Peñafiel Fernando Saldías, Tapia Alejandro Peñaloza, Nesvadba Daniela Farías, Oksenberg Katia Farcas, Sánchez Antonia Reyes, Meza Josefina Cortés, Rossel Gerardo Salinas, Rodríguez Isabel Leiva
Departamento de Enfermedades Respiratorias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Med Chil. 2023 Sep;151(9):1207-1220. doi: 10.4067/s0034-98872023000901207.
The acute respiratory illness caused by coronavirus SARS-CoV-2 (COVID-19) has spread throughout the world, causing significant morbidity and mortality.
To assess clinical and laboratory variables measured at hospital admission associated with clinically relevant adverse outcomes in patients hospitalized with community-acquired pneumonia caused by coronavirus SARSCoV-2.
We conducted a descriptive prospective study in adult patients hospitalized due to COVID-19-associated pneumonia at the UC Christus Health Network. The adverse events examined were ICU admission, need for mechanical ventilation, prolonged length of stay, and hospital mortality. We analyzed predictive variables using univariate and multivariate analysis in a logistic regression model.
We evaluated 710 COVID-19-associated pneumonia hospitalized patients aged 59 ± 17 years; 55% were males. 76% of the cohort presented comorbidities, mainly hypertension (45%), diabetes (24%), and hypothyroidism (10%); 42% of the cohort received treatment in critical care units, 16.3% required mechanical ventilation, the mean hospital stay was 15 days, and 11.4% died in the hospital. Age, comorbidities, especially cardiovascular, metabolic, and chronic kidney disease, altered mental status and vital signs (tachypnea, hypoxemia) at hospital admission, renal failure, and elevated biomarkers of systemic inflammation were associated with ICU admission, prolonged hospital stay, and death. Men had a higher risk of ICU admission, connection to mechanical ventilation, and prolonged hospital stay but did not have higher fatalities.
Age, male sex, comorbidities, altered mental status and vital signs, renal dysfunction, and elevation of inflammatory parameters were associated with a higher risk of severe COVID-19. These may serve as useful baseline parameters in developing prediction tools for COVID-19 prognosis.
由冠状病毒SARS-CoV-2(COVID-19)引起的急性呼吸道疾病已在全球蔓延,导致了显著的发病率和死亡率。
评估因冠状病毒SARS-CoV-2引起的社区获得性肺炎住院患者入院时测量的临床和实验室变量与临床相关不良结局的关系。
我们在UC Christus健康网络对因COVID-19相关肺炎住院的成年患者进行了一项描述性前瞻性研究。所检查的不良事件包括入住重症监护病房、需要机械通气、住院时间延长和医院死亡率。我们在逻辑回归模型中使用单变量和多变量分析来分析预测变量。
我们评估了710例年龄为59±17岁的COVID-19相关肺炎住院患者;55%为男性。该队列中76%患有合并症,主要为高血压(45%)、糖尿病(24%)和甲状腺功能减退(10%);42%的队列在重症监护病房接受治疗,16.3%需要机械通气,平均住院时间为15天,11.4%在医院死亡。年龄、合并症,尤其是心血管、代谢和慢性肾脏病、入院时精神状态改变和生命体征(呼吸急促、低氧血症)、肾衰竭以及全身炎症生物标志物升高与入住重症监护病房、住院时间延长和死亡相关。男性入住重症监护病房、连接机械通气和住院时间延长的风险较高,但死亡率并不更高。
年龄、男性、合并症、精神状态和生命体征改变、肾功能不全以及炎症参数升高与严重COVID-19的较高风险相关。这些可能作为开发COVID-19预后预测工具的有用基线参数。