Sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized COVID-19 patients at alternate care site: a Latin American experience
Por:
Alegria-Banos, Jorge A., Rosas-Alvarado, Montserrat A., Jimenez-Lopez, Jose C., Juarez-Mucino, Marcos, Mendez-Celis, Carlos A., Enriquez-de los Santos, Sharon T., Valdez-Vazquez, Rafael R., Prada-Ortega, Diddier
Publicada:
12 dic 2023
Categoría:
Medicine (miscellaneous)
Resumen:
Background The establishment of Alternate Care Sites (ACS) helped the
most severely impacted countries expand their response capability. The
aim of this study was to evaluate the clinical characteristics and risk
factors associated with the mortality of hospitalized COVID-19 patients
at Alternate Care Site in Mexico City. Patients and methods A
monocentric cohort study was conducted at Mexico City's Temporary Unit
COVID-19 (UTC-19). Sociodemographic, clinical, laboratory and treatment
variables were included in the analysis. Results A total of 4865
patients were included, with a mean age of 49.33 years +/- SD 15.28
years (IQR 38 to 60 years); 50.53% were women. 63.53% of the patients
presented at least one comorbidity, the most frequent being: obesity
(39.94%), systemic arterial hypertension (25.14%), and diabetes
mellitus (21.52%). A total of 4549 patients (93.50%) were discharged
due to improvement, 64 patients (1.31%) requested voluntary discharge,
39 patients (0.80%) were referred to another unit, and 213 patients
(4.37%) died. Factors that were independently and significantly
associated with death included male gender (odds ratio [OR], 1.60),
age >= 50 years (OR 14.75), null or low schooling (OR 3.47), have at
least one comorbidity (OR 3.26), atrial fibrillation (OR 22.14). In the
multivariate analysis, the lymphopenia <= 1 x 10(3/)mu L (OR 1.91), and
having required steroid treatment (OR 2.85), supplemental oxygen with
high-flow nasal cannula (OR 3.12) or invasive mechanical ventilation (OR
42.52), was significantly associated with an increased risk of death.
Conclusions This study identified the clinical characteristics and risk
factors for mortality of hospitalized COVID-19 patients at ACS in Mexico
City. KEY MESSAGES An Alternate Care Site (ACS) is any building or
structure that is temporarily converted or constructed for healthcare
use during a public health emergency. Factors associated with death
included male gender, age over 50 years, and lower educational
attainment (elementary school or less). The findings corroborate the
utility of the CALL score as a predictor of mortality; lymphopenia <= 1
x 10(3)/mu L was the most relevant biomarker.
Filiaciones:
Alegria-Banos, Jorge A.:
Medica Sur, Oncol Ctr, Mexico City, Mexico
Rosas-Alvarado, Montserrat A.:
Mex City Hlth Secretariat, Gen Directorate Provis Med Serv & Emergencies, Mexico City, Mexico
Jimenez-Lopez, Jose C.:
Univ Nacl Autonoma Mexico, Inst Geol, Postgrad Earth Sci, Mexico City, Mexico
Juarez-Mucino, Marcos:
Mex City Hlth Secretariat, Gen Directorate Provis Med Serv & Emergencies, Mexico City, Mexico
Mendez-Celis, Carlos A.:
Univ Nacl Autonoma Mexico, Fac Med, Lab Immunotherapy & Tissue Engn, Mexico City, Mexico
Enriquez-de los Santos, Sharon T.:
Gen Hosp 47 Vicente Guerrero, Mexican Social Secur Inst, Dept Med Serv, Mexico City, Mexico
Valdez-Vazquez, Rafael R.:
Ctr Citibanamex, Temporary COVID 19 Unit, Med Coordinat, Mexico City, Mexico
Prada-Ortega, Diddier:
Inst Nacl Cancerol, Direcc Invest, Mexico City, Mexico
Columbia Univ, Dept Environm Hlth Sci, Mailman Sch Publ Hlth, New York, NY USA
Mt Sinai Hosp, Inst Hlth Equ Res, New York, NY USA
gold, Gold
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