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Research
Gustavo Lugo-Goytia
INER: Instituto Nacional de Enfermedades Respiratorias
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4591-5285
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This work is licensed under a CC BY 4.0 License. Read Full License
Background
Little literature exists about the experience with critically ill COVID-19 patients from Latin America, despite this is the current epicenter of the pandemic. Here, we aimed to describe the clinical characteristics and risk factors for mortality in mechanically-ventilated COVID-19 patients from Mexico.
Methods
Clinical data from sixty-seven consecutive, mechanically-ventilated COVID-19 patients were analyzed. Patients were grouped according to their clinical outcome (survival vs. death). Clinical risk factors for mortality were identified by machine-learning algorithms and traditional regression analyses.
Results
The median age of study participants was 42 years and 65% were men. The most common comorbidity observed in our study was obesity (49.2%). Fever was the most frequent symptom of illness (88%), followed by dyspnea (84%), and cough (62%). Multilobe ground-glass opacities were observed in 76% of patients by thoracic CT scan. Fifty-two percent of study participants were ventilated in prone position, and 59% required cardiovascular support with norepinephrine. Furthermore, 49% of participants had a coinfection with a second pathogen. Two-thirds of COVID-19 patients developed acute kidney injury (AKIN). Thirty deaths occurred during the study (44.7%). Levels of uric acid, creatinine, bilirubin, and SOFA score, were significantly higher among deceased patients, whereas survivors showed higher PaO2/FiO2 values at admission. AKIN, uric acid, LDH, and a longitudinal increase in ventilatory ratio were associated with mortality. Baseline PaO2/FiO2 values and a longitudinal recovery of lymphocytes were protective factors against mortality.
Conclusions
Our study provides reference data about the clinical phenotype and risk factors for COVID-19-assocaited mortality among mechanically-ventilated Mexican patients.
Keywords
COVID-19, SARS-CoV-2, ARDS, risk factors, mortality
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Gustavo Lugo-Goytia
INER: Instituto Nacional de Enfermedades Respiratorias
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4591-5285
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 23 Nov, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Little literature exists about the experience with critically ill COVID-19 patients from Latin America, despite this is the current epicenter of the pandemic. Here, we aimed to describe the clinical characteristics and risk factors for mortality in mechanically-ventilated COVID-19 patients from Mexico.
Methods
Clinical data from sixty-seven consecutive, mechanically-ventilated COVID-19 patients were analyzed. Patients were grouped according to their clinical outcome (survival vs. death). Clinical risk factors for mortality were identified by machine-learning algorithms and traditional regression analyses.
Results
The median age of study participants was 42 years and 65% were men. The most common comorbidity observed in our study was obesity (49.2%). Fever was the most frequent symptom of illness (88%), followed by dyspnea (84%), and cough (62%). Multilobe ground-glass opacities were observed in 76% of patients by thoracic CT scan. Fifty-two percent of study participants were ventilated in prone position, and 59% required cardiovascular support with norepinephrine. Furthermore, 49% of participants had a coinfection with a second pathogen. Two-thirds of COVID-19 patients developed acute kidney injury (AKIN). Thirty deaths occurred during the study (44.7%). Levels of uric acid, creatinine, bilirubin, and SOFA score, were significantly higher among deceased patients, whereas survivors showed higher PaO2/FiO2 values at admission. AKIN, uric acid, LDH, and a longitudinal increase in ventilatory ratio were associated with mortality. Baseline PaO2/FiO2 values and a longitudinal recovery of lymphocytes were protective factors against mortality.
Conclusions
Our study provides reference data about the clinical phenotype and risk factors for COVID-19-assocaited mortality among mechanically-ventilated Mexican patients.
Figure 1
Figure 1
Figure 2
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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