Outcomes of patients with COVID-19 in the intensive care unit in Mexico: A multicenter observational study
Silvio A Ñamendys-Silva, Pedro E Alvarado-Ávila, MD, FCCM Guillermo Domínguez-Cherit, MD Eduardo Rivero-Sigarroa, Luis A Sánchez-Hurtado, Alan Gutiérrez-Villaseñor, Juan P Romero-González, MD a , Heber Rodríguez-Bautista, MD Alondra García-Briones, César E Garnica-Camacho, Néstor G Cruz-Ruiz, María O González-Herrera, Francisco J García-Guillén, Manuel A Guerrero-Gutiérrez, José D Salmerón-González, Laura Romero-Gutiérrez, José L Canto-Castro, MD k , Victor H Cervantes
Heart & Lung, doi:10.1016/j.hrtlng.2020.10.013
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 laboratoryconfirmed 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 4.5À9) 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 6À14). 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, 1.02À1.08; p<0.001) and C-reactive protein levels upon ICU admission (1.008; 95% CI, 1.003À1.012; 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, 0.84À0.94; p<0.001).
Author contributions
Dr e Namendys-Silva had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: e Namendys-Silva, Dominguez-Cherit Acquisition of data: All authors Statistical analysis: e Namendys-Silva.
Drafting of the manuscript: e Namendys-Silva, Alvarado-Avila, Dominguez-Cherit, Rivero-Sigarroa Critical revision of the manuscript for important intellectual content: All authors.
Declarations of Competing Interest The authors state that there are no conflicts of interest related to this study.
Supplementary materials Supplementary material associated with this article can be found in the online version at doi:10.1016/j.hrtlng.2020.10.013.
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