Epidemiología y factores de riesgo para cuidados intensivos y mortalidad en pacientes hospitalizados por COVID-19 / Epidemiology and risk factors for intensive care and mortality in COVID-19 hospitalized patients

RESUMEN

INTRODUCCIÓN: El Complejo Hospitalario Universitario Nuestra Señora de Candelaria (CHUNSC) ha sido el hospital con más ingresos COVID-19 de Canarias. OBJETIVO: determinar factores de riesgo de ingreso en Unidad de Cuidados Intensivos (UCI) y mortalidad. MATERIAL Y MÉTODOS: Estudio observacional analítico retrospectivo de pacientes con COVID-19 confirmado, ingresados entre 25 febrero y 31 mayo 2020 en el CHUNSC. RESULTADOS: Ingresaron 264 pacientes, 56,8% hombres, edad media 65,3 años. Tasa de letalidad 15,2%. Factores de riesgo asociados con ingreso en UCI neumonía (OR 2,22, IC 95% 1,08-4,55, p = 0,029) y síndrome de distrés respiratorio agudo (SDRA) (OR 4,94, IC 95% 1,46-16,68; p = 0,010). Factores asociados con mortalidad edad ≥ 60 años (OR 3,94, IC 95% 1,21-12,82, p = 0,023), neumonía (OR 3,38, IC 95% 1,35-8,47, p = 0,009), SDRA (OR 5,84, IC 95% 1,60-21,24, p = 0,007) y enfermedad renal crónica (ERC) (OR 3,74, IC 95% 1,40-9,98, p = 0,009). CONCLUSIONES: Neumonía y SDRA se asociaron con ingreso en UCI. Neumonía, SDRA, edad ≥ 60 años y ERC se asociaron con mayor riesgo de mortalidad

ABSTRACT

INTRODUCTION: Complejo Hospitalario Universitario Nuestra Señora de Candelaria (CHUNSC) had the highest number of COVID-19 admissions in the Canary Islands. Aim of the study was to determine the risk factors for admission to the Intensive Care Unit (ICU) and mortality. METHODS: Retrospective analytical longitudinal study of patients with confirmed COVID-19, hospitalized between February 25 and May 31, 2020, at CHUNSC. RESULTS: In the study period, 264 patients were admitted, 56.8% men, mean age 65.3 years. Most frequent symptoms cough (67%) and fever (59.8%), most frequent comorbidities cardiovascular disease (60.6%) and diabetes (26.5%). Global Case Fatality Rate (CFR) 15.2%. Risk factors associated with ICU admission Pneumonia (OR 2.22, 95%CI 1.08-4.55, p = 0.029) and Acute Respiratory Distress Syndrome (ARDS) (OR 4.94, 95%CI 1.46-16.68; p = 0.010). Risk factors associated with mortality age ≥ 60 years (OR 3.94, 95%CI 1.21-12.82, p = 0.023), pneumonia (OR 3.38, 95%CI 1.35-8.47, p = 0.009), ARDS (OR 5.84, 95%CI 1.60-21.24, p = 0.007) and chronic kidney disease (CKD) (OR 3.74, 95%CI 1.40-9.98, p = 0.009). CONCLUSION: Pneumonia and ARDS were associated with ICU admission. Pneumonia, ARDS, age ≥ 60 years and CKD were associated with mortality