Risk factors for mortality of adult patients with COVID-19 hospitalised in an emerging country: a cohort study.
BMJ Open
; 11(7): e050321, 2021 07 19.
Article
in English
| MEDLINE | ID: covidwho-1318034
ABSTRACT
OBJECTIVE:
To describe mortality of in-hospital patients with COVID-19 and compare risk factors between survivors and non-survivors.DESIGN:
Prospective cohort of adult inpatients.SETTING:
Tertiary healthcare teaching hospital in Guadalajara, Mexico.PARTICIPANTS:
All patients with confirmed COVID-19 hospitalised from 25 March to 7 September 2020 were included. End of study 7 November 2020. PRIMARY OUTCOMEMEASURES:
Patient survival analysed by the Kaplan-Meier method and comparison of factors by the log-rank test. Mortality risk factors analysed by multivariate Cox's proportional-hazard model.RESULTS:
One thousand ten patients included 386 (38%) died, 618 (61%) alive at discharge and six (0.6%) remained hospitalised. There was predominance of men (63%) and high frequency of overweight-obesity (71%); hypertension (54%); diabetes (40%); and lung (9%), cardiovascular (8%) and kidney diseases (11%); all of them significantly more frequent in non-survivors. Overweight-obesity was not different between groups, but severity of disease (Manchester Triage System and quick Sequential Organ Failure Assessment) was significantly worse in non-survivors, who were also significantly older (65 vs 45 years, respectively) and had haematological, biochemical, coagulation and inflammatory biomarkers more altered than survivors. Mortality predictors were invasive mechanical ventilation (IMV; OR 3.31, p<0.0001), admission to intensive care unit (ICU; OR 2.18, p<0.0001), age (OR 1.02, p<0.0001), Manchester Triage System (urgent OR 1.44, p=0.02; immediate/very urgent OR 2.02, p=0.004), baseline C reactive protein (CRP; OR 1.002, p=0.009) and antecedent of kidney disease (OR 1.58, p=0.04)CONCLUSIONS:
Mortality in hospitalised patients with COVID-19 in this emerging country centre seemed to be higher than in developed countries. Patients displayed a high frequency of risk factors for poor outcome, but the need for IMV, ICU admission, older age, more severe disease at admission, antecedent of kidney disease and higher CRP levels significantly predicted mortality.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adult
/
Aged
/
Humans
/
Male
Country/Region as subject:
Mexico
Language:
English
Journal:
BMJ Open
Year:
2021
Document Type:
Article
Affiliation country:
Bmjopen-2021-050321
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