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Medicina crítica (Colegio Mexicano de Medicina Crítica)

Print version ISSN 2448-8909

Abstract

DIAZ AGUILAR, Francisco Alonso et al. Experience in the clinical picture, diagnosis and treatment of COVID-19. Med. crít. (Col. Mex. Med. Crít.) [online]. 2021, vol.35, n.5, pp.243-249.  Epub May 23, 2022. ISSN 2448-8909.  https://doi.org/10.35366/102352.

Introduction:

The SARS-CoV-2 infection in Wuhan, China caused a pandemic of such magnitude that it has caused the death of millions of people from pneumonia due to infectious disease caused by coronavirus 19 (COVID-19). We took on the task of collecting all the characteristics of the patients who were hospitalized for this disease in our Adult Intensive Care Unit.

Material and methods:

An analytical, descriptive, observational and retrospective study was carried out in patients with a diagnosis of COVID-19 admitted to the Intensive Care Unit (ICU) of the Hospital Ángeles Clínica Londres in Mexico City, evaluated in the period of March 23 from 2020 to May 10, 2020. The files were reviewed and the data taken from them, demographic variables, risk factors, signs and symptoms, medical treatment and respiratory care were described. SAPS III, APACHE II, SOFA and CALL-score mortality scales were reviewed. Two groups were formed with and without mortality, performing bivariate and multivariate analyzes of the significant variables. Statistical analysis was performed with the SPSS 25 program.

Results:

In the period considered, 25 files met the inclusion criteria for them: demographics and risk factors were 18 (72%) corresponding to men and seven (38%) to women. With a mortality of 10 (40%). The most frequent risk factors are diabetes mellitus (DM) in seven (38%), arterial hypertension (SAH) six (24%), obesity four (16%), chronic obstructive pulmonary disease (COPD) one (4%), smoking 11 (44%) and alcoholism seven (28%). Statistically significant differences were found in the groups without mortality and with mortality 15 and 10 patients respectively, observing the following significance: glucose 105 mg/dL (percentil [PE] 88) versus 171 mg/dL (PE 125) p = 0.012, urea 33 mg/dL (PE 22) versus 95 mg/dL (PE 57) p = 0.03, BUN 15.3 mg/dL (PE 11) versus 44.2 mg/dL (PE 26.28) p = 0.04, TGO 32 U/L (PE 24.4) versus 58 U/L (PE 43.8) p = 0.010, DHL 239 U/L (PE 198) 454 U/L (PE 260) p = 0.003, triglycerides 148 mg/dL (PE 120) versus 187.5 mg/dL (PE 165) p = 0.002, CPK 70 U/L (PE 35) versus 81 U/L (PE 78.25) p = 0.003, ferritin 446 mg/L (PE 238) versus 1,030 mg/L (PE 665) p = 0.007. A bivariate analysis with binary logistic regression was performed, with the dichotomous mortality variable, not resulting in this significant test.

Conclusions:

It is understood that no variable is predominantly important to explain mortality and that many factors are involved that are combined to explain this outcome, one of these being the same severity of the respiratory problem in which the patient is.

Keywords : COVID-19; SARS-CoV-2; SAPS III; APACHE II; SOFA; CALL-score.

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