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Impact of preemptive hospitalization on health outcomes at the temporary COVID-19 hospital in Mexico City: a prospective observational study
Author(s) -
Rafael Ricardo Valdez Vázquez,
Héctor GallardoRincón,
Julieta LomelínGascón,
Rodrigo Benavides,
Linda Morales Juárez,
Héctor Herrera Bello,
Lidia Moreno Castañeda,
Adrián Palacios Chavarría,
Pablo Escalera Castillo,
Luis Esteban Ramírez González,
Mónica Avendaño,
Santiago Treviño Berlanga,
Reyna Albertina Rosas Loza,
Renate Victoria Álvarez Wyssmann,
Erika Salinas Lezama,
Alonso Gutiérrez Romero,
María Dolores Niembro Ortega,
Liudmila Villegas Acosta,
Ailyn Cendejas Schotman,
Jennifer Bertin-Montoya,
Andrea Gonzalez Rodriguez,
Laura Ramos,
Luis Alberto MartínezJuárez,
Rodrigo Saucedo-Martínez,
Alejandra Montoya,
Roberto TapiaConyer
Publication year - 2021
Publication title -
therapeutic advances in infectious disease
Language(s) - English
Resource type - Journals
eISSN - 2049-937X
pISSN - 2049-9361
DOI - 10.1177/20499361211040325
Subject(s) - medicine , observational study , confidence interval , mechanical ventilation , oxygen therapy , odds ratio , intensive care unit , emergency medicine , prospective cohort study , covid-19 , emergency department , disease , infectious disease (medical specialty) , psychiatry
In response to the evolution of the coronavirus disease 2019 (COVID-19) pandemic, the admission protocol for the temporary COVID-19 hospital in Mexico City has been updated to hospitalize patients preemptively with an oxygen saturation (SpO 2 ) of >90%.Methods: This prospective, observational, single-center study compared the progression and outcomes of patients who were preemptively hospitalized versus those who were hospitalized based on an SpO 2 ⩽90%. We recorded patient demographics, clinical characteristics, COVID-19 symptoms, and oxygen requirement at admission. We calculated the risk of disease progression and the benefit of preemptive hospitalization, stratified by CALL Score: age, lymphocyte count, and lactate dehydrogenase (<8 and ⩾8) at admission.Results: Preemptive hospitalization significantly reduced the requirement for oxygen therapy (odds ratio 0.45, 95% confidence interval 0.31–0.66), admission to the intensive care unit (ICU) (0.37, 0.23–0.60), requirement for invasive mechanical ventilation (IMV) (0.40, 0.25–0.64), and mortality (0.22, 0.10–0.50). Stratification by CALL score at admission showed that the benefit of preemptive hospitalization remained significant for patients requiring oxygen therapy (0.51, 0.31–0.83), admission to the ICU (0.48, 0.27–0.86), and IMV (0.51, 0.28–0.92). Mortality risk remained significantly reduced (0.19, 0.07–0.48).Conclusion: Preemptive hospitalization reduced the rate of disease progression and may be beneficial for improving COVID-19 patient outcomes.

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