High mortality at the beginning of the COVID-19 pandemic in a referral center in the metropolitan area of Mexico City.

INTRODUCTION: There is limited information about the coronavirus disease 2019 (COVID-19) disease in Latin-American countries. Our objective was to describe the clinical characteristics and outcomes of COVID-19 patients in Mexico. METHODOLOGY: We conducted a retrospective cohort study with 333 consecutive patients who were admitted to Hospital de Especialidades "Dr. Antonio Fraga Mouret" in Mexico City with COVID-19 between April 1, 2020, and June 30, 2020. Demographic, clinical, laboratory data, treatment details and 30-day outcomes were analyzed. RESULTS: The patients studied included 52% men (172/233) and the median age was 45 years. Up to 75% (250/333) of patients were classified as overweight or obese. There were 185 (56%) inpatients; 85% (158/185) were hospitalized in the general ward, and 15% (27/185) in the Intensive Care Unit (ICU). Laboratory measurements showed significant differences between inpatients and outpatients such as lymphocyte-count (median 0.8 vs 1.2×109/L, p < 0.001), LDH (median 650 vs 294 U/L, p < 0.001), CRP (median 147 vs 5 mg/L, p = 0.007), CK-MB (median, 15 vs 10 U/L, p = 0.008), ferritin (median, 860 vs 392 ng/mL, p = 0.02), and D-dimer (median, 780 vs 600 ng/mL, p = 0.15). These differences were seen between survivor and non-survivor patients as well. The rate of death in mechanically ventilated patients was 94% (67/71). Mortality at 30-day follow-up was 57% (105/185). CONCLUSIONS: We observed that majority of the non-survivors were obese and young. Complications leading to death was observed in majority of the cases.

Decreased quality of life and spirometric alterations even after mild-moderate COVID-19.

BACKGROUND: The follow-up of recovered COVID-19 patients is still limited. We aimed to evaluate the changes in quality-of-life (QOL) and spirometric alterations in the convalescent phase of 115 patients with at least 30 days post-COVID-19. METHODS: We included patients with confirmed COVID-19 infection, available past medical records and at least 30 days after the onset of symptoms. All patients were asked to rate their general health condition before and after COVID-19 using the EQ-5D-5L standardized questionary and perform a spirometry at evaluation. RESULTS: In this study, that included 70%(81/115) of patients with mild or moderate COVID-19; there was a severe decrease in QOL up to 56%(64/115). Alterations in usual activities and anxiety/depression were present in 59% of patients with a severe decrease in QOL. The persistence of symptoms was present in 63%(72/115). Restrictive lung impairment was the most common spirometric alteration in 17%(20/115), of whom 65%(13/20) had mild COVID-19. CONCLUSIONS: Spirometric alterations are presented even in mild COVID-19, and more remarkably, there is a high rate of alterations in quality of life after the recovery of this disease.