Factores de riesgo de mortalidad en pacientes mayores de 65 años hospitalizados por COVID-19 / Risk factors for mortality in patients over 65 years old hospitalized by COVID-19

RESUMEN

Antecedentes y objetivoCOVID-19 es una enfermedad causada por el coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2), que ha provocado una pandemia que sufrimos en la actualidad.Objetivo:identificar factores asociados con la mortalidad en pacientes de 65 años o más hospitalizados por COVID-19.Materiales y métodos: Estudio observacional retrospectivo. Incluimos pacientes de edad ≥65 años ingresados por COVID-19 entre el 5 y el 25 de marzo del 2020. Utilizamos el análisis bivariante y la regresión logística multivariante para determinar los factores de riesgo asociados a la mortalidad hospitalaria.Resultados: Se incluyeron 277 pacientes en el presente estudio. El análisis bivariante mostró diferencias significativas (p<0,05) entre fallecidos y supervivientes edad, mayor dependencia y comorbilidad, antecedentes de cardiopatía isquémica, insuficiencia renal y neoplasias no hematológicas, insuficiencia cardiaca durante el ingreso, leucocitosis, valores elevados de creatinina, PCR, GOT y troponina Ic, linfopenia, y disminución de SatO2 y pH sanguíneo. La regresión logística multivariante reveló que la edad ≥65 años [OR 4,23 (IC 95% 1,43-12,52); p=0,009], linfopenia <1.000/μl [OR 2,36 (IC 95% 1,07-5,20); p=0,033], creatinina>1,2mg/dl [OR 3,08 (IC 95% 1,37-6,92); p=0,006], SatO2 <90% [OR 2,29 (IC 95% 1,01-5,21); p=0,049] y la troponina Ic>11ng/ml [OR 2,32 (IC 95% 1,04-5,16); p=0,040] se asociaron independientemente con mayor mortalidad hospitalaria.Conclusiones: La edad avanzada, linfopenia, SatO2 <90%, valores elevados de creatinina y troponina Ic se asociaron independientemente con mayor mortalidad en pacientes hospitalizados con COVID-19, lo que podría ayudar a los médicos a identificar a los pacientes con mal pronóstico para su manejo y tratamiento. (AU)

ABSTRACT

Background and objectiveCOVID-19 is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has caused a global pandemic that we are currently suffering from.Objective: to identify factors associated with the death of patients aged 65 years or older hospitalized for COVID-19.Materials and methods: Retrospective cohort study. We included patients aged 65 years or older who were hospitalized for COVID-19 and dead o discharged between March 5 and 25, 2020. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death.Results: 277 patients were included in this study. The bivariate analysis showed significant differences (p<0.05) between survivors and non survivors age, increased dependence and comorbidity, history of ischemic heart disease, renal failure and non-hematological neoplasms, heart failure during admission, leukocytosis, elevated creatinine, PCR, GOT and troponin Ic values, lymphopenia, and decreased blood pH and SatO2. Multivariate logistic regression revealed that age ≥65 years (OR 4.23 (95% CI 1.43-12.52; p=0.009), lymphopenia <1000/μL (OR 2.36 (95% CI 1.07-5.20; p=0.033), creatinine>1.2mg/dL (OR 3.08 (95% CI 1.37-6.92; p=0.006), SatO2 <90% (OR 2.29 (95% CI 1.01-5.21; p=0.049) and troponin Ic>11ng/mL (OR 2.32 (95% CI 1.04-5.16; p=0.040) were independently associated with higher hospital mortality. Conclusions: Older age, lymphopenia, SatO2 <90%, elevated creatinine and troponin Ic values were independently associated with higher mortality in hospitalized patients with COVID-19, these factors could help clinicians to identify patients with poor prognosis. (AU)