Antecedents and objective: To describe clinical features, comorbidity, and prognostic factors associated with in-hospital mortality in a cohort of COVID-19 admitted to a general hospital.
Material and methods: Retrospective cohort study of patients with COVID-19 admitted from 26th February 2020, who had been discharged or died up to 29th April 2020. A descriptive study and an analysis of factors associated with intrahospital mortality were performed.
Results: Out of the 101 patients, 96 were analysed. Of these, 79 (82%) recovered and were discharged, and 17 (18%) died in the hospital. Diagnosis of COVID-19 was confirmed by polymerase chain reaction to SARS-CoV2 in 92 (92.5%). The mean age was 63 years, and 66% were male. The most frequent comorbidities were hypertension (40%), diabetes mellitus (16%) y cardiopathy (14%). Patients who died were older (mean 77 vs 60 years), had higher prevalence of hypertension (71% vs 33%), and cardiopathy (47% vs 6%), and higher levels of lactate dehydrogenase (LDH) and reactive C protein (mean 662 vs 335 UI/L, and 193 vs 121mg/L respectively) on admission. In a multivariant analysis the variables significantly associated to mortality were the presence of cardiopathy (CI 95% OR 2,58-67,07), levels of LDH≥345 IU/L (CI 95% OR 1,52-46,00), and age≥65 years (CI 95% OR 1,23-44,62).
Conclusions: The presence of cardiopathy, levels of LDH≥345 IU/L and age≥65 years, are associated with a higher risk of death during hospital stay for COVID-19. This model should be validated in prospective cohorts.
Antecedentes y objetivo: Describir el perfil clínico, comorbilidad y factores pronósticos de mortalidad intrahospitalaria en una cohorte COVID-19 de un hospital general.
Material y métodos: Estudio de cohortes retrospectivo de pacientes con COVID-19 ingresados desde el 26 de febrero de 2020, y dados de alta o fallecidos hasta el 29 de abril; estudio descriptivo y análisis de factores asociados a la mortalidad intrahospitalaria.
Resultados: De los pacientes ingresados (N = 101), fueron analizados 96, siendo dados de alta por curación 79 (82%), y falleciendo 17 (18%). Se confirmó COVID-19 por reacción en cadena de la polimerasa a SARS-CoV-2 en 92 casos (92,5%). La edad media fue de 63 años y 66% fueron varones. La comorbilidad previa más frecuente fue hipertensión arterial (40%), diabetes mellitus (16%) y cardiopatía (14%). Los pacientes que fallecieron tenían significativamente más edad (media 77 vs. 60 años), hipertensión arterial (71% vs 33%), cardiopatía previa (47% vs. 6%), y niveles más elevados de lactato deshidrogenasa (LDH) (662 vs. 335 UI/L) y proteína C reactiva (PCR) (193 vs. 121 mg/L) al ingreso. En análisis multivariante, se asociaron significativamente a mayor riesgo de muerte la presencia de cardiopatía (IC 95% OR 2,58–67,07), los niveles de LDH ≥ 345 UI/L (IC 95% OR 1,52–46,00), y la edad ≥ 65 años (IC 95% OR 1,23–44,62).
Conclusiones: El antecedente de cardiopatía, niveles de LDH ≥ 345 UI/L al ingreso, y una edad ≥ 65 años, se asocian a mayor mortalidad durante el ingreso por COVID-19. Hay que validar este modelo pronóstico en cohortes prospectivas.
Keywords: COVID-19; Cardiopathy; Cardiopatía; Factores pronósticos; Prognostic factors; SARS-CoV-2.
Copyright © 2020 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.