CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF PATIENTS DIAGNOSED WITH COVID-19 IN A TERTIARY CARE CENTER IN MEXICO CITY: A PROSPECTIVE COHORT STUDY

Rev Invest Clin. 2020;72(3):165-177. doi: 10.24875/RIC.20000211.

Abstract

Background: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic.

Objective: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC).

Methods: We conducted a prospective cohort, including consecutive patients with COVID-19 from February 26, 2020 to April 11, 2020.

Results: We identified 309 patients (140 inpatients and 169 outpatients). The median age was 43 years (interquartile range, 33-54), 59.2% men, and 18.6% healthcare workers (12.3% from our center). The median body mass index (BMI) was 29.00 kg/m2 and 39.6% had obesity. Compared to outpatients, inpatients were older, had comorbidities, cough, and dyspnea more frequently. Twenty-nine (20.7%) inpatients required treatment in the IC unit (ICU). History of diabetes (type 1 or 2) and abdominal pain were more common in ICU patients compared to non-ICU patients. ICU patients had higher BMIs, higher respiratory rates, and lower room-air capillary oxygen saturations. ICU patients showed a more severe inflammatory response as assessed by white blood cell count, neutrophil and platelet count, C-reactive protein, ferritin, procalcitonin, and albumin levels. By the end of the study period, 65 inpatients had been discharged because of improvement, 70 continued hospitalized, and five had died.

Conclusions: Patients with comorbidities, either middle-age obese or elderly complaining of fever, cough, or dyspnea, were more likely to be admitted. At admission, patients with diabetes, high BMI, and clinical or laboratory findings consistent with a severe inflammatory state were more likely to require IC.

Keywords: 2019-novel coronavirus; Cohort; Coronavirus; Coronavirus disease-2019; Mexico; Severe acute respiratory syndrome coronavirus 2.

MeSH terms

  • Abdominal Pain / epidemiology
  • Adult
  • Aged
  • Ambulatory Care
  • Betacoronavirus*
  • Biomarkers / blood
  • Body Mass Index
  • Comorbidity
  • Coronavirus Infections / complications
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / therapy
  • Critical Care
  • Dyspnea / etiology
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Humans
  • Inpatients / statistics & numerical data
  • Male
  • Mexico
  • Middle Aged
  • Obesity / epidemiology
  • Outpatients / statistics & numerical data
  • Pandemics*
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / therapy
  • Severity of Illness Index
  • Tertiary Care Centers / statistics & numerical data
  • Treatment Outcome

Substances

  • Biomarkers

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2