Bernardo A Martínez-Guerra, Carla Medrano-Borromeo, María F González-Lara, Carla M Román-Montes, Karla M Tamez-Torres, Sandra Rajme-López, Karla D Salgado-Guízar, Noe A Juárez-Menéndez, Pilar Ramos-Cervantes, Guillermo M Ruiz-Palacios, Alfredo Ponce-de-León, José Sifuentes-Osornio
{"title":"年轻无合并症COVID-19患者预后不良的预测因素","authors":"Bernardo A Martínez-Guerra, Carla Medrano-Borromeo, María F González-Lara, Carla M Román-Montes, Karla M Tamez-Torres, Sandra Rajme-López, Karla D Salgado-Guízar, Noe A Juárez-Menéndez, Pilar Ramos-Cervantes, Guillermo M Ruiz-Palacios, Alfredo Ponce-de-León, José Sifuentes-Osornio","doi":"10.24875/RIC.22000162","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Prognostic factors in previously healthy young patients with COVID-19 remained understudied.</p><p><strong>Objectives: </strong>The objective of the study was to identify factors associated with in-hospital death or need for invasive mechanical ventilation (IMV) in young (aged ≤ 65 years) and previously healthy patients with COVID-19.</p><p><strong>Methods: </strong>We conducted a prospective cohort study that included patients admitted with COVID-19. The primary outcome was in-hospital death/need for IMV. Secondary outcomes included need for IMV during follow-up, days on IMV, length of stay (LOS), hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP), and pulmonary embolism (PE). Bivariate and multivariate analyses were performed.</p><p><strong>Results: </strong>Among 92 patients, primary outcome occurred in 16 (17%), death in 12 (13%), need for IMV in 16 (17%), HAP/VAP in 7 (8%), and PE in 2 (2%). Median LOS and IMV duration were 7 and 12 days, respectively. Independent associations were found between the primary outcome and male sex (Adjusted odds ratio [aOR] 7.1, 95%CI 1.1-46.0, p < 0.05), D-dimer levels > 1000ng/mL (aOR 9.0, 95%CI 1.6-49.1, p < 0.05), and RT-PCR Ct-value ≤ 24 on initial swab samples (aOR 14.3, 95%CI 2.0-101.5, p < 0.01).</p><p><strong>Conclusions: </strong>In young and non-comorbid COVID-19 patients, male sex, higher levels of D-dimer, and low SARS-CoV-2 RT-PCR Ct-value on an initial nasopharyngeal swab were independently associated with increased in-hospital mortality or need for IMV. (Rev Invest Clin. 2022;74(5):268-75).</p>","PeriodicalId":49612,"journal":{"name":"Revista De Investigacion Clinica-Clinical and Translational Investigation","volume":"74 5","pages":"268-275"},"PeriodicalIF":1.4000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictors of Poor Outcomes in Young Non-Comorbid Patients with COVID-19.\",\"authors\":\"Bernardo A Martínez-Guerra, Carla Medrano-Borromeo, María F González-Lara, Carla M Román-Montes, Karla M Tamez-Torres, Sandra Rajme-López, Karla D Salgado-Guízar, Noe A Juárez-Menéndez, Pilar Ramos-Cervantes, Guillermo M Ruiz-Palacios, Alfredo Ponce-de-León, José Sifuentes-Osornio\",\"doi\":\"10.24875/RIC.22000162\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Prognostic factors in previously healthy young patients with COVID-19 remained understudied.</p><p><strong>Objectives: </strong>The objective of the study was to identify factors associated with in-hospital death or need for invasive mechanical ventilation (IMV) in young (aged ≤ 65 years) and previously healthy patients with COVID-19.</p><p><strong>Methods: </strong>We conducted a prospective cohort study that included patients admitted with COVID-19. The primary outcome was in-hospital death/need for IMV. Secondary outcomes included need for IMV during follow-up, days on IMV, length of stay (LOS), hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP), and pulmonary embolism (PE). Bivariate and multivariate analyses were performed.</p><p><strong>Results: </strong>Among 92 patients, primary outcome occurred in 16 (17%), death in 12 (13%), need for IMV in 16 (17%), HAP/VAP in 7 (8%), and PE in 2 (2%). Median LOS and IMV duration were 7 and 12 days, respectively. Independent associations were found between the primary outcome and male sex (Adjusted odds ratio [aOR] 7.1, 95%CI 1.1-46.0, p < 0.05), D-dimer levels > 1000ng/mL (aOR 9.0, 95%CI 1.6-49.1, p < 0.05), and RT-PCR Ct-value ≤ 24 on initial swab samples (aOR 14.3, 95%CI 2.0-101.5, p < 0.01).</p><p><strong>Conclusions: </strong>In young and non-comorbid COVID-19 patients, male sex, higher levels of D-dimer, and low SARS-CoV-2 RT-PCR Ct-value on an initial nasopharyngeal swab were independently associated with increased in-hospital mortality or need for IMV. (Rev Invest Clin. 2022;74(5):268-75).</p>\",\"PeriodicalId\":49612,\"journal\":{\"name\":\"Revista De Investigacion Clinica-Clinical and Translational Investigation\",\"volume\":\"74 5\",\"pages\":\"268-275\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista De Investigacion Clinica-Clinical and Translational Investigation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.24875/RIC.22000162\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista De Investigacion Clinica-Clinical and Translational Investigation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.24875/RIC.22000162","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Predictors of Poor Outcomes in Young Non-Comorbid Patients with COVID-19.
Background: Prognostic factors in previously healthy young patients with COVID-19 remained understudied.
Objectives: The objective of the study was to identify factors associated with in-hospital death or need for invasive mechanical ventilation (IMV) in young (aged ≤ 65 years) and previously healthy patients with COVID-19.
Methods: We conducted a prospective cohort study that included patients admitted with COVID-19. The primary outcome was in-hospital death/need for IMV. Secondary outcomes included need for IMV during follow-up, days on IMV, length of stay (LOS), hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP), and pulmonary embolism (PE). Bivariate and multivariate analyses were performed.
Results: Among 92 patients, primary outcome occurred in 16 (17%), death in 12 (13%), need for IMV in 16 (17%), HAP/VAP in 7 (8%), and PE in 2 (2%). Median LOS and IMV duration were 7 and 12 days, respectively. Independent associations were found between the primary outcome and male sex (Adjusted odds ratio [aOR] 7.1, 95%CI 1.1-46.0, p < 0.05), D-dimer levels > 1000ng/mL (aOR 9.0, 95%CI 1.6-49.1, p < 0.05), and RT-PCR Ct-value ≤ 24 on initial swab samples (aOR 14.3, 95%CI 2.0-101.5, p < 0.01).
Conclusions: In young and non-comorbid COVID-19 patients, male sex, higher levels of D-dimer, and low SARS-CoV-2 RT-PCR Ct-value on an initial nasopharyngeal swab were independently associated with increased in-hospital mortality or need for IMV. (Rev Invest Clin. 2022;74(5):268-75).
期刊介绍：
The Revista de Investigación Clínica – Clinical and Translational Investigation (RIC-C&TI), publishes original clinical and biomedical research of interest to physicians in internal medicine, surgery, and any of their specialties. The Revista de Investigación Clínica – Clinical and Translational Investigation is the official journal of the National Institutes of Health of Mexico, which comprises a group of Institutes and High Specialty Hospitals belonging to the Ministery of Health. The journal is published both on-line and in printed version, appears bimonthly and publishes peer-reviewed original research articles as well as brief and in-depth reviews. All articles published are open access and can be immediately and permanently free for everyone to read and download. The journal accepts clinical and molecular research articles, short reports and reviews.
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– Original Articles
– Brief Reviews
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