León-Jiménez Franco, Vives-Kufoy Camila, Failoc-Rojas Virgilio E, Valladares-Garrido Mario J
Departamento Medicina Interna, Hospital Santa Rosa Piura, Piura, Perú.
Sanidad del Grupo 7-FAP, Piura, Perú.
Rev Med Chil. 2021 Oct;149(10):1459-1466. doi: 10.4067/s0034-98872021001001459.
Peru has one of the highest mortality rates due to COVID-19 in the world.
To describe the clinical features, evolution and explore factors associated with mortality in patients with moderate to severe Covid-19.
Prospective analytical study. The clinical, laboratory, imaging, and mortality data of patients admitted at a COVID service of the Santa Rosa de Piura Hospital were recorded from April to June 2020.
Data from 391 patients with a median age of 60 years (70% women) was gathered. The time lapse between the onset of the disease and hospitalization was seven days. The most common alteration in the blood count was Neutrophilia in 78% of patients. The median PaO2/FiO2 ratio was 77. The distribution of tomographic patterns was Ground glass in 91% of patients, interstitial involvement in 57%, consolidation in 43%. Sixteen percent of patients had at least one complication, the most common was an increase in transaminases in 2%. Four percent were admitted to the intensive care unit and 53% died (94% during hospitalization and 5.8% during ICU stay). In the bivariate analysis, an association was found between a higher mortality and older age (p = 0.01), having fewer days of illness (p = 0.03), fewer days of hospital stay (p < 0.01), having at least one comorbidity (p = 0.02), lymphopenia (p = 0.02), neutrophilia (P = 0.03) and lower PaO2/ FiO2 ratio (p < 0.01).
Fifty percent of these patients died. Age, rapid progression, having comorbidities and other laboratory alterations were associated with mortality.
秘鲁是全球因新冠病毒疾病(COVID-19)导致死亡率最高的国家之一。
描述中度至重度新冠病毒疾病患者的临床特征、病情演变,并探究与死亡率相关的因素。
前瞻性分析研究。记录了2020年4月至6月期间在皮乌拉圣罗莎医院新冠科室住院患者的临床、实验室、影像学及死亡率数据。
收集了391例患者的数据,中位年龄为60岁(70%为女性)。疾病发作至住院的时间间隔为7天。血细胞计数最常见的异常是78%的患者出现中性粒细胞增多。中位氧合指数(PaO2/FiO2)为77。断层扫描模式分布为:91%的患者出现磨玻璃影,57%出现间质受累,43%出现实变。16%的患者至少有一种并发症,最常见的是2%的患者转氨酶升高。4%的患者入住重症监护病房,53%的患者死亡(94%在住院期间死亡,5.8%在重症监护病房停留期间死亡)。在双变量分析中,发现较高的死亡率与年龄较大(p = 0.01)、患病天数较少(p = 0.03)、住院天数较少(p < 0.01)、至少有一种合并症(p = 0.02)、淋巴细胞减少(p = 0.02)、中性粒细胞增多(P = 0.03)及较低的氧合指数(p < 0.01)有关。
这些患者中有50%死亡。年龄、快速进展、合并症及其他实验室异常与死亡率相关。