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Revista médica de Chile · Sep 2023
[Severity of community-acquired pneumonia due to coronavirus SARS-CoV-2 in immunocompetent hospitalized adult patients].
- PeñafielFernando SaldíasFSDepartamento de Enfermedades Respiratorias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., TapiaAlejandro PeñalozaAP, NesvadbaDaniela FaríasDF, OksenbergKatia FarcasKF, SánchezAntonia ReyesAR, MezaJosefina CortésJC, Gerardo Salinas Rossel, and RodríguezIsabel LeivaILDepartamento de Enfermedades Respiratorias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile..
- Departamento de Enfermedades Respiratorias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Rev Med Chil. 2023 Sep 1; 151 (9): 120712201207-1220.
UnlabelledThe acute respiratory illness caused by coronavirus SARS-CoV-2 (COVID-19) has spread throughout the world, causing significant morbidity and mortality.ObjectivesTo assess clinical and laboratory variables measured at hospital admission associated with clinically relevant adverse outcomes in patients hospitalized with community-acquired pneumonia caused by coronavirus SARSCoV-2.MethodsWe conducted a descriptive prospective study in adult patients hospitalized due to COVID-19-associated pneumonia at the UC Christus Health Network. The adverse events examined were ICU admission, need for mechanical ventilation, prolonged length of stay, and hospital mortality. We analyzed predictive variables using univariate and multivariate analysis in a logistic regression model.ResultsWe evaluated 710 COVID-19-associated pneumonia hospitalized patients aged 59 ± 17 years; 55% were males. 76% of the cohort presented comorbidities, mainly hypertension (45%), diabetes (24%), and hypothyroidism (10%); 42% of the cohort received treatment in critical care units, 16.3% required mechanical ventilation, the mean hospital stay was 15 days, and 11.4% died in the hospital. Age, comorbidities, especially cardiovascular, metabolic, and chronic kidney disease, altered mental status and vital signs (tachypnea, hypoxemia) at hospital admission, renal failure, and elevated biomarkers of systemic inflammation were associated with ICU admission, prolonged hospital stay, and death. Men had a higher risk of ICU admission, connection to mechanical ventilation, and prolonged hospital stay but did not have higher fatalities.ConclusionAge, male sex, comorbidities, altered mental status and vital signs, renal dysfunction, and elevation of inflammatory parameters were associated with a higher risk of severe COVID-19. These may serve as useful baseline parameters in developing prediction tools for COVID-19 prognosis.
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