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2021, Number 3

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Revista Habanera de Ciencias Médicas 2021; 20 (3)

Predictive factors of unsatisfactory evolution among 20-65 year-old patients infected with COVID-19

Sosa FA, Vergara SAC, Mojena MO

Language: English
References: 24
Page: 1-8
PDF size: 663.55 Kb.


ABSTRACT

Introduction: Several authors validated the use of clinical, humoral, and radiological indicators as predictors of unsatisfactory evolution in patients with COVID-19.
Objective: To evaluate the clinical-humoral variables and the findings in the first chest x-ray as predictors of unsatisfactory evolution in patients with COVID-19.
Material and Methods: An observational and retrospective case-control study was carried out in 484 patients infected with COVID-19 admitted to the Cuban Hospital of Qatar between March and July 2020. The sample was composed of 60 patients. Cases: patients with respiratory failure who required invasive ventilation or death. Controls: patients with COVID-19 without complications. Input variables: age, sex, BMI, presence of comorbidities, leukocyte value, and severity index of the first chest x-ray. Response variable: clinical evolution. The bivariate analysis was performed using the Chi-square test. In the multivariate analysis, using binary logistic regression, p values ​​lower than 0.05 were considered significant. The results were expressed in the Odds Ratio.
Results: The progression of age, belonging to the group of 61-65 years, female sex, suffering from diabetes or arterial hypertension, having two comorbidities, abnormal leukogram, and the severity index of the first chest X-ray between 2-6 / 6 were related to unsatisfactory evolution. The leukogram (ODDS RATIO 68.634 p = 0.000) and the severity index of the first chest x-ray (ODDS RATIO 12.201 p = 0.008) have an independent influence on patients with COVID-19.
Conclusion: The predictive value of the leukogram and the severity index in the first chest x-ray over unsatisfactory evolution were demonstrated in these patients.


REFERENCES

  1. Huang C, Wang Y, Li x, Ren L, Zhao J, Hu J. Clinical features of patient infected with 2019 novel coronavirus in Wuhan, China. Lancet [Online]. 2020 [Cited 02/07/2020]; 395(10223):497-506. Available from: Available from: http://doi.org/10.1016/S0140-6736(20)30183-5

  2. COVID-19 Map. Johns Hopkins Coronavirus Resource Center [Online]. [Cited 02/07/2020]. Baltimore: Johns Hopkins Coronavirus Resource Center; 2020. Available from: https://coronavirus.jhu.edu/map.html

  3. Williamson E, Walker A, Goldacre B. Factors associated with COVID-19-related death using Open SAFELY. Nature [Online]. 2020 [Cited 02/07/2020];584:430-6 Available from: Available from: https://doi.org/10.1038/s41586-020-2521-4

  4. Sattar N, McInnes I, McMurray J. Obesity is a Risk Factor for Severe COVID-19 Infection. Circulation [Online]. 2020 [Cited 02/07/2020];142:4-6. Available from: Available from: https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.120.047659

  5. Adhikari SP, Meng S, Wu Y, Mao YP, Wang QZ. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty [Online]. 2020 [Cited 02/07/2020];9:29. Available from: Available from: https://doi.org/10.1186/s40249-020-00646-x

  6. Lauer SA, Grantz KH, Bi Q, Forrest KJ, Zheng Q, Meredith H, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Int Med [Online]. 2020 [Cited 02/07/2020];172(9):577-82. Available from: Available from: https://doi.org/10.7326/M20-0504

  7. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-CoV Infection from an Asymptomatic Contact in Germany. N Engl J Med [Online]. 2020 [Cited 02/07/2020];382:970-1. Available from: Available from: https://doi.org/ 10.1056/NEJMc2001468

  8. Yu P, Zhu J, Zhang Z, Han Y. A Familial cluster of infection associated with the 2019 novel coronavirus indicating possible person-to-person transmission during the incubation period. J Infect Dis [Online]. 2020 [Cited 02/07/2020];221(11):1757-61 Available from: Available from: https://doi.org/10.1093/infdis/jiaa077

  9. Pascarella G, Strumia A, Piliego Ch, Bruno F, Del Buono R, Costa, et al. COVID-19 diagnosis and management: a comprehensive review. J Intern Med [Online]. 2020 [Cited 13/07/2020];288(2):192-206. Available from: Available from: https://doi.org/10.1111/joim.13091

  10. Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA [Online]. 2020 [Cited 02/07/2020];323(18):1843-4. Available from: Available from: https://doi.org/10.1001/jama.2020.3786

  11. Zhang W, Du RH, Li B, Zheng XS, Yang XL, Hu B, et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microb Infect [Online]. 2020 [Cited 02/07/2020];9:386-9 Available from: Available from: https://doi.org/10.1080/22221751.2020.1729071

  12. Dugar S, Choudhary Ch, Duggal A. Sepsis and septic shock: Guideline-based management. Cleveland Clinic Journal Medcine [Online]. 2020 [Cited 02/07/2020];87(1):[Aprox. 2 p.]. Available from: Available from: https://doi.org/10.3949/ccjm.87a.18143

  13. Li x, Liu Ch, Mao Z, Xiao M, Wang L, Qi Sh, et al. Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis. Critical Care [Online]. 2020 [Cited 21/03/2021];24(647):[Aprox. 2 p.]. Available from: Available from: https://doi.org/10.1186/s13054-020-03374-8

  14. Yao Y, Cao J, Wang Q, Shi Q, Liu K, Luo Z, et al. D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study. Journal of Intensive Care [Online]. 2020 [Cited 21/03/2021];49(8):[Aprox. 2 p.]. Available from: Available from: https://doi.org/10.1186/s40560-020-00466-z

  15. Toussie D, Voutsinas N, Finkelstein M, Cedillo M, Manna S, Maro SZ, et al. Clinical and Chest Radiography Features Determine Patient Outcomes In Young and Middle Age Adults with COVID-19. Radiology [Online]. 2020 [Cited 02/07/2020];297(1):197-206. Available from: Available from: https://doi.org/10.1148/radiol.2020201754

  16. Cellina M, Panzeri M, Oliva G. Chest Radiograph Features Predict a Favorable Outcome in Patients with COVID-19. Radiology [Online]. 2020 [Cited 02/07/2020];297(1):[Aprox. 2 p.]. Available from: Available from: https://doi.org/10.1148/radiol.2020202326

  17. Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for radiologists on COVID-19: an update-radiology scientific expert panel. Radiology [Online]. 2020 [Cited 02/07/2020];296(2):E113-E114. Available from: Available from: https://doi.org/10.1148/radiol.2020200527

  18. Bernheim A, Mei X, Huang M, Yang Y, Fayad Z, Zhang N, et al. Chest CT findings in coronavirus disease-19 (COVID- 19): relationship to duration of infection. Radiology [Online]. 2020 [Cited 22/11/2020];295(3):685-91. Available from: Available from: https://doi.org/10.1148/radiol.2020200463

  19. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad Ali. Coronavirus disease 2019 (COVID-19): A systematic review of imaging findings in 919 patients. Am J Roentgenol [Online]. 2019 [Cited 02/07/2020];215(1):87-93. Available from: Available from: https://doi.org/10.2214/AJR.20.23034

  20. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis [Online]. 2020 [Cited 02/07/2020];20(4):425-34. Available from: Available from: https://doi.org/10.1016/S1473-3099(20)30086-4

  21. Li Y, Yang Z, Ai T, Wu Sh, Xia L. Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19). Eur Radiol [Online]. 2020 [Cited 22/11/2020];30:6186-93. Available from: Available from: https://doi.org/10.1007/s00330-020-06969-5

  22. Li K, Chen D, Chen Sh, Feng Y, Cheng Ch, Wand Z, et al. Predictors of fatality including radiographic findings in adults with COVID-19. Respir Res [Online]. 2020 [Cited 22/11/2020];21(146):[Aprox. 2 p.]. Available from: Available from: https://doi.org/10.1186/s12931-020-01411-2

  23. Pan D, Sze Sh, Minhas JS, Bangash MN, Pareek N, Divall Pip, et al. The impact of ethnicity on clinical outcomes in COVID-19: A systematic review. The Lancet [Online]. 2020 [Cited 23/10/2020];23(100404):1-8. Available from: Available from: https://doi.org/10.1016/j.eclinm.2020.100404

  24. Luo X, Zhou W, Yan X, Guo T, Wang B, Xia H, et al. Prognostic Value of C-Reactive Protein in Patients With Coronavirus 2019. Clin Infect Dis [Online]. 2020 [Cited 23/10/2020];71(16):2174-9. Available from: Available from: https://doi.org/10.1093/cid/ciaa641




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