• Bernardo A Martínez-Guerra, Carla Medrano-Borromeo, María F González-Lara, Carla M Román-Montes, Karla M Tamez-Torres, Sandra Rajme-López, Karla D Salgado-Guízar, Noe A Juárez-Menéndez, Pilar Ramos-Cervantes, Guillermo M Ruiz-Palacios, Alfredo Ponce-de-León, and José Sifuentes-Osornio.
• Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
• Rev Invest Clin. 2022 Jan 1; 74 (5): 268-275.

BackgroundPrognostic factors in previously healthy young patients with COVID-19 remained understudied.ObjectivesThe objective of the study was to identify factors associated with in-hospital death or need for invasive mechanical ventilation (IMV) in young (aged ≤ 65 years) and previously healthy patients with COVID-19.MethodsWe conducted a prospective cohort study that included patients admitted with COVID-19. The primary outcome was in-hospital death/need for IMV. Secondary outcomes included need for IMV during follow-up, days on IMV, length of stay (LOS), hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP), and pulmonary embolism (PE). Bivariate and multivariate analyses were performed.ResultsAmong 92 patients, primary outcome occurred in 16 (17%), death in 12 (13%), need for IMV in 16 (17%), HAP/VAP in 7 (8%), and PE in 2 (2%). Median LOS and IMV duration were 7 and 12 days, respectively. Independent associations were found between the primary outcome and male sex (Adjusted odds ratio [aOR] 7.1, 95%CI 1.1-46.0, p < 0.05), D-dimer levels > 1000ng/mL (aOR 9.0, 95%CI 1.6-49.1, p < 0.05), and RT-PCR Ct-value ≤ 24 on initial swab samples (aOR 14.3, 95%CI 2.0-101.5, p < 0.01).ConclusionsIn young and non-comorbid COVID-19 patients, male sex, higher levels of D-dimer, and low SARS-CoV-2 RT-PCR Ct-value on an initial nasopharyngeal swab were independently associated with increased in-hospital mortality or need for IMV. (Rev Invest Clin. 2022;74(5):268-75).Copyright: © 2022 Permanyer.

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