R, Banerjee M. COVID-19 and the endocrine system:exploring the unexplored. J Endocrinol Invest 2020; 43 (7):1027-1031. DOI:10.1007/s40618-020-01276-8.

  13. World Health Organization. Weekly epidemiologicalupdate – 25 August 2021. 2021. https://www.who.int/publications/m/item/weekly-epidemiological-update-25-August-2021.

  14. Yang X, Yu Y, Xu J, Shu H, et al. Clinical course and outcomesof critically ill patients with SARS-CoV-2 pneumonia in Wuhan,China: a single-centered, retrospective, observationalstudy. Lancet Respir Med 2020; 8 (5): 475-481. DOI: https://doi.org/10.1016/S2213-2600(20)30079-5.

  15. Marazuela M, Giustina A, Puig-Domingo M. Endocrine andmetabolic aspects of the COVID-19 pandemic [publishedcorrection appears in Rev Endocr Metab Disord 2021; 22(1): 145]. Rev Endocr Metab Disord 2020; 21 (4): 495-507.DOI:10.1007/s11154-020-09569-2.

  16. Instituto Nacional de Estadística y Geografía. EncuestaNacional de Salud y Nutrición (ENSANUT) 2018. https://www.inegi.org.mx/programas/ensanut/2018.

  17. 17Guan WJ, Ni ZY, Hu Y, Liang W, et al. Clinical characteristicsof coronavirus disease 2019 in China. N Engl J Med2020; 382 (18): 1708-1720. DOI:10.1056/NEJMoa2002032.

  18. Huang C, Wang Y, Li X, Ren L, et al. Clinical features ofpatients infected with 2019 novel coronavirus in Wuhan,China [published correction appears in Lancet 2020].Lancet 2020; 395 (10223): 497-506. DOI:10.1016/S0140-6736(20)30183-5.

  19. Ñamendys-Silva SA, Gutiérrez-Villaseñor A, Romero-González JP. Hospital mortality in mechanically ventilatedCOVID-19 patients in Mexico. Intensive Care Med 2020;46 (11): 2086-2088. DOI:10.1007/s00134-020-06256-3.

  20. Du RH, Liang LR, Yang CQ, Wang W, et al. Predictors ofmortality for patients with COVID-19 pneumonia caused bySARS-CoV-2: a prospective cohort study [published correctionappears in Eur Respir J 2020; 56 (3)]. Eur Respir J 2020;55 (5): 2000524. DOI:10.1183/13993003.00524-2020.

  21. Zhou F, Yu T, Du R, Fan G, et al. Clinical course and risk factorsfor mortality of adult inpatients with COVID-19 in Wuhan,China: a retrospective cohort study [published correctionappears in Lancet 2020; 395 (10229): 1038. DOI:10.1016/S0140-6736(20)30566-3.

  22. South AM, Diz DI, Chappell MC. COVID-19, ACE2, andthe cardiovascular consequences. Am J Physiol HeartCirc Physiol 2020; 318 (5): H1084-H1090. DOI:10.1152/ajpheart.00217.2020.

  23. Nigro E, Perrotta F, Polito R, D'Agnano V, Scialò F, Bianco A,Daniele A. Metabolic perturbations and severe COVID-19disease: Implication of molecular pathways. Int J Endocrinol2020:8896536. DOI: 10.1155/2020/8896536.

  24. Michalakis K, Ilias I. SARS-CoV-2 infection and obesity:Common inflammatory and metabolic aspects. DiabetesMetab Syndr 2020; 14 (4): 469-471. DOI: 10.1016/j.dsx.2020.04.033.

  25. Simonnet A, Chetboun M, Poissy J, Raverdy V, et al.High prevalence of obesity in severe acute respiratorysyndrome coronavirus-2 (SARS-CoV-2) requiring invasivemechanical ventilation [published correction appearsin Obesity (Silver Spring). 2020; 28 (10): 1994]. Obesity(Silver Spring) 2020; 28 (7): 1195-1199. DOI: 10.1002/oby.22831.

  26. Caballero AE, Ceriello A, Misra A, Aschner P, et al. COVID-19in people living with diabetes: An international consensus.J Diabetes Complications 2020; 34 (9): 107671. DOI:10.1016/j.jdiacomp.2020.107671.

  27. Yanai H. Metabolic syndrome and COVID-19. Cardiol Res2020; 11 (6): 360-365. doi: 10.14740/cr1181.

  28. Lala A, Johnson KW, Januzzi JL, Russak A, et al. Prevalenceand impact of myocardial injury in patients hospitalizedwith COVID-19 infection. J Am Coll Cardiol 2020; 76 (5):533-546. DOI: 10.1016/j.jacc.2020.06.007.




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