Factores de riesgo asociado a la mortalidad por Covid-19 en pacientes hospitalizados en el Hospital Regional del Cusco, 2021.

Abstract

Introducción: El COVID-19 es una enfermedad viral causada por el virus SARS-CoV2 que puede causar una enfermedad respiratoria de leve a moderada y se puede recuperar sin requerir tratamiento adicional, a diferencia de las personas mayores, aquellas con afecciones medicas subyacentes que tienen mayor probabilidad de desarrollar una enfermedad grave e incluso morir. El objetivo de este estudio fue identificar los factores de riesgo asociado a la mortalidad por COVID-19 en pacientes hospitalizados en el Hospital Regional del Cusco, 2021. Métodos: Se realizó un estudio casos y controles en 342 pacientes hospitalizados en el Hospital Regional del Cusco, 2021, previo asentimiento informado. Se utilizó medidas de frecuencia (número y %), el OR como medida de asociación y pruebas de significancia estadística (IC 95% y p valor). Resultados: Se encontró asociación entre las comorbilidades (diabetes mellitus (OR=3.677, IC95% [2.089-6.470], p=0.000) e hipertensión arterial (OR= 2.228, IC95% [1.341-3.704], p=0.002)) y manifestaciones clínicas (dificultad respiratoria (OR=2.213, IC95% [1.143-4.283], p=0.016), fiebre (OR=2.111, IC95% [1.267-3.516], p=0.004) y diarrea (OR=1.994, IC95% [1.224-3.249], p=0.005)), datos laboratoriales (PaFio2 leve- severo OR=30.722, IC95% [7.219130.746], p=0.000), ferritina elevada (OR=11.581, IC95% [4.088-32.698], p=0.000), leucocitos

elevados

(OR=11.594), IC95% [6.672-20.146], p=0.000), LDH (OR=3.923, IC95% [2.1957.011], p=0.000), linfopenia (OR=2.680, IC95% [1.426-5.038], p=0.002), procalcitonina elevada

(OR=2.490,

IC95% [1.064-5.829], p=0.033), PCR elevado (OR=1.7, IC95% [1.060-2.972], p=0.029)), compromiso pulmonar severo-critico (OR=53.961, IC95% [25.404-114.620], p=0.000), y complicaciones (SDRA (OR=71.57, IC95% [25.318-202.327], p=0.000), coinfección bacteriana (OR=35.069, IC95% [16.696-73.660], p=0.000), trombosis venosa profunda (OR=26.650, IC95% [6.329-112.212], p=0.000), sepsis (OR=13.719, IC95% [5.313-35.427], p=0.000), hiperglicemia (OR=7.887, IC95% [4.600-13.524], p=0.000), insuficiencia renal aguda (OR=7.404, IC95% [3.956-13.854], p=0.000), neumonía intrahospitalaria (OR=3.424, IC95% [1.785-6.568], p=0.000) y neumotórax (OR=2.377, IC95% [1.090-5.186], p=0.026) y la edad >50 años (OR=7.840, IC95% [4.630-13.276], p=0.000), y la mortalidad por COVID-19. Conclusiones: Son factores de riesgo para la mortalidad por COVID-19: DM y HTA como comorbilidades; dificultad respiratoria, fiebre, diarrea fiebre, manifestaciones clínicas; PaFio2 leve- severo, ferritina elevada, leucocitos totales elevados, LDH elevado, linfopenia, procalcitonina elevada como datos laboratoriales; compromiso pulmonar severo- critico; SDRA, coinfección bacteriana, trombosis venosa profunda, sepsis, hiperglicemia, insuficiencia renal aguda, neumonía intrahospitalaria y neumotórax como complicaciones y edad en los pacientes hospitalizados en el Hospital Regional del Cusco, 2021.

Background: COVID-19 is a viral illness caused by the SARS-CoV2 virus that can cause mild to moderate respiratory illness and can recover without requiring additional treatment, unlike older people, those with underlying medical conditions who are more likely to of developing a serious illness and even dying. The objective of this study was to identify the risk factors associated with mortality from COVID-19 in patients hospitalized at the Regional Hospital of Cusco, 2021.

Methods: A case-control study was carried out on 342 patients hospitalized at the Regional Hospital of Cusco, 2021, after informed consent. Frequency measures (number and %) were used, the OR as a measure of association and statistical significance tests (95% IC and p value).

Results: An association was found between comorbidities (diabetes mellitus (OR=3.677, IC95% [2.089-6.470], p=0.000) and arterial hypertension (OR= 2.228, IC95% [1.341-3.704], p=0.002)) and clinical manifestations. (respiratory difficulty (OR=2.213, IC95% [1.143-4.283], p=0.016), fever (OR=2.111, IC95% [1.267-3.516], p=0.004) and diarrhea (OR=1.994, 95%CI [1.224] 3.249],

p=0.005)) laboratory data (PaFio2 mild-severe (OR=30.722, IC95% [7.219-130.746], p=0.000), elevated ferritin (OR=11.581, IC95% [4.088-32.698], p= 0.000), elevated leukocytes (OR=11.594,IC95% [6.672-20.146], p=0.000), elevated LDH (OR=3.923, IC95% [2.195-7.011], p=0.000), lymphopenia (OR=2.680, IC95% [1.426-5.038], p=0.002), elevated procalcitonin (OR=2.490, IC95% [1.064-5.829], p=0.033), elevated PCR (OR=1.7, IC95% [1.060-2.972], p=0.029)), severe-critical pulmonary involvement (OR=53.961, IC95% [25.404-114.620], p=0.000), and complications (ARDS (OR=71.57, IC95% [25.318-202.327], p=0.000), bacterial coinfection (OR =35.069, IC95%[16.696-73.660], p=0.000), deep vein thrombosis (OR=26.650, IC95% [6.329-112.212], p=0.000), sepsis (OR=13.719, IC95% [5.313-35.427] , p=0.000), hyperglycemia (OR=7.887, IC95% [4.600-13.524], p=0.000), acute renal failure (OR=7.404, IC95% [3.956-13.854], p=0.000), nosocomial pneumonia (OR =3.424, IC95%[1.785-6.568], p=0.000) and pneumothorax (OR=2.377, IC95% [1.090-5.186], p=0.026) and age >50 years (OR=7.840, IC95% [4.630- 13.276], p=0.000), and mortality from COVID-19.

Conclusions: Risk factors for mortality from COVID-19 are: DM and HTA as comorbidities; respiratory distress, fever, diarrhea fever, clinical manifestations; Mild-severe PaFio2, elevated ferritin, elevated total leukocytes, elevated LDH, lymphopenia, elevated procalcitonin as laboratory data; severe-critical lung involvement; ARDS, bacterial coinfection, deep vein thrombosis, sepsis, hyperglycemia, acute renal failure, hospital-acquired pneumonia and pneumothorax as complications and age in patients hospitalized at the Regional Hospital of Cusco, 2021.