2022, Number 1
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Rev Cubana Hig Epidemiol 2022; 59 (1)
Clinical Characterization and Treatment of Hospitalized COVID-19 Patients in Cuban Intensive CareUnits
Pereda GR, Castillo SJU, Lorenzo LP, Vidal LMJ, Calvo MM, Hidalgo SÁO, Sabina RR, Pérez DCR, Sánchez VL
Language: Spanish
References: 19
Page: 1-17
PDF size: 919.75 Kb.
ABSTRACT
Introduction:
COVID-19 pandemic was declared an international public health emergency. The knowledge of the symptoms, comorbidities, and the risk associated with the treatment received could contribute to better classification and care of patients.
Objective:
To clinically characterize COVID-19 patients admitted to the Cuban intensive care units.
Methods:
A retrospective observational study of all patients treated in the Cuban intensive care units from March 11 to July 30, 2020. Demographic, clinical and outcome data were collected. The prevalence of fatal and recovery cases was compared by covariables using the standard chi-square test. A logistic regression was performed to evaluate the predictor variables for in-hospital mortality.
Results:
A total of 175 patients were treated, including 106 acutely ill and 69 critically ill. Patients were predominantly male (52.0%), over 60 years old (67.2%) and had hypertension (57.0%). Age (over 80 years old, OR= 9.62, 95% CI: 3.16-29.2), health status at admission (OR= 8.32, 95% CI: 2.30-30.10), and hemodynamic instability (OR=6.9, 95% CI: 2.96-16.37) were associated with an increased risk of death. Patients treated with Kaletra, chloroquine, Itolizumab, or Jusvinza increased survival. Mortality risk in critically ill patients decreased from 80% to 25% with the use of Jusvinza.
Conclusions:
The clinical characterization performed demonstrates the effectiveness of the clinical protocols used in the country’s intensive care units.
REFERENCES
World Health Organization. Coronavirus disease (COVID-19). Situation Report-105. Ginebra: WHO; 2020 [acceso 06/04/2020]. Disponible en: Disponible en: http://www.who.int/docs/default-source/coronaviruse/situation-reports/20200719-covid-19-sitrep-181.pdf?sfvrsn=82352496_2 1.
Cheng C, Barceló J, Hartnett AS, Kubinec R, Messerschmidt L. COVID-19 Government Response Event Dataset (CoronaNet v.1.0). Nat Hum Behav. 2020 [acceso 07/07/20];4(7):756-68. Disponible en: http://doi.org/10.1038/s41562-020-0909-72.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62. DOI: http://doi.org/10.1016/S0140-6736(20)30566-33.
PérezGuzman PN, Daunt A, Mukherjee S, Crook P, Forlano R, Kont MD, et al.Clinical characteristics and predictors of outcomes of hospitalised patients with COVID-19 in a London NHS Trust: a retrospective cohort study. Clin Infect Dis. 2021 [acceso29/04/2020];73(11):e4047-57. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32766823/4.
Plasencia Urizarri TM, Aguilera Rodríguez R, Almaguer Mederos LE. Comorbilidades y gravedad clínica de la COVID-19: revisión sistemática y metaanálisis. Rev Habanera Cienc Méd. 2020 [acceso07/07/2020];19(Supl.):e3389. Disponible en: http://www.revhabanera.sld.cu/index.php/ rhab/article/view/33895.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. DOI: http://doi.org/10.1056/NEJMoa20020326.
Chih Cheng L, Tzu-Ping S, Wen-Chien K, Hung-Jen T, Po-Ren H. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3). DOI: http://doi.org/10.1016/j.ijantimicag.2020.1059247.
Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging. 2020;12(7):6049-657. DOI: http://doi.org/10.18632/aging.1030008.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. DOI: http://doi.org/10.1016/S0140-6736(20)30183-59.
Ministerio de Salud Pública. Protocolo de actuación nacional para la COVID-19. 2020. La Habana: Minsap; 2020. [acceso 05/05/2020]. Disponible en: Disponible en: https://covid19cubadata.github.io/protocolos/protocolo-version-3.pdf 10.
Balakrishnan Colton T, Everitt B, Piegorsch W, Ruggeri F, Teugels JL Wiley Stats Ref: Statistics Reference Online || Nelson-Aalen Estimator. EE. UU, Los Ángeles, C. A., California: Wiley Stats Ref; 2014. DOI: 10.1002/9781118445112.stat0366711.
Ferrer Castro JE, Sànchez Hernández E, Poulout Mendoza A, Del Rio Caballero G, Figueredo Sánchez D. Caracterización clínica y epidemiológica de pacientes confirmados con la COVID-19 en la provincia de Santiago de Cuba. Medisan. 2020 [acceso 07/07/2020];24(3):473-85. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-3019202000030047312.
Pereda R, González D, Rivero HB, Rivero JC, Pérez A, Lopez LR, et al. Therapeutic effectiveness of interferon-alpha2b against COVID-19: The Cuban experience. J Interferon Cytokine Res. 2020 [acceso 07/07/2020];40(9):438-42. Disponible en: https://www.liebertpub.com/doi/10.1089/jir.2020.0124?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&13.
Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic treatments for coronavirus diseases 2019 (COVID-19): A review. JAMA. 2020;323(18):1824-36. DOI: http://doi.org/10.1001/jama.2020.601914.
Gómez Tejeda JJ, Dieguez Guach RA, Pérez Abreu MR. Alternativas terapéuticas para el manejo de la COVID-19. Rev Habanera Cien Méd. 2020 [acceso17/07/2021];19(Supl.):e3328. Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/332815.
Rodríguez PC, Prada DM, Moreno E, Aira LE, Molinero C, López AM, et al. The anti-CD6 antibody itolizumab provides clinical benefit without lymphopenia in rheumatoid arthritis patients: results from a 6-month, open-label Phase I clinical trial. Clin Exp Immunol. 2018;191(2):229-39. DOI: http://doi.org/10.1111/cei.1306116.
Aira LE, Lopez Requena A, Fuentes D, Sànchez L, Pérez T, Urquiza A, et al.I mmunological and histological evaluation of clinical samples from psoriasis patients treated with anti-CD6 itolizumab. mAbs. 2014;6(3):783-92. DOI: http://doi.org/10.4161/mabs.2837617.
Wang D, Hu B, Hu Ch, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020.[acceso 17/07/2021];323(11):1061-9. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/276104418.
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China. Lancet Respir Med. 2020;8(5):475-81. DOI: http://doi.org/10.1016/S2213-2600(20)30079-519.