Predictors of poor outcomes in young non-comorbid patients with COVID-19

• Bernardo A. Martinez Guerra ^[1] ; Carla Medrano-Borromeo ^[1] ; María F. González Lara ^[1] ; Carla M. Román Montes ^[1] ; Karla M. Tamez Torres ^[1] ; Sandra Rajme López ^[1] ; Karla D. Salgado-Guízar ^[1] ; Noé A. Riande Juárez ^[1] ; María del Pilar Ramos Cervantes ^[1] ; Guillermo M. Ruiz Palacios ^[1] ; Alfredo Ponce de León ^[1] ; José Sifuentes Osornio ^[1]
  1. [1] Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

     Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

     México

     
• Localización: Revista de investigación clínica, ISSN 0034-8376, ISSN-e 2564-8896, Vol. 74, Nº. 5, 2022, págs. 268-275
• Idioma: inglés
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• Resumen

  • Background: Prognostic factors in previously healthy young patients with COVID-19 remained understudied. Objective: 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)