Prognostic scale for in-hospital mortality in patients with COVID-19 viral pneumonia
Main Article Content
Keywords
Mortality, Risk Factors, Prognosis, Pneumonia, Viral, Coronavirus Infections
Abstract
Background: The COVID-19 pandemic represented a challenge in medical care. A tool would be very useful to establish the prognosis of in-hospital death that is reliable and can be applied to the Mexican population entitled to the IMSS.
Objective: To propose a prognostic scale to stratify patients with viral pneumonia COVID-19 in the emergency services.
Material and methods: A nested case-control study was conducted in a cohort of patients who were consecutively admitted to the emergency department with viral pneumonia COVID-19. The cases were those patients who died, and the controls were those who were discharged due to health improvement. An association analysis was performed between the variables with significant differences between groups. Subsequently, the association was adjusted using a multivariate logistic regression model, from which the prognostic scale was developed.
Results: A total of 70 subjects with COVID-19 were included, 34 cases and 36 controls. Chronic diseases, smoking, severe pulmonary involvement diagnosed by tomography, leukocytosis, and pulse oximetry less than 80% with were associated with in-hospital mortality; Odds Ratio (OR) of >1.1. Vaccination was a protective factor (OR = 0.04, CI95%: 0.01-0.16). A score greater than 3 points on the prognostic scale predicts in-hospital mortality with a specificity of 0.86 and a sensitivity of 0.73.
Conclusions: The proposed prognostic scale can be a useful tool in the classification of patients with COVID-19 viral pneumonia in the emergency room services of secondary care level Hospitals.
References
Ochani R, Asad A, Yasmin F, et al. COVID-19 pandemic: from origins to outcomes. A comprehensive review of viral pathogenesis, clinical manifestations, diagnostic evaluation, and management. Infez Med. 2021;29(1):20-36.
Candal-Pedreira C, Fernandez-Villar A, Lopez-Campos JL, et al. Prognostic Scales of COVID-19 Morbidity and Mortality: Necessary but also Reliable. Arch Bronconeumol. 2021;57 Suppl 2:62-3.
Salinas-Escudero G, Carrillo-Vega MF, Granados-Garcia V, et al. A survival analysis of COVID-19 in the Mexican population. BMC Public Health. 2020;20(1):1616.
Malagón-Rojas J, Ibáñez E, Parra EL, et al. Analysis of COVID-19 Mortality and Survival in Colombia: A prospective Cohort Study. Infectio. 2021;25(3).
Majumder J, Minko T. Recent Developments on Therapeutic and Diagnostic Approaches for COVID-19. Aaps j. 2021;23(1):14.
Vandenberg O, Martiny D, Rochas CO, et al. Considerations for diagnostic COVID-19 tests. Nat Rev Microbiol. 2021;19 (3):171-83.
Byeon KH, Kim DW, Kim J, et al. Factors affecting the survival of early COVID-19 patients in South Korea: An observational study based on the Korean National Health Insurance big data. Int J Infect Dis. 2021;105:588-94.
Bansal M. Cardiovascular disease and COVID-19. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020; 14(3):247-50.
Caricchio R, Gallucci M, Dass C, et al. Preliminary predictive criteria for COVID-19 cytokine storm. Annals of the Rheumatic Diseases. 2021;80(1):88-95.
Gattinoni L, Chiumello D, Caironi P, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med. 2020;46(6):1099-102.
López-Izquierdo R, Ruiz-Albi T, Bermejo-Martín JF, et al. Risk models for predicting in-hospital mortality from COVID-19 pneumonia in the elderly. Emergencias. 2021;33(4):282-91.
Sirvent JM, Baro A, Morales M, et al. Predictive biomarkers of mortality in critically ill patients with COVID-19. Med Intensiva (Engl Ed). 2020.
Ji D, Zhang D, Xu J, et al. Prediction for Progression Risk in Patients With COVID-19 Pneumonia: The CALL Score. Clin Infect Dis. 2020;71(6):1393-9.
Sousa GJB, Garces TS, Cestari VRF, et al. Mortality and survival of COVID-19. Epidemiol Infect. 2020;148:e123.
Article Sidebar
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.