tetano
Editor, Senior Moderator
Ther Adv Infect Dis
. 2021 Aug 27;8:20499361211040325.
doi: 10.1177/20499361211040325. eCollection Jan-Dec 2021.
Impact of preemptive hospitalization on health outcomes at the temporary COVID-19 hospital in Mexico City: a prospective observational study
Rafael Ricardo Valdez Vazquez[SUP] 1 [/SUP], Héctor Gallardo-Rincón[SUP] 2 [/SUP], Julieta Lomelín-Gascon[SUP] 1 [/SUP], Rodrigo Ville Benavides[SUP] 1 [/SUP], Linda Morales Juárez[SUP] 1 [/SUP], Héctor Herrera Bello[SUP] 1 [/SUP], Lidia Moreno Castañeda[SUP] 1 [/SUP], Adrian Palacios Chavarria[SUP] 1 [/SUP], Pablo Escalera Castillo[SUP] 1 [/SUP], Luis Esteban Ramirez Gonzalez[SUP] 1 [/SUP], Mónica Arboleya Avendaño[SUP] 1 [/SUP], Santiago Treviño Berlanga[SUP] 1 [/SUP], Reyna Albertina Rosas Loza[SUP] 1 [/SUP], Renate Victoria Álvarez Wyssmann[SUP] 1 [/SUP], Erika Salinas Lezama[SUP] 1 [/SUP], Alonso Gutiérrez Romero[SUP] 1 [/SUP], María Dolores Niembro Ortega[SUP] 1 [/SUP], Liudmila Villegas Acosta[SUP] 1 [/SUP], Ailyn Cendejas Schotman[SUP] 1 [/SUP], Jennifer Bertin Montoya[SUP] 1 [/SUP], Andrea Gonzalez Rodriguez[SUP] 1 [/SUP], Laura María Badel Ramos[SUP] 1 [/SUP], Luis Alberto Martinez-Juarez[SUP] 3 [/SUP], Rodrigo Saucedo-Martínez[SUP] 3 [/SUP], Alejandra Montoya[SUP] 3 [/SUP], Roberto Tapia-Conyer[SUP] 3 [/SUP]
Affiliations
Abstract
Introduction: In response to the evolution of the coronavirus disease 2019 (COVID-19) pandemic, the admission protocol for the temporary COVID-19 hospital in Mexico City has been updated to hospitalize patients preemptively with an oxygen saturation (SpO[SUB]2[/SUB]) of >90%.
Methods: This prospective, observational, single-center study compared the progression and outcomes of patients who were preemptively hospitalized versus those who were hospitalized based on an SpO[SUB]2[/SUB] ⩽90%. We recorded patient demographics, clinical characteristics, COVID-19 symptoms, and oxygen requirement at admission. We calculated the risk of disease progression and the benefit of preemptive hospitalization, stratified by CALL Score: age, lymphocyte count, and lactate dehydrogenase (<8 and ⩾8) at admission.
Results: Preemptive hospitalization significantly reduced the requirement for oxygen therapy (odds ratio 0.45, 95% confidence interval 0.31-0.66), admission to the intensive care unit (ICU) (0.37, 0.23-0.60), requirement for invasive mechanical ventilation (IMV) (0.40, 0.25-0.64), and mortality (0.22, 0.10-0.50). Stratification by CALL score at admission showed that the benefit of preemptive hospitalization remained significant for patients requiring oxygen therapy (0.51, 0.31-0.83), admission to the ICU (0.48, 0.27-0.86), and IMV (0.51, 0.28-0.92). Mortality risk remained significantly reduced (0.19, 0.07-0.48).
Conclusion: Preemptive hospitalization reduced the rate of disease progression and may be beneficial for improving COVID-19 patient outcomes.
Keywords: CALL score; COVID-19; HFNC; IMV; Mexico; SARS-CoV-2; preemptive hospitalization; pulse oximetry; temporary hospital.
. 2021 Aug 27;8:20499361211040325.
doi: 10.1177/20499361211040325. eCollection Jan-Dec 2021.
Impact of preemptive hospitalization on health outcomes at the temporary COVID-19 hospital in Mexico City: a prospective observational study
Rafael Ricardo Valdez Vazquez[SUP] 1 [/SUP], Héctor Gallardo-Rincón[SUP] 2 [/SUP], Julieta Lomelín-Gascon[SUP] 1 [/SUP], Rodrigo Ville Benavides[SUP] 1 [/SUP], Linda Morales Juárez[SUP] 1 [/SUP], Héctor Herrera Bello[SUP] 1 [/SUP], Lidia Moreno Castañeda[SUP] 1 [/SUP], Adrian Palacios Chavarria[SUP] 1 [/SUP], Pablo Escalera Castillo[SUP] 1 [/SUP], Luis Esteban Ramirez Gonzalez[SUP] 1 [/SUP], Mónica Arboleya Avendaño[SUP] 1 [/SUP], Santiago Treviño Berlanga[SUP] 1 [/SUP], Reyna Albertina Rosas Loza[SUP] 1 [/SUP], Renate Victoria Álvarez Wyssmann[SUP] 1 [/SUP], Erika Salinas Lezama[SUP] 1 [/SUP], Alonso Gutiérrez Romero[SUP] 1 [/SUP], María Dolores Niembro Ortega[SUP] 1 [/SUP], Liudmila Villegas Acosta[SUP] 1 [/SUP], Ailyn Cendejas Schotman[SUP] 1 [/SUP], Jennifer Bertin Montoya[SUP] 1 [/SUP], Andrea Gonzalez Rodriguez[SUP] 1 [/SUP], Laura María Badel Ramos[SUP] 1 [/SUP], Luis Alberto Martinez-Juarez[SUP] 3 [/SUP], Rodrigo Saucedo-Martínez[SUP] 3 [/SUP], Alejandra Montoya[SUP] 3 [/SUP], Roberto Tapia-Conyer[SUP] 3 [/SUP]
Affiliations
- PMID: 34471535
- PMCID: PMC8404663
- DOI: 10.1177/20499361211040325
Abstract
Introduction: In response to the evolution of the coronavirus disease 2019 (COVID-19) pandemic, the admission protocol for the temporary COVID-19 hospital in Mexico City has been updated to hospitalize patients preemptively with an oxygen saturation (SpO[SUB]2[/SUB]) of >90%.
Methods: This prospective, observational, single-center study compared the progression and outcomes of patients who were preemptively hospitalized versus those who were hospitalized based on an SpO[SUB]2[/SUB] ⩽90%. We recorded patient demographics, clinical characteristics, COVID-19 symptoms, and oxygen requirement at admission. We calculated the risk of disease progression and the benefit of preemptive hospitalization, stratified by CALL Score: age, lymphocyte count, and lactate dehydrogenase (<8 and ⩾8) at admission.
Results: Preemptive hospitalization significantly reduced the requirement for oxygen therapy (odds ratio 0.45, 95% confidence interval 0.31-0.66), admission to the intensive care unit (ICU) (0.37, 0.23-0.60), requirement for invasive mechanical ventilation (IMV) (0.40, 0.25-0.64), and mortality (0.22, 0.10-0.50). Stratification by CALL score at admission showed that the benefit of preemptive hospitalization remained significant for patients requiring oxygen therapy (0.51, 0.31-0.83), admission to the ICU (0.48, 0.27-0.86), and IMV (0.51, 0.28-0.92). Mortality risk remained significantly reduced (0.19, 0.07-0.48).
Conclusion: Preemptive hospitalization reduced the rate of disease progression and may be beneficial for improving COVID-19 patient outcomes.
Keywords: CALL score; COVID-19; HFNC; IMV; Mexico; SARS-CoV-2; preemptive hospitalization; pulse oximetry; temporary hospital.