medigraphic.com
ISSN 1729-519X (Impreso)

2021, Número 3

<< Anterior Siguiente >>

Revista Habanera de Ciencias Médicas 2021; 20 (3)


Factores predictivos de evolución no satisfactoria en pacientes infectados por COVID-19 entre 20-65 años

Sosa FA, Vergara SAC, Mojena MO

Idioma: Ingles.
Referencias bibliográficas: 24
Paginas: 1-8
Archivo PDF: 663.55 Kb.


RESUMEN

Introducción: Varios autores validaron el uso de indicadores clínicos, humorales y radiológicos como predictores de evolución no satisfactoria en pacientes con COVID-19.
Objetivo: Evaluar las variables clínica-humorales y los hallazgos del primer rayos-x de tórax, como predictores de evolución no satisfactoria en pacientes con COVID-19.
Material y Métodos: Se realizó un estudio observacional y retrospectivo de casos-controles, a 484 pacientes infectados con COVID-19 admitidos en el Hospital Cubano de Catar, entre marzo y julio de 2020. La muestra 60 pacientes. Casos: pacientes con insuficiencia respiratoria que necesitaron ventilación invasiva o muerte. Controles: enfermos con COVID-19 sin complicaciones. Variables de entrada: edad, sexo, IMC, presencia de comorbilidades, valor del leucocito e índice de severidad del primer rayos-x de tórax. Variable respuesta: evolución clínica. El análisis bi-variado se realizó mediante la prueba Chi-cuadrado. El análisis multivariado, mediante regresión logística binaria, p valores inferiores a 0,05 se consideraron como significativo. Los resultados se expresaron en Odd Ratio.
Resultados: La progresión de la edad, pertenecer al grupo de 61-65 años, el sexo femenino, padecer diabetes o hipertensión arterial, tener dos comorbilidades, leucograma anormal y el índice de severidad del primer Rx de tórax entre 2-6/6, estaban relacionados con la evolución no satisfactoria. El leucograma (ODD RATIO 68,634 p = 0.000) y el índice de severidad del primer rayos-x de tórax (ODD RATIO 12,201 p = 0.008) tienen influencia independiente, en pacientes con COVID-19.
Conclusión: Se demostró el valor predictor del leucograma y el índice de severidad en el primer rayos-x de tórax con la evolución no satisfactoria en estos pacientes.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Huang C, Wang Y, Li x, Ren L, Zhao J, Hu J. Clinical features of patient infected with 2019 novel coronavirus in Wuhan, China. Lancet [Online]. 2020 [Cited 02/07/2020]; 395(10223):497-506. Available from: Available from: http://doi.org/10.1016/S0140-6736(20)30183-5

  2. COVID-19 Map. Johns Hopkins Coronavirus Resource Center [Online]. [Cited 02/07/2020]. Baltimore: Johns Hopkins Coronavirus Resource Center; 2020. Available from: https://coronavirus.jhu.edu/map.html

  3. Williamson E, Walker A, Goldacre B. Factors associated with COVID-19-related death using Open SAFELY. Nature [Online]. 2020 [Cited 02/07/2020];584:430-6 Available from: Available from: https://doi.org/10.1038/s41586-020-2521-4

  4. Sattar N, McInnes I, McMurray J. Obesity is a Risk Factor for Severe COVID-19 Infection. Circulation [Online]. 2020 [Cited 02/07/2020];142:4-6. Available from: Available from: https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.120.047659

  5. Adhikari SP, Meng S, Wu Y, Mao YP, Wang QZ. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty [Online]. 2020 [Cited 02/07/2020];9:29. Available from: Available from: https://doi.org/10.1186/s40249-020-00646-x

  6. Lauer SA, Grantz KH, Bi Q, Forrest KJ, Zheng Q, Meredith H, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Int Med [Online]. 2020 [Cited 02/07/2020];172(9):577-82. Available from: Available from: https://doi.org/10.7326/M20-0504

  7. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-CoV Infection from an Asymptomatic Contact in Germany. N Engl J Med [Online]. 2020 [Cited 02/07/2020];382:970-1. Available from: Available from: https://doi.org/ 10.1056/NEJMc2001468

  8. Yu P, Zhu J, Zhang Z, Han Y. A Familial cluster of infection associated with the 2019 novel coronavirus indicating possible person-to-person transmission during the incubation period. J Infect Dis [Online]. 2020 [Cited 02/07/2020];221(11):1757-61 Available from: Available from: https://doi.org/10.1093/infdis/jiaa077

  9. Pascarella G, Strumia A, Piliego Ch, Bruno F, Del Buono R, Costa, et al. COVID-19 diagnosis and management: a comprehensive review. J Intern Med [Online]. 2020 [Cited 13/07/2020];288(2):192-206. Available from: Available from: https://doi.org/10.1111/joim.13091

  10. Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA [Online]. 2020 [Cited 02/07/2020];323(18):1843-4. Available from: Available from: https://doi.org/10.1001/jama.2020.3786

  11. Zhang W, Du RH, Li B, Zheng XS, Yang XL, Hu B, et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microb Infect [Online]. 2020 [Cited 02/07/2020];9:386-9 Available from: Available from: https://doi.org/10.1080/22221751.2020.1729071

  12. Dugar S, Choudhary Ch, Duggal A. Sepsis and septic shock: Guideline-based management. Cleveland Clinic Journal Medcine [Online]. 2020 [Cited 02/07/2020];87(1):[Aprox. 2 p.]. Available from: Available from: https://doi.org/10.3949/ccjm.87a.18143

  13. Li x, Liu Ch, Mao Z, Xiao M, Wang L, Qi Sh, et al. Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis. Critical Care [Online]. 2020 [Cited 21/03/2021];24(647):[Aprox. 2 p.]. Available from: Available from: https://doi.org/10.1186/s13054-020-03374-8

  14. Yao Y, Cao J, Wang Q, Shi Q, Liu K, Luo Z, et al. D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study. Journal of Intensive Care [Online]. 2020 [Cited 21/03/2021];49(8):[Aprox. 2 p.]. Available from: Available from: https://doi.org/10.1186/s40560-020-00466-z

  15. Toussie D, Voutsinas N, Finkelstein M, Cedillo M, Manna S, Maro SZ, et al. Clinical and Chest Radiography Features Determine Patient Outcomes In Young and Middle Age Adults with COVID-19. Radiology [Online]. 2020 [Cited 02/07/2020];297(1):197-206. Available from: Available from: https://doi.org/10.1148/radiol.2020201754

  16. Cellina M, Panzeri M, Oliva G. Chest Radiograph Features Predict a Favorable Outcome in Patients with COVID-19. Radiology [Online]. 2020 [Cited 02/07/2020];297(1):[Aprox. 2 p.]. Available from: Available from: https://doi.org/10.1148/radiol.2020202326

  17. Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for radiologists on COVID-19: an update-radiology scientific expert panel. Radiology [Online]. 2020 [Cited 02/07/2020];296(2):E113-E114. Available from: Available from: https://doi.org/10.1148/radiol.2020200527

  18. Bernheim A, Mei X, Huang M, Yang Y, Fayad Z, Zhang N, et al. Chest CT findings in coronavirus disease-19 (COVID- 19): relationship to duration of infection. Radiology [Online]. 2020 [Cited 22/11/2020];295(3):685-91. Available from: Available from: https://doi.org/10.1148/radiol.2020200463

  19. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad Ali. Coronavirus disease 2019 (COVID-19): A systematic review of imaging findings in 919 patients. Am J Roentgenol [Online]. 2019 [Cited 02/07/2020];215(1):87-93. Available from: Available from: https://doi.org/10.2214/AJR.20.23034

  20. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis [Online]. 2020 [Cited 02/07/2020];20(4):425-34. Available from: Available from: https://doi.org/10.1016/S1473-3099(20)30086-4

  21. Li Y, Yang Z, Ai T, Wu Sh, Xia L. Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19). Eur Radiol [Online]. 2020 [Cited 22/11/2020];30:6186-93. Available from: Available from: https://doi.org/10.1007/s00330-020-06969-5

  22. Li K, Chen D, Chen Sh, Feng Y, Cheng Ch, Wand Z, et al. Predictors of fatality including radiographic findings in adults with COVID-19. Respir Res [Online]. 2020 [Cited 22/11/2020];21(146):[Aprox. 2 p.]. Available from: Available from: https://doi.org/10.1186/s12931-020-01411-2

  23. Pan D, Sze Sh, Minhas JS, Bangash MN, Pareek N, Divall Pip, et al. The impact of ethnicity on clinical outcomes in COVID-19: A systematic review. The Lancet [Online]. 2020 [Cited 23/10/2020];23(100404):1-8. Available from: Available from: https://doi.org/10.1016/j.eclinm.2020.100404

  24. Luo X, Zhou W, Yan X, Guo T, Wang B, Xia H, et al. Prognostic Value of C-Reactive Protein in Patients With Coronavirus 2019. Clin Infect Dis [Online]. 2020 [Cited 23/10/2020];71(16):2174-9. Available from: Available from: https://doi.org/10.1093/cid/ciaa641




2020     |     www.medigraphic.com