Características clínicas, imagenológicas y de laboratorio de pacientes con COVID-19 según requerimiento de ingreso a UCI en Cali, Colombia

Publicado

2023-04-01

Clinical, imaging, and laboratory characteristics of patients with COVID-19 according to ICU admission requirement in Cali, Colombia

Características clínicas, imagenológicas y de laboratorio de pacientes con COVID-19 según requerimiento de ingreso a UCI en Cali, Colombia

Palabras clave:

COVID-19, Intensive Care Units, Critical Care Outcomes, Real-Time Polymerase Chain Reaction, Biomarkers (en)
COVID-19, Unidades de Cuidados Intensivos, Resultados de Cuidados Críticos, Reacción en Cadena en Tiempo Real de la Polimerasa, Biomarcadores (es)

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Autores/as

Carmen Ocampo Quirónsalud - Clínica Imbanaco - Instituto de investigación - Cali - Colombia. https://orcid.org/0000-0003-0673-7401
Mónica Morales Quirónsalud - Clínica Imbanaco - Instituto de investigación - Cali - Colombia. https://orcid.org/0000-0002-3202-5734
Martín Cañón-Muñoz Quirónsalud - Clínica Imbanaco - Instituto de investigación - Cali - Colombia. https://orcid.org/0000-0003-4244-1261
Christian Pallares-Gutierrez Quirónsalud - Clínica Imbanaco - Comité de Infecciones y Vigilancia Epidemiológica - Cali - Colombia. https://orcid.org/0000-0002-6093-7845
Karen Daniela López Quirónsalud - Clínica Imbanaco - Instituto de investigación - Cali - Colombia. | Universidad del Valle - Facultad de Ingeniería - Escuela de Estadística - Cali - Colombia. https://orcid.org/0000-0002-3346-5360
Adrián Fernández-Osorio Quirónsalud - Clínica Imbanaco - Instituto de investigación - Cali - Colombia. https://orcid.org/0000-0003-2911-256X

Resumen (en)
Resumen (es)

Introduction: At present, few studies conducted in Latin America have addressed the demographic, clinical, and laboratory characteristics of patients with COVID-19 and intensive care unit (ICU) admission requirement.

Objective: To compare the sociodemographic, clinical, imaging, and laboratory characteristics of patients diagnosed with COVID-19 and treated in the emergency department of a hospital in Cali, Colombia, based on ICU admission requirement.

Materials and methods: Retrospective and descriptive single cohort study conducted in 49 adults with COVID-19 treated in the emergency department of a quaternary care hospital in Cali (Colombia) between March and April 2020. Patients were divided into two groups: ICU admission requirement (n=24) and non-ICU admission requirement (n=25). Bivariate analyses were performed to determine differences between groups (chi-square, Fisher's exact, Student's t, and Mann-Whitney U tests), with a significance level of p<0.05.

Results: Participants’ mean age was 53 years (SD=13) and 29 patients were men. Significant differences were found between groups in the following variables: mean age (ICU x̅=58 vs. Non-ICU x̅=49; p=0.020), presence of diabetes (8 vs. 1; p=0.010); presence of respiratory distress (20 vs. 11; p=0.007) ; unilateral or bilateral presence of areas of consolidation (12 vs. 3; p=0.005); median leukocyte (Med=7 570/mm³ vs. Med=5 130/mm³; p=0.0013), neutrophil (Med=5 980/mm³ vs. Med=3 450/mm³; p=0.0001) and lymphocyte (Med=865/mm³ vs. Med=1 400/mm³; p<0.0001) count; median C-reactive protein (Med=141,25mg/L vs. Med=27.95mg/L; p<0.001), ferritin (Med=1038ng/L vs. Med=542.5ng/L; p=0.0073) and lactate dehydrogenase (Med=391U/L vs. Med=248.5U/L, p=0.0014) levels. Finally, 15 patients required invasive mechanical ventilation, 2 presented with extubation failure, and 5 died.

Conclusions. Significant differences were observed in the values of several inflammatory markers, cellular damage and complete blood count parameters between patients who required admission to the ICU and those who did not, so these variables could be used to develop tools that contribute to establishing the prognosis of this disease.

Introducción. Actualmente hay pocos estudios en Latinoamérica sobre las características demográficas, clínicas y de laboratorio de pacientes con COVID-19 y con requerimiento de ingreso a la unidad de cuidados intensivos (UCI).

Objetivo. Comparar las características sociodemográficas, clínicas, imagenológicas y de laboratorio de pacientes diagnosticados con COVID-19 atendidos en el servicio de urgencias de una clínica en Cali, Colombia, según requerimiento de ingreso a UCI.

Materiales y métodos. Estudio retrospectivo descriptivo de cohorte única realizado en 49 adultos con COVID-19 atendidos en el servicio de urgencias de un hospital de cuarto nivel de atención de Cali entre marzo y abril de 2020, los cuales se dividieron en dos grupos: requerimiento de ingreso a UCI (n=24) y no requerimiento de ingreso a UCI (n=25). Se realizaron análisis bivariados para determinar las diferencias entre ambos grupos (pruebas de chi-cuadrado, exacta de Fisher, t de Student y U de Mann-Whitney), con un nivel de significancia de p<0.05.

Resultados. La edad promedio fue 53 años (DE=13) y 29 pacientes fueron hombres. Se encontraron diferencias significativas entre ambos grupos en las siguientes variables: edad promedio (UCI x̅=58 vs. No UCI x̅=49; p=0.020); presencia de diabetes (8 vs. 1; p=0.010); presencia de dificultad respiratoria (20 vs. 11; p=0.007); presencia uni o bilateral de áreas de consolidación (12 vs. 3; p=0.005), y mediana del conteo de leucocitos (Med=7 570/mm³ vs. Med=5 130/mm³; p=0.0013), neutrófilos (Med=5 980/mm³ vs. Med=3 450/mm³; p=0.0001), linfocitos (Med=865/mm³ vs. Med=1 400/mm³; p<0.0001), proteína C reactiva (Med=141.25 mg/L vs. Med=27.95 mg/L; p<0.001), ferritina (Med=1038 ng/L vs. Med=542.5 ng/L; p=0.0073) y lactato-deshidrogenasa (Med=391 U/L vs. Med=248.5 U/L; p=0.0014). Finalmente, 15 pacientes requirieron ventilación mecánica invasiva, 2 presentaron extubación fallida y 5 fallecieron.

Conclusiones. Se observaron diferencias significativas en los valores de varios marcadores inflamatorios, daño celular y parámetros del hemograma entre los pacientes que requirieron admisión a la UCI y los que no, por lo que estas variables podrían emplearse para desarrollar herramientas que contribuyan a establecer el pronóstico de esta enfermedad.

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