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Rev. invest. clín ; 72(3): 165-177, May.-Jun. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1251851

RESUMEN

ABSTRACT Background: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic. Objective: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC). Methods: We conducted a prospective cohort, including consecutive patients with COVID-19 from February 26, 2020 to April 11, 2020. Results: We identified 309 patients (140 inpatients and 169 outpatients). The median age was 43 years (interquartile range, 33-54), 59.2% men, and 18.6% healthcare workers (12.3% from our center). The median body mass index (BMI) was 29.00 kg/m2 and 39.6% had obesity. Compared to outpatients, inpatients were older, had comorbidities, cough, and dyspnea more frequently. Twenty-nine (20.7%) inpatients required treatment in the IC unit (ICU). History of diabetes (type 1 or 2) and abdominal pain were more common in ICU patients compared to non-ICU patients. ICU patients had higher BMIs, higher respiratory rates, and lower room-air capillary oxygen saturations. ICU patients showed a more severe inflammatory response as assessed by white blood cell count, neutrophil and platelet count, C-reactive protein, ferritin, procalcitonin, and albumin levels. By the end of the study period, 65 inpatients had been discharged because of improvement, 70 continued hospitalized, and five had died. Conclusions: Patients with comorbidities, either middle-age obese or elderly complaining of fever, cough, or dyspnea, were more likely to be admitted. At admission, patients with diabetes, high BMI, and clinical or laboratory findings consistent with a severe inflammatory state were more likely to require IC.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias , Betacoronavirus , Índice de Severidad de la Enfermedad , Biomarcadores/sangre , Dolor Abdominal/epidemiología , Índice de Masa Corporal , Comorbilidad , Resultado del Tratamiento , Cuidados Críticos , Disnea/etiología , Centros de Atención Terciaria/estadística & datos numéricos , Atención Ambulatoria , Enfermedades Gastrointestinales/epidemiología , SARS-CoV-2 , COVID-19 , Pacientes Internos/estadística & datos numéricos , México , Obesidad/epidemiología
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