Mortality due to COVID-19 and Risk Factors at Pachuca´s General Hospital in the State of Hidalgo, Mexico
##plugins.themes.bootstrap3.article.main##
Aim: To estimate the risk of death secondary to COVID-19 infection and to identify the factors associated with these deaths at the Pachuca General Hospital, Hidalgo, Mexico.
Material and methods: The information was obtained from the daily report of patients whose were attended at Hospital Genera de Pachuca for respiratory disease compatible with COVID-19 from March 2020 to March 2021, the information obtained was captured electronically in a database by the epidemiology department of the institution. A cross-sectional design was used. Patients who died secondary to complications of respiratory disease were compared with survivors of the same disease. Pearson's Chi-square was used to estimate the differences between the deceased and the survivors. For the crude risk of dying from COVID-19, the odds ratio was used, and for the adjusted risk, non-conditional logistic regression was used, a trend analysis was performed, with the corresponding trend Chi-square test, all calculations were made with 95% confidence.
Results: The information of 4418 people with respiratory disease was analyzed. During the study period, 647 people died of COVID-19, corresponding to 14.64%. Of the population, 50.97% were men, their mortality was 18.92% and that of women was 10.22% (P <0.05). Variables associated with dying from complications from COVID-19 were found to be male (OR 2.05, 95% CI 1.71-2.45), being 40 years old or older (OR 9.62, 95% CI 7.30-12.86), having a positive RT-PCR result (OR 3.53 95% CI 2.83-4.43), and being a carrier of a Chronic Degenerative Disease (OR 4.79 95% CI 4.01-5.73).
Conclusions: The results indicate that the risk of dying from COVID-19 is related to male patients, at the older age of the patients, having a positive RT-PCR and suffering from at least one chronic degenerative disease.
References
Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020; 579(7798): 265-269.
Jebril N. World Health Organization declared a pandemic public health menace: a systematic review of the coronavirus disease 2019 “COVID-19”. International Journal of Psychosocial Rehabilitation. (2020): 2784-2795.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020; 395(10223): 507-513.
Suárez V, Quezada MS, Ruiz SO, De Jesús ER. Epidemiología de COVID-19 en México: del 27 de febrero al 30 de abril de 2020. Revista clínica española. 2020; 220(8): 463-471. Spanish.
Mendoza-González MF. Rezago social y letalidad en México en el contexto de la pandemia de enfermedad por coronavirus (COVID-19): una aproximación desde la perspectiva de la salud colectiva en los ámbitos nacional, estatal y municipal. Notas de Población. 2021: 133-154. Spanish.
Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, China. Allergy. 2020; 75(7): 1730-1741.
Gil-Rodrigo A, Miró Ò, Piñera P, Burillo-Putze 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(4). Spanish.
Zunyou W, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020: 1239-1242.
Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al. Comorbidity and its impact on patients with COVID-19. SN Comprehensive Clinical Medicine. 2020; 2(8): 1069-1076.
Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M. Defining comorbidity: implications for understanding health and health services. The Annals of Family Medicine. 2009; 7(4): 357-363.
Phan LT, Nguyen TV, Huynh LK, Dao MH, Vo TA, Vu NH, et al. Clinical features, isolation, and complete genome sequence of severe acute respiratory syndrome coronavirus 2 from the first two patients in Vietnam. Journal of Medical Virology. 2020; 92(10): 2209-2215.
Wang X, Fang X, Cai Z, Wu X, Gao X, Min J, et al. Comorbid chronic diseases and acute organ injuries are strongly correlated with disease severity and mortality among COVID-19 patients: a systemic review and meta-analysis. Research. 2020.
Tian W, Jiang W, Yao J, Nicholson CJ, Li RH, Sigurslid HH, et al. Predictors of mortality in hospitalized COVID‐19 patients: a systematic review and meta‐analysis. Journal of Medical Virology. 2020; 92(10): 1875-1883.
Andrade-Castellanos CA, Colunga-Lozano LE. Características epidemiológicas relacionadas con la mortalidad en pacientes adultos hospitalizados con COVID-19 en el estado de Jalisco, México. Medicina Interna de México. 2021; 37 (3): 366-372.
Escobar G, Matta J, Taype W, Ayala R, Amado J. Características clínicoepidemiológicas de pacientes fallecidos por COVID-19 en un hospital nacional de Lima, Perú. Revista de la Facultad de Medicina Humana. 2020; 20(2): 180-185. Spanish.
Serrano-Martínez JL, Machado-Casas JF, Redondo-Orts M, Manzano-Manzano F, Castaño-Pérez J, Pérez-Villares JM. Características y resultados de una serie de 59 pacientes con neumonía grave por COVID-19 ingresados en UCI. Medicina Intensiva. 2020; 44(9): 580. Spanish.
Rearte A, Baldani AEM, Barcena Barbeira P, Domínguez CS, Laurora MA, Pesce M, et al. Características epidemiológicas de los primeros 116 974 casos de COVID-19 en Argentina, 2020. Revista Argentina de Salud Pública. 2020; 12: 5-5. Spanish.
Hernández-Solís A, Torres-Rojasm B, Reding-Bernal A. Comorbilidad asociada con infección por SARS-CoV-2 (Covid-19), en el Hospital General de México Dr. Eduardo Liceaga. Salud Pública de México. 2021: 159-160. Spanish.
Pérez FM, Del Pino JL, García NJ, Ruiz EM, Méndez CA, Jiménez JG, et al. Comorbidity and prognostic factors on admission in a COVID-19 cohort of a general hospital. Revista Clínica Española (English Edition). 2021; 221(9): 529-535.
Miró Ò, Alquézar-Arbé A, Llorens P, Martín-Sánchez FJ, Jiménez S, Martín A, et al. Comparación de las características demográficas y comorbilidad de los pacientes con COVID-19 fallecidos en hospitales españoles, en función de si ingresaron o no en Cuidados Intensivos. Medicina Intensiva. 2021; 45(1): 14-26. Spanish.
Marín-Sánchez A. Características clínicas básicas en los primeros 100 casos fatales de COVID-19 en Colombia. Revista Panamericana de Salud Pública. 2020; 44. Spanish.
Jin JM, Bai P, He W, Wu F, Liu XF, Han DM, et al. Gender differences in patients with COVID-19: focus on severity and mortality. Frontiers in Public Health. 2020: 152.
Bhopal SS, Bhopal R. Sex differential in COVID-19 mortality varies markedly by age. The Lancet. 2020: 532-533.
Penna C, Mercurio V, Tocchetti CG, Pagliaro P. Sex‐related differences in COVID‐19 lethality. British Journal of Pharmacology. 2020; 177(19): 4375-4385.
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; 323(11): 1061-1069.
Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. Jama. 2020; 323(16): 1612-1614.
Zunyou W, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020: 1239-1242.
Bialek S, Boundy E, Bowen V, Chow N, Cohn A, Dowling N, et al. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)—United States, February 12–March 16, 2020. Morbidity and Mortality Weekly Report. 2020; 69(12): 343.
Gaipov A, Gusmanov A, Abbay A, Sakko Y, Issanov A, Kadyrzhanuly K, et al. SARS-CoV-2 PCR-positive and PCR-negative cases of pneumonia admitted to the hospital during the peak of COVID-19 pandemic: analysis of in-hospital and post-hospital mortality. BMC Infectious Diseases. 2021; 21(1): 1-15.
da Silva-Júnior MJ, Mendonça KS, de Lima CA, Pires PLS, Calegari T, de de Stefan SV. Analysis of the spatio-temporal dynamics of incidence, mortality and test rates (rapid and RT-PCR) of COVID-19 in the state of Minas Gerais, Brazil. Revista de Epidemiologia e Controle de Infecção. 2021; 11(1).
Rothman KJ. Modern Epidemiology. Boston, MA: Little. Brown and Company, 1986: 51-76.
Kleinbaum DG, Kupper LL, Morgenstern H. Epidemiologic research: principles and quantitative methods. John Wiley & Sons, 1991: 81-83.
Miettinen O. Estimability and estimation in case-referent studies. American Journal of Epidemiology. 1976; 103(2): 226-235.
Pallás, JMA, Villa JJ. Métodos de investigación clínica y epidemiológica. Elsevier, 2019: 76-80. Spanish.
Du RH, Liu LM, Yin W, Wang W, Guan LL, Yuan ML, et al. Hospitalization and critical care of 109 decedents with COVID-19 pneumonia in Wuhan, China. Annals of the American Thoracic Society. 2020; 17(7): 839-846.
Graziano O, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020; 323(18): 1775-1776.
Borobia AM, Carcas AJ, Arnalich F, Álvarez-Sala R, Monserrat-Villatoro J, Quintana M, et al. A cohort of patients with COVID-19 in a major teaching hospital in Europe. Journal of Clinical Medicine. 2020; 9(6): 1733.
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. Jama. 2020; 323(20): 2052-2059.
Casas-Rojo JM, Antón-Santos JM, Millán-Núñez-Cortés J, Lumbreras-Bermejo C, Ramos-Rincón JM, Roy-Vallejo E, et al. Características clínicas de los pacientes hospitalizados con COVID-19 en España: resultados del Registro SEMI-COVID-19. Revista Clínica Española. 2020; 220(8): 480-494. Spanish.
Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020; 369.
García YP, Padilla AS, Blanco NMA. Caracterización de casos positivos y sospechosos de COVID-19 con comorbilidades. Revista Finlay. 2020; 10(3): 314-319. Spanish.
Escobar G, Matta J, Taype W, Ayala R, Amado J. Características clínicoepidemiológicas de pacientes fallecidos por COVID-19 en un hospital nacional de Lima, Perú. Revista de la Facultad de Medicina Humana. 2020; 20(2): 180-185. Spanish.
Serrano-Martínez JL, Machado-Casas JF, Redondo-Orts M, Manzano-Manzano F, Castaño-Pérez J, Pérez-Villares JM. Características y resultados de una serie de 59 pacientes con neumonía grave por COVID-19 ingresados en UCI. Medicina Intensiva. 2020; 44(9): 580.
Sharma G, Santos Volgman A, Michos ED. Sex differences in mortality from COVID-19 pandemic: are men vulnerable and women protected? Case Reports. 2020; 2(9): 1407-1410.
Bourgonje AR, Abdulle AE, Timens W, Hillebrands JL, Navis GJ, Gordijn SJ, et al. Angiotensin‐converting enzyme 2 (ACE2), SARS‐CoV‐2 and the pathophysiology of coronavirus disease 2019 (COVID‐19). The Journal of Pathology. 2020; 251(3): 228-248.
Carrillo CJA. La enzima convertidora de angiotensina 2 en hipertensión, diabetes y obesidad, y su participación en la vulnerabilidad ante el virus SARS-COV-2. Revista de Educación Bioquímica. 2021; 39(4): 121-130. Spanish.
Sama IE, Ravera A, Santema BT, Van Goor H, Ter Maaten JM, Cleland JG, et al. Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin–angiotensin–aldosterone inhibitors. European Heart Journal. 2020; 41(19): 1810-1817.
Ramírez LMM, Flores-Soto E. COVID-19 y su asociación con los inhibidores de la enzima convertidora de angiotensina y los antagonistas de los receptores para angiotensina II. Revista de la Facultad de Medicina UNAM. 2020; 63(4): 30-34. Spanish.
Bevacqua RJ, Perrone SV. COVID-19: relación entre enzima convertidora de angiotensina 2, sistema cardiovascular y respuesta inmune del huésped. Insuficiencia Cardiaca. 2020; 15(2): 34-51. Spanish.
Liang W, Liang H, Ou L, Chen B, Chen A, Li C, et al. Development and validation of a clinical risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19. JAMA Internal Medicine. 2020;180(8): 1081-1089.
Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G, et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Internal Medicine. 2020; 180(10). 1345-1355.
Ferrando C, Mellado-Artigas R, Gea A, Arruti E, Aldecoa C, Bordell A, et al. Características, evolución clínica y factores asociados a la mortalidad en UCI de los pacientes críticos infectados por SARS-CoV-2 en España: estudio prospectivo, de cohorte y multicéntrico. Revista Española de Anestesiología y Reanimación. 2020; 67(8): 425-437. Spanish.
Romero-Cabrera ÁJ, Amores-Hernández L, Fernández-Casteleiro E. Inmunosenescencia y fragilidad: una mirada actual. Medicina Interna de México. 2013; 29(6): 605-611. Spanish.
Barrera-Salas M, Morales-Hernández AE, Hernández-Osorio JJ, Hernández-Salcedo DR, Valencia-López R, Ramírez-Crescencio MA. Inmunosenescencia. Medicina interna de México. 2017; 33(5): 696-704. Spanish.
Hernández DS, Verdecia BG. Inmunosenescencia: efectos de la edad sobre el sistema inmune. Revista Cubana de Hematología, Inmunología y Hemoterapia. 2014; 30(4): 332-345. Spanish.
De la Fuente M. Role of neuroimmunomodulation in aging. Neuroimmunomodulation. 2008; 15(4-6): 213-223.
Amancio Castro AM, del Carpio Flórez S. Relación entre las comorbilidades y la morbimortalidad en la COVID-19. Anales de la Academia de Ciencias de Cuba. 2021; 11(2).
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020; 395(10223): 507-513.