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2021, Number 4

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Enf Infec Microbiol 2021; 41 (4)

Mortality from COVID-19 in a second level hospital in a marginalized area of Mexico City, during the first months of the epidemic

Alanís NJM, Anguiano ÁVM, Hammeken LEF

Language: Spanish
References: 21
Page: 137-147
PDF size: 219.28 Kb.


ABSTRACT

Introduction. Low socioeconomic conditions have been associated with higher mortality rates in hospitalized patients with COVID-19. Mexico City has become the country’s highest death toll. Iztapalapa is the district with the highest population density and marginalization in Mexico City. Most of the information on COVID-19 in-hospital mortality in Mexico comes from intensive care units or tertiary hospitals without considering level of income. Data regarding mortality in care centers with low availability of intensive care beds has not been explored.
Material and methods. A retrospective cohort study in patients with COVID-19 hospitalized outside the intensive care unit of a secondary care center in Mexico City from April 1st, 2020, to May 31st, 2020. Analysis between subgroups with a p-value ‹0.05 was considered statistically significant.
Results. 164 patients were recruited; the median age was 52.5 years (IQR 44 to 64.5), 68% were males, 48.7% were obese, and 59.7% had comorbidities. Among those, 67% required mechanical ventilation and 32.3% vasopressor support. In this population, 52 recovered (31.7%) and 112 died (68.3%). The main risk factors associated with death were male sex, age ›50 years, diabetes, severe pneumonia, PORT/PSI ›91, SMART-COP › 5, SCAP SCORE ›10, dyspnea on admission, fever during hospitalization (p ‹0.05) and the administration of intravenous antibiotics (RR 3.45, 95% CI 1.69-7.06, p ‹0.001).
Conclusions. In this study we found higher in-hospital mortality compared to previous reports. We suggest that administration of intravenous antibiotics could impact patient survival for the risk of developing hospital-acquired infections.


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