Outcomes of patients with COVID-19 in the intensive care unit in Mexico: A multicenter observational study.

Autor: Ñamendys-Silva SA; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14000, Mexico; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico. Electronic address: snamendys@gmail.com., Alvarado-Ávila PE; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14000, Mexico., Domínguez-Cherit G; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14000, Mexico; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico., Rivero-Sigarroa E; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14000, Mexico., Sánchez-Hurtado LA; Hospital de Especialidades del Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico., Gutiérrez-Villaseñor A; Hospital Médica Sur, Mexico City, Mexico., Romero-González JP; Hospital Médica Sur, Mexico City, Mexico., Rodríguez-Bautista H; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14000, Mexico., García-Briones A; Hospital Médica Sur, Mexico City, Mexico., Garnica-Camacho CE; Hospital General de Zona No.1 'Dr. Enrique Von Borstel Labastida', IMSS, La Paz, Baja California Sur, Mexico., Cruz-Ruiz NG; Hospital General de Zona No. 1, 'Dr. Demetrio Mayoral Pardo', IMSS, Oaxaca, Mexico., González-Herrera MO; Hospital General de Zona 1, IMSS, Tlaxcala, Mexico., García-Guillén FJ; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico., Guerrero-Gutiérrez MA; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico., Salmerón-González JD; Hospital General 'Dr. Miguel Silva', Morelia, Michoacán, Mexico., Romero-Gutiérrez L; Hospital de Especialidades del Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico., Canto-Castro JL; Unidad Médica de Alta Especialidad 'Ignacio García Téllez', IMSS, Mérida, Yucatán, Mexico., Cervantes VH; Hospital General Regional No. 58, IMSS, León, Guanajuato, Mexico.
Jazyk: angličtina
Zdroj: Heart & lung : the journal of critical care [Heart Lung] 2021 Jan - Feb; Vol. 50 (1), pp. 28-32. Date of Electronic Publication: 2020 Oct 21.
DOI: 10.1016/j.hrtlng.2020.10.013
Abstrakt: Background: As of June 15, 2020, a cumulative total of 7,823,289 confirmed cases of COVID-19 have been reported across 216 countries and territories worldwide. However, there is little information on the clinical characteristics and outcomes of critically ill patients with severe COVID-19 who were admitted to intensive care units (ICUs) in Latin America. The present study evaluated the clinical characteristics and outcomes of critically ill patients with severe COVID-19 who were admitted to ICUs in Mexico.
Methods: This was a multicenter observational study that included 164 critically ill patients with laboratory-confirmed COVID-19 who were admitted to 10 ICUs in Mexico, from April 1 to April 30, 2020. Demographic data, comorbid conditions, clinical presentation, treatment, and outcomes were collected and analyzed. The date of final follow-up was June 4, 2020.
Results: A total of 164 patients with severe COVID-19 were included in this study. The mean age of patients was 57.3 years (SD 13.7), 114 (69.5%) were men, and 6.0% were healthcare workers. Comorbid conditions were common in patients with critical COVID-19: 38.4% of patients had hypertension and 32.3% had diabetes. Compared to survivors, nonsurvivors were older and more likely to have diabetes, hypertension or other conditions. Patients presented to the hospital a median of 7 days (IQR 4.5-9) after symptom onset. The most common presenting symptoms were shortness of breath, fever, dry cough, and myalgias. One hundred percent of patients received invasive mechanical ventilation for a median time of 11 days (IQR 6-14). A total of 139 of 164 patients (89.4%) received vasopressors, and 24 patients (14.6%) received renal replacement therapy during hospitalization. Eighty-five (51.8%) patients died at or before 30 days, with a median survival of 25 days. Age (OR, 1.05; 95% CI, 1.02-1.08; p<0.001) and C-reactive protein levels upon ICU admission (1.008; 95% CI, 1.003-1.012; p<0.001) were associated with a higher risk of in-hospital death. ICU length of stay was associated with reduced in-hospital mortality risk (OR, 0.89; 95% CI, 0.84-0.94; p<0.001).
Conclusions: This observational study of critically ill patients with laboratory-confirmed COVID-19 who were admitted to the ICU in Mexico demonstrated that age and C-reactive protein level upon ICU admission were associated with in-hospital mortality, and the overall hospital mortality rate was high.
Trial Registration: ClinicalTrials.gov, NCT04336345.
Competing Interests: Declarations of Competing Interest The authors state that there are no conflicts of interest related to this study.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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