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Tuberc Respir Dis > Accepted Articles
DOI: https://doi.org/10.4046/trd.2020.0095    [Accepted]
Published online October 30, 2020.
Risk factors for mortality among hospitalized patients with COVID-19. An overview in Mexican population
Arturo Cortés-Tellés, 1, Stephanie López-Romero, 2, Roberto Mancilla-Ceballos, 2, Diana Lizbeth Ortíz-Farías, 1, Nelda Núñez-Caamal, 3, Esperanza Figueroa-Hurtado, 1
1Respiratory and Thoracic Surgery Unit. The COVID-19 Group Network. Hospital Regional de Alta Especialidad de la Peninsula de Yucatan. Yucatan, Mexico
2Internal Medicine Department. The COVID-19 Group Network. Hospital Regional de Alta Especialidad de la Peninsula de Yucatan. Yucatan, Mexico
3Epidemiology Department. The COVID-19 Group Network. Hospital Regional de Alta Especialidad de la Peninsula de Yucatan. Yucatan, Mexico
Correspondence:  Arturo Cortés-Tellés, Tel: + 52 (999) 9427600. Extension , 
Email: dr_morenheim@hotmail.com
Received: 15 August 2020   • Revised: 14 September 2020   • Accepted: 29 October 2020
Abstract
Background
Currently, Mexico ranks 3rd worldwide in mortality due to COVID-19 and reliable information is scarce with available data focused on epidemiological characteristics. This study aimed to identify risk factors associated with mortality and outcomes among hospitalized Mexican patients with COVID-19.
Methods
We prospectively assessed patients admitted to a COVID-19 reference center in the southeast of Mexico between March 28th and June 30th, 2020. Mortality was defined as survivor or non-survivor and univariate and multivariate logistic regression analysis were performed to explore the association of clinical characteristics and laboratory parameters with mortality.
Results
We included 200 patients with a mean age of 55 years, 69% were men, 72% had at least one chronic comorbidity. Eighty-six patients required invasive mechanical ventilation (IMV) with an overall mortality rate of 82.5%. Only 51% of patients with IMV had Intensive Care Unit (ICU) admission, with a survival rate of 27.3%, but only 7.2% for Non-ICU admission (p<0.014). The multivariate analysis found that Neutrophil-to-Lymphocyte Ratio ≥ 9 (OR 4.64, 95% CI 2.05-10.53) albumin < 3.5gr/dL (OR 3.76, 95% CI 1.56-9.07), LDH ≥ 725 U/L (OR 5.45, 95% CI 2.36-12.57) and IMV (OR 64.7; 95% CI 15.20-275.39) were independent risk factors associated with mortality.
Conclusion
NLR, LDH, albumin and IMV are independent risk factors for mortality in Mexican patients with COVID-19. Also, availability of ICU resources is invaluable for better outcomes of critically ill patients. Our results could provide clinical information for timely decision-making in low and middle-income countries to overcome the pandemic.
Key Words: COVID-19, Mortality, Risk Factors, Hospitalization, ICUs, Mexico


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