Open AccessVariables associated with severity in COVID-19 patients
Author(s) -
Carlos Herrera,
Julio Betancourt Cervantes,
Antonio Dávila,
Eligio Barreto Fiu,
Lizet Sánchez Valdés,
Elibet Chávez-González,
Armando Caballero López
Publication year - 2021
Publication title -
international journal of medical and surgical sciences
Language(s) - English
Resource type - Journals
eISSN - 0719-532X
pISSN - 0719-3904
DOI - 10.32457/ijmss.v8i3.1612
Subject(s) - medicine , diabetes mellitus , retrospective cohort study , cohort , gastroenterology , oxygen saturation , lymphocyte , disease , lactate dehydrogenase , biochemistry , chemistry , organic chemistry , oxygen , enzyme , endocrinology
In COVID-19, a percentage of patients develop severe disease, with high mortality, since has been necessary to study its characteristics to stop the progression of the disease. A retrospective study was carried out in a cohort of 150 adult patients attended at Manuel Fajardo Hospital in Villa Clara, Cuba, from March to June 2020. Demographic, clinical, laboratory, gasometric and radiological variables measured at hospital admission were analyzed, defining two groups of patients according to clinical evolution: severe and non-severe. For the comparison of the groups a bivariate analysis was performed, with the objective of determining those variables with a significant association to severity. Of the total number of patients, 26 (17.3%) evolved to severity and 124 (83.7%) evolved satisfactorily. Severe patients were characterized by advanced age (mean: 83 years) and comorbidities; the most significant being hypertension, diabetes mellitus, heart disease, chronic kidney disease and cancer (p< 0.0001). Polypnea and diarrhea were the clinical manifestations with the highest association with severity (p<0.0001), followed by fever (p=0.0157). The quick SOFA prognostic scale proved to be a useful instrument to evaluate patients at admission. Laboratory variables: neutrophils, lymphocytes, neutrophil/lymphocyte ratio, hemoglobin and lactate dehydrogenase were the most associated with severity (p<0.0001). Leukocytes, lactate, D-dimer, C-reactive protein, glycemia and calcium also showed significant results (p<0.05). Of the gasometric variables, arterial oxygen pressure and saturation were the most significantly associated with severity; as well as the presence of pulmonary infiltrates or consolidation in the chest X-ray (p<0.0001). The study allowed us to identify variables at hospital admission associated with progression to severe forms of the disease.