Factores de riesgo al ingreso asociados a intubación en pacientes con COVID-19

##plugins.themes.themeEleven.article.main##

Mayra Estrada-Serrano http://orcid.org/0000-0003-0749-8983
Luis García-Covarrubias http://orcid.org/0000-0003-3687-5397
Aldo García-Covarrubias http://orcid.org/0000-0002-4014-5314
Juan Carlos Hernández-Rivera http://orcid.org/0000-0002-4038-5756
Adriana Santos-Mansur http://orcid.org/0000-0001-9468-2767

Keywords

COVID-19, Intubación, Factores de Riesgo, Ingreso, Síntomas

Resumen

Introducción: se han encontrado tasas de intubación de hasta 33% en pacientes con diagnóstico de COVID-19. Algunas cohortes han informado la presencia de disnea en el 84.1% de los pacientes intubados y este ha sido el único síntoma asociado con la intubación. La saturación de oxígeno < 90% y el aumento de la frecuencia respiratoria también han sido descritos como predictores de intubación.


Objetivo: analizar los factores de riesgo asociados a intubación en pacientes con COVID-19 al momento de su admisión hospitalaria.


Material y métodos: se realizó un estudio observacional, transversal, analítico y retrospectivo. El universo de estudio consistió en pacientes mayores de 18 años, hospitalizados por diagnóstico de infección por virus SARS-CoV-2 del 1 abril de 2020 al 31 abril de 2021 en el Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez” del Centro Médico Nacional.


Resultados: se analizaron un total de 300 pacientes. La media de edad de los pacientes intubados fue de 59.17 años (p < 0.001, intervalo de confianza del 95% [IC 95%] −9.994 a −3.299). En general, el 76.7% (230) de los pacientes tenía antecedentes de una o más comorbilidades preexistentes, incluida la hipertensión en 42.3% (127), la obesidad en 36.7% (110) y la diabetes mellitus en 34.3% (103).


Conclusiones: las principales características clínicas de los pacientes hospitalizados por COVID-19 en nuestro centro que requirieron de intubación son muy similares a las observadas en distintos centros, entre ellas el sexo masculino, la edad mayor de 50 años y la obesidad, que fueron las más prevalentes.

Abstract 82 | PDF Downloads 61

Referencias

 

Mishra SK, Tripathi T. One year update on the COVID-19 pandemic: Where are we now? Acta Trop. 2021;214:105778. doi: 10.1016/j.actatropica.2020.105778.

 

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: 10.1016/S0140-6736(20)30183-5.

 

Hur K, Price CPE, Gray EL, Gulati RK, Maksimoski M, Racette SD, et al. Factors Associated with Intubation and Prolonged Intubation in Hospitalized Patients With COVID-19. Otolaryngol Head Neck Surg. 2020;163(1):170-8. doi: 10.1177/ 0194599820929640.

 

Suardi LR, Pallotto C, Esperti S, Tazzioli E, Baragli F, Salomoni E, et al. Risk factors for non-invasive/invasive ventilatory support in patients with COVID-19 pneumonia: A retrospective study within a multidisciplinary approach. Int J Infect Dis. 2020;100:258-63. doi: 10.1016/j.ijid.2020.09.012.

 

Thomson RJ, Hunter J, Dutton J, Schneider J, Khosravi M, Casement A, et al. Clinical characteristics and outcomes of critically ill patients with COVID-19 admitted to an intensive care unit in London: A prospective observational cohort study. PLoS One. 2020;15(12):e0243710. doi: 10.1371/journal.pone.0243710.

 

Zhang Q, Shen J, Chen L, Li S, Zhang W, Jiang C, et al. Timing of invasive mechanic ventilation in critically ill patients with coronavirus disease 2019. J Trauma Acute Care Surg. 2020;89(6):1092-8. doi: 10.1097/TA.0000000000002939.

 

Palaiodimos L, Kokkinidis DG, Li W, Karamanis D, Ognibene J, Arora, S, et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020;108:154262. doi: 10.1016/j.metabol.2020.154262.

 

Monárrez J, Zubía C, Reyes L, Castillo JP, Castañeda JE, Herrera AS, et al. Clinical Factors Associated with COVID-19 Severity in Mexican Patients: Cross-Sectional Analysis from a Multicentric Hospital Study. Healthcare (Basel). 2021;9(7): 895. doi: 10.3390/healthcare9070895.

 

Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934- 943. doi: 10.1001/jamainternmed.2020.0994.

 

Tong JY, Wong A, Zhu D, Fastenberg JH, Tham T. The Prevalence of Olfactory and Gustatory Dysfunction in COVID-19 Patients: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. 2020;163(1):3-11. doi: 10.1177/0194599820926473.

 

COVID-ICU Group on behalf of the REVA Network and the COVID-ICU Investigators. Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospective cohort study. Intensive Care Med. 2021;47(1):60-73. doi: 10.1007/s00134-020-06294-x.

 

Romero-Gameros CA, Colin-Martínez T, Waizel-Haiat S, Vargas-Ortega G, Ferat-Osorio E, Guerrero-Paz JA, et al. Diagnostic accuracy of symptoms as a diagnostic tool for SARS-CoV 2 infection: A cross-sectional study in a cohort of 2173 patients. BMC Infect Dis. 2021;21:1-11. doi: 10.1186/ s12879-021-05930-1.

 

Wang D, Hu B, Hu C, 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 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585.

 

Mohammadi M, Khafaee Pour Khamseh A, Varpaei HA. Invasive Airway “Intubation” in COVID-19 Patients; Statistics, Causes, and Recommendations: A Review Article. Anesth Pain Med. 2021 Jul 9;11(3):e115868. doi: 10.5812/aapm.115868.

 

Anderson MR, Geleris MD, Anderson DR, Zucker J, Nobel YR, Freedberg D, et al. Body Mass Index and Risk for Intubation or Death in SARS-CoV-2 Infection A Retrospective Cohort Study. Ann Intern Med. 2020;173(10):782-90. doi: 10.7326/M20-3214.

 

Gil A, Miró O, Piñera P, Burillo G, Jiménez S, Martín A, et al. Evaluación de las características clínicas y evolución de pacientes con COVID-19 a partir de una serie de 1000 pacientes atendidos en servicios de urgencias españoles. Emergencias 2020;32:233-41.

 

Pérez MA, Valdés J, Ortiz L. Características clínicas y gravedad de COVID-19 en adultos mexicanos. Gac Med Mex. 2020;156:379-38. doi: 10.24875/GMM.20000430.

 

Hernández DR, González MA, Romo DK, Lima R, Hernández IA, Lumbreras M, et al. Increased Risk of Hospitalization and Death in Patients with COVID-19 and Pre-existing Noncommunicable Diseases and Modifiable Risk Factors in Mexico. Arch Med Res. 2020;51(7):683-9. doi: 10.1016/j. arcmed.2020.07.003.

 

Surendra H, Elyazar I, Djaafara BA, Ekawati LL, Saraswati K, Widyastuti VA, et al. Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital based retrospective cohort study. Lancet Reg Health West Pac. 2021; 9:100108. doi: 10.1016/j.lanwpc.2021.100108.

 

Ebinger JE, Achamallah N, Ji H, Claggett BL, Sun N, Botting P, et al. Pre-existing traits associated with Covid-19 illness severity. PLoS One. 2020;15(7): e0236240. doi: 10.1371/journal. pone.0236240.

 

COVIDTrach collaborative. the outcomes of mechanically ventilated COVID-19 patients undergoing tracheostomy in the UK. Br J Surg. 2020;107(12):e583-4. doi: 10.1002/bjs.12020.

 

Raimondi N, Vial MR, Calleja J, Quintero A, Cortés A, Celis E, et al. Evidence-based guidelines for the use of tracheostomy in critically ill patients. J Crit Care. 2017;38:304-18. doi: 10.1016/j.jcrc.2016.10.009.

 

McGrath BA, Brenner MJ, Warrillow SJ, Pandian V, Arora A, Cameron TS, et al. Tracheostomy in the COVID-19 era: global and multidisciplinary guidance. Lancet Respir Med. 2020;8 (7):717-25. doi: 10.1016/S2213-2600(20)30230-7.

 

Mattioli F, Fermi M, Ghirelli M, Molteni G, Sgarbi N, Bertellini E, et al. Tracheostomy in the COVID-19 pandemic. Eur Arch Oto-Rhino-Laryngology. 2020;277:2133-5. doi: 10.1007/ s00405-020-05982-0.

 

Fonseca EKUN, Loureiro BMC, Strabelli DG, Farias LPG, Garcia JVR, Gama VAA, et al. Evaluation of the RSNA and CORADS classifications for COVID-19 on chest computed tomography in the Brazilian population. Clinics (Sao Paulo). 2021;76:e2476. doi: 10.6061/clinics/2021/e2476.

 

Maslo C, Friedland R, Toubkin M, Laubscher A, Akaloo T, Kama B. Characteristics and Outcomes of Hospitalized Patients in South Africa During the COVID-19 Omicron Wave Compared With Previous Waves. JAMA. 2022;327(6):583-4. doi: 10.1001/jama.2021.24868.

 

Tenforde MW, Self WH, Adams K, Gaglani M, Ginde AA, McNeal T, et al. Influenza and Other Viruses in the Acutely Ill (IVY) Network. Association Between mRNA Vaccination and COVID-19 Hospitalization and Disease Severity. JAMA. 2021;326(20):2043-54. doi: 10.1001/jama.2021.19499.

 

Pormohammad A, Zarei M, Ghorbani S, Mohammadi M, Razizadeh MH, Turner DL, et al. Efficacy and Safety of COVID-19 Vaccines: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Vaccines (Basel). 2021;9(5):467. doi: 10.3390/vaccines9050467.