tetano
Editor, Senior Moderator
Int J Clin Pract
. 2021 Sep 26;e14919.
doi: 10.1111/ijcp.14919. Online ahead of print.
Clinical Characteristics and In-Hospital Mortality of Patients with COVID-19 in Chile: A Prospective Cohort Study
Francisco J González[SUP] 1 2 [/SUP], Fabián A Miranda[SUP] 1 2 3 [/SUP], Sebastián M Chávez[SUP] 1 2 3 [/SUP], Abraham I Gajardo[SUP] 1 3 [/SUP], Ariane R Hernández[SUP] 1 2 3 [/SUP], Dannette V Guiñez[SUP] 1 2 3 [/SUP], Gonzalo A Díaz[SUP] 1 2 3 [/SUP], Natalia V Sarmiento[SUP] 1 2 [/SUP], Fernando E Ihl[SUP] 1 2 [/SUP], María A Cerda[SUP] 1 2 3 [/SUP], Camila S Valencia[SUP] 1 2 3 [/SUP], Rodrigo A Cornejo[SUP] 1 3 [/SUP]
Affiliations
Abstract
Aims of this study: To describe the Latin American population affected by COVID-19, and to determine relevant risk factors for in-hospital mortality.
Methods: We prospectively registered relevant clinical, laboratory, and radiological data of adult patients with COVID-19, admitted within the first 100 days of the pandemic from a single teaching hospital in Santiago, Chile. The primary outcome was in-hospital mortality. Secondary outcomes included the need for respiratory support and pharmacological treatment, among others. We combined the chronic disease burden and the severity of illness at admission with predefined clinically relevant risk factors. Cox regression models were used to identify risk factors for in-hospital mortality.
Results: We enrolled 395 adult patients, their median age was 61 years; 62.8% of patients were male and 40.1% had a Modified Charlson Comorbidity Index (MCCI) ≥5. Their median Sequential Organ Failure Assessment (SOFA) score was 3; 34.9% used a high-flow nasal cannula and 17.5% required invasive mechanical ventilation. The in-hospital mortality rate was 14.7%. In the multivariate analysis, were significant risk factors for in-hospital mortality: MCCI ≥5 (HR 4.39, p < 0.001), PaO[SUB]2[/SUB] /FiO[SUB]2[/SUB] ratio ≤200 (HR 1.92, p-value = 0.037), and advanced chronic respiratory disease (HR 3.24, p = 0.001); pre-specified combinations of these risk factors in four categories was associated with the outcome in a graded manner.
Conclusions and clinical implications: The relationship between multiple prognostic factors has been scarcely reported in Latin American patients with COVID-19. By combining different clinically relevant risk factors, we can identify COVID-19 patients with high-, medium-, and low-risk of in-hospital mortality.
Keywords: COVID-19; Charlson Index; Coronavirus disease 2019; Latin American; MCCI; Modified Charlson Comorbidity Index; in-hospital mortality.
. 2021 Sep 26;e14919.
doi: 10.1111/ijcp.14919. Online ahead of print.
Clinical Characteristics and In-Hospital Mortality of Patients with COVID-19 in Chile: A Prospective Cohort Study
Francisco J González[SUP] 1 2 [/SUP], Fabián A Miranda[SUP] 1 2 3 [/SUP], Sebastián M Chávez[SUP] 1 2 3 [/SUP], Abraham I Gajardo[SUP] 1 3 [/SUP], Ariane R Hernández[SUP] 1 2 3 [/SUP], Dannette V Guiñez[SUP] 1 2 3 [/SUP], Gonzalo A Díaz[SUP] 1 2 3 [/SUP], Natalia V Sarmiento[SUP] 1 2 [/SUP], Fernando E Ihl[SUP] 1 2 [/SUP], María A Cerda[SUP] 1 2 3 [/SUP], Camila S Valencia[SUP] 1 2 3 [/SUP], Rodrigo A Cornejo[SUP] 1 3 [/SUP]
Affiliations
- PMID: 34564929
- DOI: 10.1111/ijcp.14919
Abstract
Aims of this study: To describe the Latin American population affected by COVID-19, and to determine relevant risk factors for in-hospital mortality.
Methods: We prospectively registered relevant clinical, laboratory, and radiological data of adult patients with COVID-19, admitted within the first 100 days of the pandemic from a single teaching hospital in Santiago, Chile. The primary outcome was in-hospital mortality. Secondary outcomes included the need for respiratory support and pharmacological treatment, among others. We combined the chronic disease burden and the severity of illness at admission with predefined clinically relevant risk factors. Cox regression models were used to identify risk factors for in-hospital mortality.
Results: We enrolled 395 adult patients, their median age was 61 years; 62.8% of patients were male and 40.1% had a Modified Charlson Comorbidity Index (MCCI) ≥5. Their median Sequential Organ Failure Assessment (SOFA) score was 3; 34.9% used a high-flow nasal cannula and 17.5% required invasive mechanical ventilation. The in-hospital mortality rate was 14.7%. In the multivariate analysis, were significant risk factors for in-hospital mortality: MCCI ≥5 (HR 4.39, p < 0.001), PaO[SUB]2[/SUB] /FiO[SUB]2[/SUB] ratio ≤200 (HR 1.92, p-value = 0.037), and advanced chronic respiratory disease (HR 3.24, p = 0.001); pre-specified combinations of these risk factors in four categories was associated with the outcome in a graded manner.
Conclusions and clinical implications: The relationship between multiple prognostic factors has been scarcely reported in Latin American patients with COVID-19. By combining different clinically relevant risk factors, we can identify COVID-19 patients with high-, medium-, and low-risk of in-hospital mortality.
Keywords: COVID-19; Charlson Index; Coronavirus disease 2019; Latin American; MCCI; Modified Charlson Comorbidity Index; in-hospital mortality.