398. Risk Factors Associated with Requiring Invasive Mechanical Ventilation in Patients with SARS-CoV-2 Infection: Experience in a Tertiary Care Hospital in Mexico City

BACKGROUND: The clinical presentation of SARS-CoV-2 disease ranges from asymptomatic respiratory infection to acute respiratory distress syndrome. Risk factors upon hospital admission associated with the need for invasive mechanical ventilation are not well documented. METHODS: 185 hospitalized patients with confirmed COVID-19 were enrolled in this study, and they were classified as patients who required invasive mechanical ventilation and patients who did not require it. Comorbidities such as diabetes, high blood pressure, obesity, chronic lung disease and immunodeficiency were recorded. Laboratory studies were requested upon admission such as C-reactive protein, leukocyte and lymphocyte levels, D-dimer, troponin, serum ferritin and procalcitonin. RESULTS: Of the patients who entered the study, 65 patients (35%) required invasive mechanical ventilation (IMV), while 120 (65%) did not require advanced airway management. Of the patients with invasive mechanical ventilation, age > 65 years, male sex, obesity (BMI > 30) and high blood pressure were the most frequent characteristics, presenting the latter two in 26% and 27% respectively. Regarding laboratory studies, the parameters most associated with the requirement for mechanical ventilation were a D-dimer (> 1000) and troponin (> 1), with 26% and 18%, respectively. CONCLUSION: This study showed the high proportion of obesity, hypertension and advanced age among patients who required invasive mechanical ventilation associated with SARS-CoV2 infection. The presence of elevated D-dimer and troponin on admission are associated with more severe presentations and a requirement for invasive mechanical ventilation. DISCLOSURES: All Authors: No reported disclosures