tetano
Editor, Senior Moderator
Rev Invest Clin
. 2020;72(3):165-177.
doi: 10.24875/RIC.20000211.
CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF PATIENTS DIAGNOSED WITH COVID-19 IN A TERTIARY CARE CENTER IN MEXICO CITY: A PROSPECTIVE COHORT STUDY
Edgar Ortiz-Brizuela[SUP] 1 [/SUP], Marco Villanueva-Reza[SUP] 1 [/SUP], Mar?a F Gonz?lez-Lara[SUP] 1 [/SUP], Karla M Tamez-Torres[SUP] 1 [/SUP], Carla M Rom?n-Montes[SUP] 1 [/SUP], Bruno A D?az-Mej?a[SUP] 2 [/SUP], Esteban P?rez-Garc?a[SUP] 1 [/SUP], Antonio Olivas-Mart?nez[SUP] 2 [/SUP], Sandra Rajme-L?pez[SUP] 1 [/SUP], Bernardo A Martinez-Guerra[SUP] 1 [/SUP], Nereyda A de-Le?n-Cividanes[SUP] 1 [/SUP], Oscar A Fern?ndez-Garc?a[SUP] 1 [/SUP], Lorena Guerrero-Torres[SUP] 1 [/SUP], Lorena Torres-Gonz?lez[SUP] 1 [/SUP], Fabi?n A Carrera-Pati?o[SUP] 1 [/SUP], Ever A Corral-Herrera[SUP] 1 [/SUP], Aldo N Hern?ndez-Alem?n[SUP] 1 [/SUP], Maria de Los ? Tovar-Vargas[SUP] 1 [/SUP], Yamile G Serrano-Pinto[SUP] 1 [/SUP], Cristian E Espejo-Ortiz[SUP] 1 [/SUP], Mar?a de la L Morales-Ortega[SUP] 2 [/SUP], ?scar A Lozano-Cruz[SUP] 2 [/SUP], Jos? L C?rdenas-Fragoso[SUP] 2 [/SUP], Jos? de J Vidal-Mayo[SUP] 3 [/SUP], Thierry Hern?ndez-Gilsoul[SUP] 3 [/SUP], Eduardo Rivero-Sigarroa[SUP] 4 [/SUP], Guillermo Dom?nguez-Cherit[SUP] 4 [/SUP], Luz E Cervantes-Villar[SUP] 2 [/SUP], Maria Del P Ramos-Cervantes[SUP] 2 [/SUP], Violeta Ibarra-Gonz?lez[SUP] 2 [/SUP], Juan J Calva-Mercado[SUP] 1 [/SUP], Juan G Sierra-Madero[SUP] 1 [/SUP], ?lvaro L?pez-??iguez[SUP] 1 [/SUP], Eric Ochoa-Hein[SUP] 1 [/SUP], Brenda E Crabtree-Ram?rez[SUP] 1 [/SUP], Arturo Galindo-Fraga[SUP] 5 [/SUP], Mar?a de L Guerrero-Almeida[SUP] 1 [/SUP], Guillermo M Ruiz-Palacios[SUP] 1 [/SUP], Alfonso Gul?as-Herrero[SUP] 2 [/SUP], Jos? Sifuentes-Osornio[SUP] 2 [/SUP], David Kershenobich-Stalnikowitz[SUP] 6 [/SUP], Alfredo Ponce-de-Le?n[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic.
Objective: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC).
Methods: We conducted a prospective cohort, including consecutive patients with COVID-19 from February 26, 2020 to April 11, 2020.
Results: We identified 309 patients (140 inpatients and 169 outpatients). The median age was 43 years (interquartile range, 33-54), 59.2% men, and 18.6% healthcare workers (12.3% from our center). The median body mass index (BMI) was 29.00 kg/m[SUP]2[/SUP] and 39.6% had obesity. Compared to outpatients, inpatients were older, had comorbidities, cough, and dyspnea more frequently. Twenty-nine (20.7%) inpatients required treatment in the IC unit (ICU). History of diabetes (type 1 or 2) and abdominal pain were more common in ICU patients compared to non-ICU patients. ICU patients had higher BMIs, higher respiratory rates, and lower room-air capillary oxygen saturations. ICU patients showed a more severe inflammatory response as assessed by white blood cell count, neutrophil and platelet count, C-reactive protein, ferritin, procalcitonin, and albumin levels. By the end of the study period, 65 inpatients had been discharged because of improvement, 70 continued hospitalized, and five had died.
Conclusions: Patients with comorbidities, either middle-age obese or elderly complaining of fever, cough, or dyspnea, were more likely to be admitted. At admission, patients with diabetes, high BMI, and clinical or laboratory findings consistent with a severe inflammatory state were more likely to require IC.
Keywords: 2019-novel coronavirus; Cohort; Coronavirus; Coronavirus disease-2019; Mexico; Severe acute respiratory syndrome coronavirus 2.
. 2020;72(3):165-177.
doi: 10.24875/RIC.20000211.
CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF PATIENTS DIAGNOSED WITH COVID-19 IN A TERTIARY CARE CENTER IN MEXICO CITY: A PROSPECTIVE COHORT STUDY
Edgar Ortiz-Brizuela[SUP] 1 [/SUP], Marco Villanueva-Reza[SUP] 1 [/SUP], Mar?a F Gonz?lez-Lara[SUP] 1 [/SUP], Karla M Tamez-Torres[SUP] 1 [/SUP], Carla M Rom?n-Montes[SUP] 1 [/SUP], Bruno A D?az-Mej?a[SUP] 2 [/SUP], Esteban P?rez-Garc?a[SUP] 1 [/SUP], Antonio Olivas-Mart?nez[SUP] 2 [/SUP], Sandra Rajme-L?pez[SUP] 1 [/SUP], Bernardo A Martinez-Guerra[SUP] 1 [/SUP], Nereyda A de-Le?n-Cividanes[SUP] 1 [/SUP], Oscar A Fern?ndez-Garc?a[SUP] 1 [/SUP], Lorena Guerrero-Torres[SUP] 1 [/SUP], Lorena Torres-Gonz?lez[SUP] 1 [/SUP], Fabi?n A Carrera-Pati?o[SUP] 1 [/SUP], Ever A Corral-Herrera[SUP] 1 [/SUP], Aldo N Hern?ndez-Alem?n[SUP] 1 [/SUP], Maria de Los ? Tovar-Vargas[SUP] 1 [/SUP], Yamile G Serrano-Pinto[SUP] 1 [/SUP], Cristian E Espejo-Ortiz[SUP] 1 [/SUP], Mar?a de la L Morales-Ortega[SUP] 2 [/SUP], ?scar A Lozano-Cruz[SUP] 2 [/SUP], Jos? L C?rdenas-Fragoso[SUP] 2 [/SUP], Jos? de J Vidal-Mayo[SUP] 3 [/SUP], Thierry Hern?ndez-Gilsoul[SUP] 3 [/SUP], Eduardo Rivero-Sigarroa[SUP] 4 [/SUP], Guillermo Dom?nguez-Cherit[SUP] 4 [/SUP], Luz E Cervantes-Villar[SUP] 2 [/SUP], Maria Del P Ramos-Cervantes[SUP] 2 [/SUP], Violeta Ibarra-Gonz?lez[SUP] 2 [/SUP], Juan J Calva-Mercado[SUP] 1 [/SUP], Juan G Sierra-Madero[SUP] 1 [/SUP], ?lvaro L?pez-??iguez[SUP] 1 [/SUP], Eric Ochoa-Hein[SUP] 1 [/SUP], Brenda E Crabtree-Ram?rez[SUP] 1 [/SUP], Arturo Galindo-Fraga[SUP] 5 [/SUP], Mar?a de L Guerrero-Almeida[SUP] 1 [/SUP], Guillermo M Ruiz-Palacios[SUP] 1 [/SUP], Alfonso Gul?as-Herrero[SUP] 2 [/SUP], Jos? Sifuentes-Osornio[SUP] 2 [/SUP], David Kershenobich-Stalnikowitz[SUP] 6 [/SUP], Alfredo Ponce-de-Le?n[SUP] 1 [/SUP]
Affiliations
- PMID: 32584326
- DOI: 10.24875/RIC.20000211
Abstract
Background: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic.
Objective: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC).
Methods: We conducted a prospective cohort, including consecutive patients with COVID-19 from February 26, 2020 to April 11, 2020.
Results: We identified 309 patients (140 inpatients and 169 outpatients). The median age was 43 years (interquartile range, 33-54), 59.2% men, and 18.6% healthcare workers (12.3% from our center). The median body mass index (BMI) was 29.00 kg/m[SUP]2[/SUP] and 39.6% had obesity. Compared to outpatients, inpatients were older, had comorbidities, cough, and dyspnea more frequently. Twenty-nine (20.7%) inpatients required treatment in the IC unit (ICU). History of diabetes (type 1 or 2) and abdominal pain were more common in ICU patients compared to non-ICU patients. ICU patients had higher BMIs, higher respiratory rates, and lower room-air capillary oxygen saturations. ICU patients showed a more severe inflammatory response as assessed by white blood cell count, neutrophil and platelet count, C-reactive protein, ferritin, procalcitonin, and albumin levels. By the end of the study period, 65 inpatients had been discharged because of improvement, 70 continued hospitalized, and five had died.
Conclusions: Patients with comorbidities, either middle-age obese or elderly complaining of fever, cough, or dyspnea, were more likely to be admitted. At admission, patients with diabetes, high BMI, and clinical or laboratory findings consistent with a severe inflammatory state were more likely to require IC.
Keywords: 2019-novel coronavirus; Cohort; Coronavirus; Coronavirus disease-2019; Mexico; Severe acute respiratory syndrome coronavirus 2.