Severe SARS-CoV-2 infection: Mortality and comorbidities in a third level hospital in San Luis Potosi, Mexico

Authors

  • Garcia-Ruiz R Facultad de Medicina, Universidad Naciona Autónoma de México. CDMX, México
  • Benitez-Arvizu G Banco de Sangre, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, CDMX, México
  • Salas-Rojas M Unidad de Investigación Médica en Inmunología, UMAE Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, CDMX, México
  • Galvez-Romero G Unidad de Investigación Médica en Inmunología, UMAE Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, CDMX, México
  • Flores- Ramirez R Coordinación para la Innovación de la Aplicación de la Ciencia y Tecnología, Universidad Autónoma de San Luis Potosí, Mexico
  • Diaz-Barriga F Coordinación para la Innovación de la Aplicación de la Ciencia y Tecnología, Universidad Autónoma de San Luis Potosí, Mexico
  • Perez-Vazquez F Coordinación para la Innovación de la Aplicación de la Ciencia y Tecnología, Universidad Autónoma de San Luis Potosí, Mexico
  • Alcantara Quintana LE Coordinación para la Innovación de la Aplicación de la Ciencia y Tecnología, Universidad Autónoma de San Luis Potosí, Mexico

Abstract

The high rates of hypertension, obesity and diabetes in San Luis Potosí are worrying, since it has been
shown that the existence of comorbidities associated with SARS-CoV-2 infection increases the risk of
mortality, however most of the evidence comes from of other populations in the world for which it is
necessary other investigations that focus on the Mexican population, in this case potosine. The objective
of this study is to describe the clinical and respiratory characteristics of seriously ill and deceased patients
with COVID-19, in a state in northeastern Mexico. And determine comorbidities, in order to apply
better measures aimed at safeguarding the population at risk. Design: prospective and observational
in the same medical center. Methods: Different types of variables, such as demographic data, severity,
laboratory variables, ventilatory assistance received (high-flow oxygen therapy [HFO] and invasive
mechanical ventilation [IMV]), oxygenation (PaO2, PaO2/FiO2), comorbidities and complications were
automatically obtained. In order to analyze the difference between medians, the Fisher test (categorical
variables) and the Mann-Whitney U test were used. A value of p <0.001 was considered significant.
Results: 163 patients were included (G1 = 51 [31.2%]; G2 = 92 [56.44%] and G3 = 20 [31.74%]); age
65 (52-72) years; 68% men, APACHE II 18 (15 -24); SOFA 6 (4-7); arterial hypertension (25.11%) and
obesity (16.82%) were the most frequent comorbidities. HFO was used in 62.7% of the patients, 85%
failed. 95% of the patients required IMV and 85% ventilation in the prone position. In the population,
baseline PaO2/FiO2 improved at the 7th day (165 [125-210] vs 194 [153-285]; p = 0.02), as in G1 (164
[125-197] vs 207 [160-294]; p = 0.07), but not in G2 (163 [95-197] vs. 135 [85-177]). The development
of pneumonia associated with IMV was high. The amount of D-dimer and IL-6 was also significantly
increased in patients who died on the 7th day of the study. Conclusions: The lack of improvement in
PaO2/FiO2 at the 7th day could be a prognostic marker for deterioration, as well as D-dimer and IL-6
secretion. Special attention needs to be paid to managing hypertension and diabetes in adults over 60
years of age. Which was the age group with the highest mortality. .

Downloads

Published

2021-05-18

Issue

Vol. 1 No. 2

Section

Articles