Aguilar-Andino David, Umaña Andrea N, Alas-Pineda César, Santos Freddy Medina, Gómez Alejandro Cárcamo, Soto Marco Molina, Osorio Ana Liliam
Departamento de Epidemiologia, Hospital General Dr. Mario Catarino Rivas, San Pedro Sula, Honduras.
Departamento de Medicina, Universidad Nacional Autónoma de Honduras, San Pedro Sula, Honduras.
Thromb Update. 2022 Dec;9:100124. doi: 10.1016/j.tru.2022.100124. Epub 2022 Oct 4.
SARS-COV-2, in most cases, only generates a mild acute respiratory disease. However, patients with severe disease show an exaggerated response of the immune system, creating a pro-inflammatory state, which could cause abnormalities in the coagulation system that increases mortality. Latin American countries, specially those with limited resources, have few studies about clinical features, coagulation and inflammatory biomarkers that could be useful at admission to assess poor outcomes.
The objective of this study is to describe the clinical features, coagulation, and inflammatory biomarkers, and identify risk factors at admission that are associated poor outcomes in Honduran population.
A cohort study was conducted. 210 patients were included, which 105 died during hospitalization due to COVID-19 and 105 were discharged alive, between September 2020 and January 2021. Clinical and laboratorial data was retrospectively collected.
57,6% of the population were male. The median age was 58 years. The median time between symptom onset and hospital admission was 6 days. D-dimer median was higher in the dead group compared with the alive group. Poor prognosis factors in the Cox multivariable model were male gender, age, symptom's duration, obesity and an elevated d dimer at admission.
In low-middle income countries, the assessment of these clinical and laboratory tools, especially in those with risk factors for prothrombotic states, could help clinicians to correctly stratify disease prognosis, establish a baseline to evaluate further evolution, and also predict outcomes, thus improving patient management.
在大多数情况下，新型冠状病毒2（SARS-CoV-2）仅引发轻度急性呼吸道疾病。然而，重症患者会出现免疫系统的过度反应，产生促炎状态，这可能导致凝血系统异常，从而增加死亡率。拉丁美洲国家，尤其是资源有限的国家，关于临床特征、凝血和炎症生物标志物的研究较少，而这些指标在入院时可能有助于评估不良预后。
本研究的目的是描述洪都拉斯人群的临床特征、凝血和炎症生物标志物，并确定入院时与不良预后相关的危险因素。
进行了一项队列研究。纳入了210名患者，其中105人在2020年9月至2021年1月期间因新冠肺炎住院期间死亡，105人存活出院。回顾性收集了临床和实验室数据。
57.6%的人群为男性。中位年龄为58岁。症状出现至入院的中位时间为6天。死亡组的D-二聚体中位数高于存活组。Cox多变量模型中的不良预后因素为男性、年龄、症状持续时间、肥胖和入院时D-二聚体升高。
在低收入和中等收入国家，评估这些临床和实验室工具，特别是在那些有血栓前状态危险因素的患者中，有助于临床医生正确分层疾病预后，建立评估进一步病情发展的基线，还能预测预后，从而改善患者管理。
