Clinical Medicine Research

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Clinical and Demographic Characteristics on Admission and Their Prognostic Value at Discharge in 529 Consecutive COVID-19 Patients in Santiago, Chile

Received: 13 December 2020    Accepted: 28 December 2020    Published: 04 January 2021
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Abstract

On June 04, 2020, Chile had 113,628 cases COVID-19, 1275 deaths, 1450 patients were on invasive mechanical ventilation (IMV). The objective was describing the characteristics on admission and their relationship with the condition at discharge of patients with positive real-time polymerase chain reaction test for SARS CoV-2 (RT-PCR) in a tertiary health center. Methods: Retrospective and observational cohort study of 529 consecutive patients with positive RT-PCR for SARS CoV-2, discharged between March 14 and June 4, 2020 from Clinica Davila, Santiago. Demographic data, laboratory tests, Quality Adjusted Life Years (QALY), medical insurance, ventilatory assistance, and discharge condition were collected. Differences were evaluated by chi-square test, student’s t test, or Mann–Whitney U test. Logistic regression analysis was performed to identify variables that were predictive of condition at discharge. Results: A total of 529 patients were included (median age, 49 years [interquartile range {IQR}, 37-62; range, 0-97 years]; 45% women). The most common comorbidities were hypertension (171, 32.3%) and diabetes mellitus (98, 18.5%), On admission 352 patients (66.5%) had respiratory symptoms and 177 (33.4%) had other symptoms or other diagnoses. The median (IQR) PaO2 / FiO2 on admission of survivors, non-survivors and transferred were 316 (261-360), 167 (80-268) and 212 (130-261) respectively. At discharge, 448 (84.7%) were survivors, 54 (10.2%) non-survivors, and 27 (5.1%) were transferred to other centers. Median age of survivors and non-survivors was 46 (36-59) and 75.5 (66-84) years. Of the 116 patients (21,9%) who received support ventilation, 67 were discharged alive (57.8%), 28 died (24%), and 21 (18%) were transferred to another hospital. The variables associated with risk of death were: age ≥ 60 years (OR 15.3; 95% CI: 7.25–32.2; P = 0.001); QALY score ≤ 15 points (OR 14.01; 95% CI: 4.82 -40.67; P = 0.001); state health insurance (OR, 2.82; 95% CI: 1.38–5.77; P = 0.004); PaO2 / FiO2 on admission ≤ 200 (OR 5.2; 95% CI: 1.94-13.94; P = 0.001) and high sensitivity T Troponin ≥ 15 ng / L (OR 5.16; 95% CI: 1.95-13.64; P = 0.001). Conclusions: this cohort showed that on admission COVID-19 patients, the PaO2 / FiO2, creatinine and high sensitivity T troponin at the described cut-off points had prognostic value. At discharge, the non-survivors were the older, most often had state health insurance and their QALY scores were significantly lower.

DOI 10.11648/j.cmr.20211001.11
Published in Clinical Medicine Research (Volume 10, Issue 1, January 2021)
Page(s) 1-8
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Coronavirus Infections, Quality Adjusted Life Years, Health Insurance, Pcr Sars CoV2, Prognostic Factors, COVID-19

References
[1] https://www.diariooficial.interior.gob.cl/publicaciones/2020/06/04/42672/01/1769770.pdf
[2] https://www.diariooficial.interior.gob.cl/publicaciones/2020/06/04/42672/01/1769770.pdf Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020, http://dx.doi.org/10.1001/jama.2020.2648 [Epub ahead of print].
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[9] Haomiao Jia, Erica I. Lubetkin, John P. Barile, Willi Horner-Johnson, Kimberly DeMichele, Debra S. Stark, Matthew M. Zack, William W. Thompson. Quality-adjusted Life Years (QALY) for 15 Chronic Conditions and Combinations of Conditions Among US Adults Aged 65 and Older. Medical Care 2018; 56 (8): 740-746.
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[13] Gupta S, Hayek S, Wang W, Chan L, Mathews K, Melamed M, et al. Factors Associated with Death in Critically III Patients with Coronavirus Disease 2019 in the US. JAMA Intern Med. 2020 Jul 15; e203596. Doi: 10.1001/jamaintermed.2020.3596.
[14] Correspondence. Clinical Characteristics of COVID-19 in New York City. N Engl J Med 382; 24.
[15] Richardson S, Hirsch J, Narasimhan M, Crawford J, McGinn T, Davidson K, Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized Witch COVID-19 in the New York City Area. 2020; 323 (20): 2052-2059.
[16] Winck JC, Ambrosino N. COVID-19 pandemic and non-invasive respiratory management: Every Goliath needs a David. An evidence-based evaluation of problems. Pulmonology. 2020; 26 (4): 213–20
[17] Gattinoni L, Chiumello D, Caironi P, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med. 2020; 46 (6): 1099–102.
[18] Charlson ME, Pompei P, Ales KL, MacKenzie CR.: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40 (5): 373-383.
[19] Shi, S.; Qin, M.; Shen, B.; Cai, Y.; Liu, T.; Yang, F.; Gong, W.; Liu, X.; Liang, J.; Zhao, Q.; et al. Association of Cardiac Injury with Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. 2020, 5, 802.
[20] Lala, A.; Johnson, K. W.; Januzzi, J. L.; Russak, A. J.; Paranjpe, I.; Richter, F.; Zhao, S.; Somani, S.; Van Vleck, T.; Vaid, A.; et al. Prevalence and Impact of Myocardial Injury in Patients Hospitalized With COVID-19 Infection. J. Am. Coll. Cardiol. 2020, 76, 533–546.
[21] Schiavone M, Gasperetti A, Mancone M, Kaplan A, Gobbi C, Mascioli G, Busana N, Saguner A, Mitacchione G, Giacomelli A, Sardella G, Viecca M, Duru F, Antonori S, Carugo S, Bartorelli A, Tondo C, Galli M, Fedele F and Forleo G B. Redefining the Prognostic Value of High-Sensitivity Trponin in COVID-19 Patients: The importance of Concomitant Coronary Artery Disease. J. Clin. Med. 2020, 9, 3263.
Author Information
  • Department of Pulmonary Diseases, Clinica Davila, Santiago, Chile

  • Adult Intensive Care Unit, Clinica Davila, Santiago, Chile

  • Department of Pulmonary Diseases, Clinica Davila, Santiago, Chile

  • Department of Epidemiology, School of Nurse and Midwifery, Universidad de los Andes, Santiago, Chile

  • School of Medicine, Universidad de los Andes, Santiago, Chile

  • School of Medicine, Universidad de los Andes, Santiago, Chile

  • School of Medicine, Universidad de los Andes, Santiago, Chile

  • School of Medicine, Universidad de los Andes, Santiago, Chile

  • School of Medicine, Universidad de los Andes, Santiago, Chile

  • Department of Medical Management, Clinica Davila, Santiago, Chile

  • Department of Medical Management, Clinica Davila, Santiago, Chile

  • Department of Medical Management, Clinica Davila, Santiago, Chile

  • Adult Intensive Care Unit, Clinica Davila, Santiago, Chile

  • Department of Surgery, Surgical Pavilions, Clinica Davila, Santiago, Chile

  • Emergency Service, Clinica Davila, Santiago, Chile

  • Adult Intensive Care Unit, Clinica Davila, Santiago, Chile

  • Adult Intensive Care Unit, Clinica Davila, Santiago, Chile

  • Adult Intensive Care Unit, Clinica Davila, Santiago, Chile

  • Laboratory Service, Molecular Biology Section, Santiago, Chile

  • Pediatric Intensive Care Unit, Clinica Davila, Santiago, Chile

  • Department of Pulmonary Diseases, Clinica Davila, Santiago, Chile

  • Ethics Committee, Clinica Davila, Santiago, Chile

  • Department of Medical Management, Clinica Davila, Santiago, Chile

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    Cesar Maquilon Ortiz, Jonas Alberto Gongora, Monica Antolini Toledo, Nicolas Fernando Valdes, Angela Benavente, et al. (2021). Clinical and Demographic Characteristics on Admission and Their Prognostic Value at Discharge in 529 Consecutive COVID-19 Patients in Santiago, Chile. Clinical Medicine Research, 10(1), 1-8. https://doi.org/10.11648/j.cmr.20211001.11

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    ACS Style

    Cesar Maquilon Ortiz; Jonas Alberto Gongora; Monica Antolini Toledo; Nicolas Fernando Valdes; Angela Benavente, et al. Clinical and Demographic Characteristics on Admission and Their Prognostic Value at Discharge in 529 Consecutive COVID-19 Patients in Santiago, Chile. Clin. Med. Res. 2021, 10(1), 1-8. doi: 10.11648/j.cmr.20211001.11

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    AMA Style

    Cesar Maquilon Ortiz, Jonas Alberto Gongora, Monica Antolini Toledo, Nicolas Fernando Valdes, Angela Benavente, et al. Clinical and Demographic Characteristics on Admission and Their Prognostic Value at Discharge in 529 Consecutive COVID-19 Patients in Santiago, Chile. Clin Med Res. 2021;10(1):1-8. doi: 10.11648/j.cmr.20211001.11

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  • @article{10.11648/j.cmr.20211001.11,
      author = {Cesar Maquilon Ortiz and Jonas Alberto Gongora and Monica Antolini Toledo and Nicolas Fernando Valdes and Angela Benavente and Maria Gabriela Bofill and Macarena Urra and Diego Rojas Carvajal and Javiera Huidobro Navarro and Bernardita Alvarado Breton and Maria Carolina Asenjo and Cherie Gutierrez Rojas and Jose Gajardo and Patricia Cisternas and Guillermo Garcia and Juan Pablo Peralta and Lenny Loor Garcia and Annelise Sepulveda and Cecilia Tapia and Luis Fernando Mallea and Felipe Rivera and Ezio Parodi and Jyh Kae Nien},
      title = {Clinical and Demographic Characteristics on Admission and Their Prognostic Value at Discharge in 529 Consecutive COVID-19 Patients in Santiago, Chile},
      journal = {Clinical Medicine Research},
      volume = {10},
      number = {1},
      pages = {1-8},
      doi = {10.11648/j.cmr.20211001.11},
      url = {https://doi.org/10.11648/j.cmr.20211001.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.cmr.20211001.11},
      abstract = {On June 04, 2020, Chile had 113,628 cases COVID-19, 1275 deaths, 1450 patients were on invasive mechanical ventilation (IMV). The objective was describing the characteristics on admission and their relationship with the condition at discharge of patients with positive real-time polymerase chain reaction test for SARS CoV-2 (RT-PCR) in a tertiary health center. Methods: Retrospective and observational cohort study of 529 consecutive patients with positive RT-PCR for SARS CoV-2, discharged between March 14 and June 4, 2020 from Clinica Davila, Santiago. Demographic data, laboratory tests, Quality Adjusted Life Years (QALY), medical insurance, ventilatory assistance, and discharge condition were collected. Differences were evaluated by chi-square test, student’s t test, or Mann–Whitney U test. Logistic regression analysis was performed to identify variables that were predictive of condition at discharge. Results: A total of 529 patients were included (median age, 49 years [interquartile range {IQR}, 37-62; range, 0-97 years]; 45% women). The most common comorbidities were hypertension (171, 32.3%) and diabetes mellitus (98, 18.5%), On admission 352 patients (66.5%) had respiratory symptoms and 177 (33.4%) had other symptoms or other diagnoses. The median (IQR) PaO2 / FiO2 on admission of survivors, non-survivors and transferred were 316 (261-360), 167 (80-268) and 212 (130-261) respectively. At discharge, 448 (84.7%) were survivors, 54 (10.2%) non-survivors, and 27 (5.1%) were transferred to other centers. Median age of survivors and non-survivors was 46 (36-59) and 75.5 (66-84) years. Of the 116 patients (21,9%) who received support ventilation, 67 were discharged alive (57.8%), 28 died (24%), and 21 (18%) were transferred to another hospital. The variables associated with risk of death were: age ≥ 60 years (OR 15.3; 95% CI: 7.25–32.2; P = 0.001); QALY score ≤ 15 points (OR 14.01; 95% CI: 4.82 -40.67; P = 0.001); state health insurance (OR, 2.82; 95% CI: 1.38–5.77; P = 0.004); PaO2 / FiO2 on admission ≤ 200 (OR 5.2; 95% CI: 1.94-13.94; P = 0.001) and high sensitivity T Troponin ≥ 15 ng / L (OR 5.16; 95% CI: 1.95-13.64; P = 0.001). Conclusions: this cohort showed that on admission COVID-19 patients, the PaO2 / FiO2, creatinine and high sensitivity T troponin at the described cut-off points had prognostic value. At discharge, the non-survivors were the older, most often had state health insurance and their QALY scores were significantly lower.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Clinical and Demographic Characteristics on Admission and Their Prognostic Value at Discharge in 529 Consecutive COVID-19 Patients in Santiago, Chile
    AU  - Cesar Maquilon Ortiz
    AU  - Jonas Alberto Gongora
    AU  - Monica Antolini Toledo
    AU  - Nicolas Fernando Valdes
    AU  - Angela Benavente
    AU  - Maria Gabriela Bofill
    AU  - Macarena Urra
    AU  - Diego Rojas Carvajal
    AU  - Javiera Huidobro Navarro
    AU  - Bernardita Alvarado Breton
    AU  - Maria Carolina Asenjo
    AU  - Cherie Gutierrez Rojas
    AU  - Jose Gajardo
    AU  - Patricia Cisternas
    AU  - Guillermo Garcia
    AU  - Juan Pablo Peralta
    AU  - Lenny Loor Garcia
    AU  - Annelise Sepulveda
    AU  - Cecilia Tapia
    AU  - Luis Fernando Mallea
    AU  - Felipe Rivera
    AU  - Ezio Parodi
    AU  - Jyh Kae Nien
    Y1  - 2021/01/04
    PY  - 2021
    N1  - https://doi.org/10.11648/j.cmr.20211001.11
    DO  - 10.11648/j.cmr.20211001.11
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 1
    EP  - 8
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20211001.11
    AB  - On June 04, 2020, Chile had 113,628 cases COVID-19, 1275 deaths, 1450 patients were on invasive mechanical ventilation (IMV). The objective was describing the characteristics on admission and their relationship with the condition at discharge of patients with positive real-time polymerase chain reaction test for SARS CoV-2 (RT-PCR) in a tertiary health center. Methods: Retrospective and observational cohort study of 529 consecutive patients with positive RT-PCR for SARS CoV-2, discharged between March 14 and June 4, 2020 from Clinica Davila, Santiago. Demographic data, laboratory tests, Quality Adjusted Life Years (QALY), medical insurance, ventilatory assistance, and discharge condition were collected. Differences were evaluated by chi-square test, student’s t test, or Mann–Whitney U test. Logistic regression analysis was performed to identify variables that were predictive of condition at discharge. Results: A total of 529 patients were included (median age, 49 years [interquartile range {IQR}, 37-62; range, 0-97 years]; 45% women). The most common comorbidities were hypertension (171, 32.3%) and diabetes mellitus (98, 18.5%), On admission 352 patients (66.5%) had respiratory symptoms and 177 (33.4%) had other symptoms or other diagnoses. The median (IQR) PaO2 / FiO2 on admission of survivors, non-survivors and transferred were 316 (261-360), 167 (80-268) and 212 (130-261) respectively. At discharge, 448 (84.7%) were survivors, 54 (10.2%) non-survivors, and 27 (5.1%) were transferred to other centers. Median age of survivors and non-survivors was 46 (36-59) and 75.5 (66-84) years. Of the 116 patients (21,9%) who received support ventilation, 67 were discharged alive (57.8%), 28 died (24%), and 21 (18%) were transferred to another hospital. The variables associated with risk of death were: age ≥ 60 years (OR 15.3; 95% CI: 7.25–32.2; P = 0.001); QALY score ≤ 15 points (OR 14.01; 95% CI: 4.82 -40.67; P = 0.001); state health insurance (OR, 2.82; 95% CI: 1.38–5.77; P = 0.004); PaO2 / FiO2 on admission ≤ 200 (OR 5.2; 95% CI: 1.94-13.94; P = 0.001) and high sensitivity T Troponin ≥ 15 ng / L (OR 5.16; 95% CI: 1.95-13.64; P = 0.001). Conclusions: this cohort showed that on admission COVID-19 patients, the PaO2 / FiO2, creatinine and high sensitivity T troponin at the described cut-off points had prognostic value. At discharge, the non-survivors were the older, most often had state health insurance and their QALY scores were significantly lower.
    VL  - 10
    IS  - 1
    ER  - 

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