RESUMEN
BACKGROUND: Peru is the country with the world's highest COVID-19 death rate per capita. Characteristics associated with increased mortality among adult patients with COVID-19 pneumonia in this setting are not well described. METHODS: Retrospective, single-center cohort study including 1537 adult patients hospitalized with a diagnosis of SARS-CoV-2 pneumonia between May 2020 and August 2020 at a national hospital in Lima, Peru. The primary outcome measure was in-hospital mortality. RESULTS: In-hospital mortality was 49.71%. The mean age was 60 ± 14.25 years, and 68.38% were males. We found an association between mortality and inflammatory markers, mainly leukocytes, D-dimer, lactate dehydrogenase, C-reactive protein and ferritin. A multivariate model adjusted for age, hypertension, diabetes mellitus, and corticosteroid use demonstrated that in-hospital mortality was associated with greater age (RR: 2.01, 95%CI: 1.59-2.52) and a higher level of oxygen requirement (RR: 2.77, 95%CI: 2.13-3.62). Conclusions: In-hospital mortality among COVID-19 patients in Peru is high and is associated with greater age and higher oxygen requirements.
Asunto(s)
COVID-19/mortalidad , Hospitalización/estadística & datos numéricos , Factores de Edad , Anciano , Proteína C-Reactiva/análisis , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/virología , Comorbilidad , Femenino , Ferritinas/análisis , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Perú/epidemiología , Respiración Artificial , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2/aislamiento & purificaciónRESUMEN
Se presenta el caso de un paciente varón de 20 años, natural de Ancash y procedente de Lima, sin antecedentes patológicos de importancia, que ingresa por presentar cuadro de HDA (hemorragia digestiva alta), evidenciándose en la Endoscopia digestiva alta, presencia de varices esofágicas como causa de la HDA, la eco- doppler mostro cavernomatosis portal causante de hipertensión portal. Luego de descartar patología hepática causante del cuadro; se sospechó en la presencia de trombofilia, encontrándose en el estudio de factores de coagulación la deficiencia de proteína C y S. Se le realizó endo-ligadura de varices esofágicas, y se le inicio anticoagulación permanente...
We present the case of a 20 years old male patient, born in Ancash and from Lima, without medical history of importance, he was admitted because he presented UGB (upper gastrointestinal bleeding); upper endoscopy showed esophageal varices as the cause of the UGB, Doppler ultrasound showed portal cavernomatosis as cause of portal hypertension. After discarding liver disease as cause of portal cavernomatosis; it was suspected in the presence of thrombophilia. In the study of coagulation factors, it was found protein C and S deficiency. Endo- esophageal varices ligation was performed, and permanent anticoagulation was initiated. Below, It is presented the clinical case along with a review of the literature...