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Sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized COVID-19 patients at alternate care site: a Latin American experience

BACKGROUND: The establishment of Alternate Care Sites (ACS) helped the most severely impacted countries expand their response capability. The aim of this study was to evaluate the clinical characteristics and risk factors associated with the mortality of hospitalized COVID-19 patients at Alternate C...

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Autores principales: Alegría-Baños, Jorge A., Rosas-Alvarado, Montserrat A., Jiménez-López, José C., Juárez-Muciño, Marcos, Méndez-Celis, Carlos A., Enríquez-De Los Santos, Sharon T., Valdez-Vázquez, Rafael R., Prada-Ortega, Diddier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10281393/
https://www.ncbi.nlm.nih.gov/pubmed/37322999
http://dx.doi.org/10.1080/07853890.2023.2224049
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author Alegría-Baños, Jorge A.
Rosas-Alvarado, Montserrat A.
Jiménez-López, José C.
Juárez-Muciño, Marcos
Méndez-Celis, Carlos A.
Enríquez-De Los Santos, Sharon T.
Valdez-Vázquez, Rafael R.
Prada-Ortega, Diddier
author_facet Alegría-Baños, Jorge A.
Rosas-Alvarado, Montserrat A.
Jiménez-López, José C.
Juárez-Muciño, Marcos
Méndez-Celis, Carlos A.
Enríquez-De Los Santos, Sharon T.
Valdez-Vázquez, Rafael R.
Prada-Ortega, Diddier
author_sort Alegría-Baños, Jorge A.
collection PubMed
description BACKGROUND: The establishment of Alternate Care Sites (ACS) helped the most severely impacted countries expand their response capability. The aim of this study was to evaluate the clinical characteristics and risk factors associated with the mortality of hospitalized COVID-19 patients at Alternate Care Site in Mexico City. PATIENTS AND METHODS: A monocentric cohort study was conducted at Mexico City’s Temporary Unit COVID-19 (UTC-19). Sociodemographic, clinical, laboratory and treatment variables were included in the analysis. RESULTS: A total of 4865 patients were included, with a mean age of 49.33 years ± SD 15.28 years (IQR 38 to 60 years); 50.53% were women. 63.53% of the patients presented at least one comorbidity, the most frequent being: obesity (39.94%), systemic arterial hypertension (25.14%), and diabetes mellitus (21.52%). A total of 4549 patients (93.50%) were discharged due to improvement, 64 patients (1.31%) requested voluntary discharge, 39 patients (0.80%) were referred to another unit, and 213 patients (4.37%) died. Factors that were independently and significantly associated with death included male gender (odds ratio [OR], 1.60), age ≥ 50 years (OR 14.75), null or low schooling (OR 3.47), have at least one comorbidity (OR 3.26), atrial fibrillation (OR 22.14). In the multivariate analysis, the lymphopenia ≤ 1 × 10(3/)μL (OR 1.91), and having required steroid treatment (OR 2.85), supplemental oxygen with high-flow nasal cannula (OR 3.12) or invasive mechanical ventilation (OR 42.52), was significantly associated with an increased risk of death. CONCLUSIONS: This study identified the clinical characteristics and risk factors for mortality of hospitalized COVID-19 patients at ACS in Mexico City. KEY MESSAGES: An Alternate Care Site (ACS) is any building or structure that is temporarily converted or constructed for healthcare use during a public health emergency. Factors associated with death included male gender, age over 50 years, and lower educational attainment (elementary school or less). The findings corroborate the utility of the CALL score as a predictor of mortality; lymphopenia ≤1 × 10(3)/μL was the most relevant biomarker.
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spelling pubmed-102813932023-06-21 Sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized COVID-19 patients at alternate care site: a Latin American experience Alegría-Baños, Jorge A. Rosas-Alvarado, Montserrat A. Jiménez-López, José C. Juárez-Muciño, Marcos Méndez-Celis, Carlos A. Enríquez-De Los Santos, Sharon T. Valdez-Vázquez, Rafael R. Prada-Ortega, Diddier Ann Med Public Health BACKGROUND: The establishment of Alternate Care Sites (ACS) helped the most severely impacted countries expand their response capability. The aim of this study was to evaluate the clinical characteristics and risk factors associated with the mortality of hospitalized COVID-19 patients at Alternate Care Site in Mexico City. PATIENTS AND METHODS: A monocentric cohort study was conducted at Mexico City’s Temporary Unit COVID-19 (UTC-19). Sociodemographic, clinical, laboratory and treatment variables were included in the analysis. RESULTS: A total of 4865 patients were included, with a mean age of 49.33 years ± SD 15.28 years (IQR 38 to 60 years); 50.53% were women. 63.53% of the patients presented at least one comorbidity, the most frequent being: obesity (39.94%), systemic arterial hypertension (25.14%), and diabetes mellitus (21.52%). A total of 4549 patients (93.50%) were discharged due to improvement, 64 patients (1.31%) requested voluntary discharge, 39 patients (0.80%) were referred to another unit, and 213 patients (4.37%) died. Factors that were independently and significantly associated with death included male gender (odds ratio [OR], 1.60), age ≥ 50 years (OR 14.75), null or low schooling (OR 3.47), have at least one comorbidity (OR 3.26), atrial fibrillation (OR 22.14). In the multivariate analysis, the lymphopenia ≤ 1 × 10(3/)μL (OR 1.91), and having required steroid treatment (OR 2.85), supplemental oxygen with high-flow nasal cannula (OR 3.12) or invasive mechanical ventilation (OR 42.52), was significantly associated with an increased risk of death. CONCLUSIONS: This study identified the clinical characteristics and risk factors for mortality of hospitalized COVID-19 patients at ACS in Mexico City. KEY MESSAGES: An Alternate Care Site (ACS) is any building or structure that is temporarily converted or constructed for healthcare use during a public health emergency. Factors associated with death included male gender, age over 50 years, and lower educational attainment (elementary school or less). The findings corroborate the utility of the CALL score as a predictor of mortality; lymphopenia ≤1 × 10(3)/μL was the most relevant biomarker. Taylor & Francis 2023-06-15 /pmc/articles/PMC10281393/ /pubmed/37322999 http://dx.doi.org/10.1080/07853890.2023.2224049 Text en © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
spellingShingle Public Health
Alegría-Baños, Jorge A.
Rosas-Alvarado, Montserrat A.
Jiménez-López, José C.
Juárez-Muciño, Marcos
Méndez-Celis, Carlos A.
Enríquez-De Los Santos, Sharon T.
Valdez-Vázquez, Rafael R.
Prada-Ortega, Diddier
Sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized COVID-19 patients at alternate care site: a Latin American experience
title Sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized COVID-19 patients at alternate care site: a Latin American experience
title_full Sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized COVID-19 patients at alternate care site: a Latin American experience
title_fullStr Sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized COVID-19 patients at alternate care site: a Latin American experience
title_full_unstemmed Sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized COVID-19 patients at alternate care site: a Latin American experience
title_short Sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized COVID-19 patients at alternate care site: a Latin American experience
title_sort sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized covid-19 patients at alternate care site: a latin american experience
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10281393/
https://www.ncbi.nlm.nih.gov/pubmed/37322999
http://dx.doi.org/10.1080/07853890.2023.2224049
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