ABSTRACT
INTRODUCTION: The emergence of COVID-19 represents the most significant health crisis in recent history. Incidence and mortality rates depend on several factors. Many studies have focused on investigating which characteristics could be strongly related to higher mortality and lethality. OBJECTIVE: This study aims to analyze the variables associated with in-hospital mortality among patients admitted in a reference northeastern region of a Colombian institution. METHODS: An ambidirectional cohort, single-center study was carried out in a reference hospital in northeastern Colombia. All patients admitted to the Fundación Oftalmológica de Santander (FOSCAL) between March 2020 and September 2021, with COVID-19 real-time polymerase chain reaction (PCR) positive test, were included. RESULTS: A total of 3,028 patients were included, of whom 2,034 (67.8%) survived and 994 (32.8%) died during their hospital stay; 48.8% (1,479) of the patients were female. The most common comorbidities were hypertension (1,236 patients, 40.8%), obesity (body mass index (BMI) ≥ 30; 656 patients, 21.6%), and diabetes (618 patients, 20.4%). The average age of the surviving patients was 52.2 years, while for the deceased patients, it was 70.3 years. The variables that showed significant association with in-hospital mortality were as follows: male sex ≥ 45 years, dyspnea, oxygen saturation (SatO2) < 85%, hypertension, chronic kidney disease (CKD), and a Charlson Comorbidity Index (CCI) score of >1. CONCLUSIONS: Male sex, age ≥ 45 years, dyspnea, SatO2 < 85%, hypertension, CKD, and a CCI score of >1 were associated with a higher risk of in-hospital mortality in COVID-19-infected patients.
ABSTRACT
Introduction and Objective: Metabolic syndrome (MetS) represents a group of metabolic abnormalities. It is currently a pandemic, and its prevalence is on the rise. MetS has a direct relationship with obesity, for this reason, bariatric and metabolic surgery has been proposed as a method to simultaneously control obesity and MetS. However, in Colombia the results of this intervention are unknown. This study aims to compare metabolic syndrome before and after bariatric surgery in a Colombian population. Methods: Retrospective cohort study conducted in a highly complex institution in Colombia, where comparing the prevalence of metabolic syndrome in patients who underwent bariatric surgery during a 1-year follow-up period, between January 2015 and December 2019. Of these patients, 48 underwent Roux-en-Y gastric bypass, and 32 underwent sleeve gastrectomy by laparoscopic technique. Results: A total of 80 patients were included, of which 67.5% were women and the mean age was 42.8 ± 12.9 years. The most frequent preprocedure comorbidities were arterial hypertension (36.2%), dyslipidemia (32.4%), and sleep apnea (20%). After bariatric surgery, the prevalence of metabolic syndrome decreased from 66.2% to 3.7% (p < 0.05). In addition, a reduction in the Homeostatic Model Assessment for Insulin Resistance score from 77.5% to 22.5% was observed during the follow-up period. HbA1c, creatinine, and thyroid-stimulating hormone, were the only parameters without significant changes. Conclusions: Metabolic and bariatric surgery is an effective treatment for weight reduction, with a high impact in reducing the prevalence of metabolic syndrome and insulin resistance in the short and medium term in the Colombian population.