Clinical characteristics and mortality associated with COVID-19 at high altitude: a cohort of 5161 patients in Bogotá, Colombia

David Rene Rodriguez Lima; Ángela María Pinzón Rondón; Cristhian Rubio Ramos; Darío Isaías Pinilla Rojas; Maria José Niño Orrego; Mateo Andrés Díaz Quiroz; Nicolás Molano-González; Jorge Enrique Ceballos Quintero; Alex Francisco Arroyo Santos; Ángela María Ruiz Sternberg

doi:10.1186/s12245-022-00426-4

Clinical characteristics and mortality associated with COVID-19 at high altitude: a cohort of 5161 patients in Bogotá, Colombia

David Rene Rodriguez Lima, Ángela María Pinzón Rondón, Cristhian Rubio Ramos, Darío Isaías Pinilla Rojas, Maria José Niño Orrego, Mateo Andrés Díaz Quiroz, Nicolás Molano-González, Jorge Enrique Ceballos Quintero, Alex Francisco Arroyo Santos, Ángela María Ruiz Sternberg

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Resumen

Antecedentes: Existen pocos datos sobre los resultados clínicos de los pacientes con enfermedad por coronavirus 2019 (COVID-19) en ciudades de más de 1000 m sobre el nivel del mar (msnm). Objetivos: Describir las características clínicas y la mortalidad de los pacientes con COVID-19 atendidos en un hospital de alta complejidad en Bogotá, Colombia, a 2640 msnm. Métodos: Este fue un estudio observacional de una cohorte que incluyó 5161 pacientes con infección confirmada por COVID-19 entre el 19 de marzo de 2020 y el 30 de abril de 2021. Se recolectaron datos demográficos, valores de laboratorio, comorbilidades, índices de oxigenación y resultados clínicos. Los datos se compararon entre supervivientes y no supervivientes. Se realizó un modelo predictivo independiente para la mortalidad y la ventilación mecánica invasiva (VMI) utilizando árboles de clasificación y regresión (CART). Resultados: La mediana de edad de la cohorte fue de 66 años (rango intercuartílico [IQR] 53-77), con 1305 pacientes fallecidos (25%) y 3856 supervivientes (75%). La unidad de cuidados intensivos (UCI) recibió 1223 pacientes (24%). De los 898 pacientes que recibieron VMI, 613 (68%) perecieron. La relación entre la presión arterial parcial de oxígeno (PaO2) y la fracción inspirada de oxígeno (FiO2), o relación P/F, al ingreso en la UCI fue de 105 (IQR 77-146) y 137 (IQR 91-199) en los fallecidos y los supervivientes, respectivamente. El modelo CART mostró que la necesidad de VMI, la edad superior a 79 años, la relación entre la saturación de oxígeno (SaO2) y la FiO2, o la relación S/F, inferior a 259, y la lactato deshidrogenasa (LDH) superior a 617 U/L en el momento del ingreso se asociaban a una mayor probabilidad de muerte. Conclusiones: Entre los más de 5000 pacientes con COVID-19 tratados en nuestro hospital, la mortalidad al alta hospitalaria fue del 25%. La edad avanzada, una relación S/F baja y una LDH elevada en el momento del ingreso fueron factores predictivos de mortalidad.

Idioma original	Inglés estadounidense
Número de artículo	22
Publicación	International Journal of Emergency Medicine
Volumen	15
N.º	1
DOI	https://doi.org/10.1186/s12245-022-00426-4
Estado	Publicada - dic. 2022

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Medicina de urgencias

ODS de las Naciones Unidas

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10.1186/s12245-022-00426-4

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Rodriguez Lima, D. R., Pinzón Rondón, Á. M., Rubio Ramos, C., Pinilla Rojas, D. I., Niño Orrego, M. J., Díaz Quiroz, M. A., Molano-González, N., Ceballos Quintero, J. E., Arroyo Santos, A. F., & Ruiz Sternberg, Á. M. (2022). Clinical characteristics and mortality associated with COVID-19 at high altitude: a cohort of 5161 patients in Bogotá, Colombia. International Journal of Emergency Medicine, 15(1), Artículo 22. https://doi.org/10.1186/s12245-022-00426-4

@article{18ea441b24bd4116b2f9b0321b081848,

title = "Clinical characteristics and mortality associated with COVID-19 at high altitude: a cohort of 5161 patients in Bogot{\'a}, Colombia",

abstract = "Background: There are few data on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) in cities over 1000 m above sea level (masl). Objectives: To describe the clinical characteristics and mortality of patients with COVID-19 treated at a high complexity hospital in Bogot{\'a}, Colombia, at 2640 masl. Methods: This was an observational study of a cohort including 5161 patients with confirmed COVID-19 infection from 19 March 2020 to 30 April 2021. Demographic data, laboratory values, comorbidities, oxygenation indices, and clinical outcomes were collected. Data were compared between survivors and nonsurvivors. An independent predictive model was performed for mortality and invasive mechanical ventilation (IMV) using classification and regression trees (CART). Results: The median cohort age was 66 years (interquartile range (IQR) 53–77), with 1305 patients dying (25%) and 3856 surviving (75%). The intensive care unit (ICU) received 1223 patients (24%). Of 898 patients who received IMV, 613 (68%) of them perished. The ratio of partial pressure arterial oxygen (PaO2) to fraction inspired oxygen (FiO2), or the P/F ratio, upon ICU admission was 105 (IQR 77–146) and 137 (IQR 91–199) in the deceased and survivors, respectively. The CART model showed that the need for IMV, age greater than 79 years, ratio of oxygen saturation (SaO2) to FiO2, or the S/F ratio, less than 259, and lactate dehydrogenase (LDH) greater than 617 U/L at admission were associated with a greater probability of death. Conclusion: Among more than 5000 patients with COVID-19 treated in our hospital, mortality at hospital discharge was 25%. Older age, low S/F ratio, and high LDH at admission were predictors of mortality.",

author = "{Rodriguez Lima}, {David Rene} and {Pinz{\'o}n Rond{\'o}n}, {{\'A}ngela Mar{\'i}a} and {Rubio Ramos}, Cristhian and {Pinilla Rojas}, {Dar{\'i}o Isa{\'i}as} and {Ni{\~n}o Orrego}, {Maria Jos{\'e}} and {D{\'i}az Quiroz}, {Mateo Andr{\'e}s} and Nicol{\'a}s Molano-Gonz{\'a}lez and {Ceballos Quintero}, {Jorge Enrique} and {Arroyo Santos}, {Alex Francisco} and {Ruiz Sternberg}, {{\'A}ngela Mar{\'i}a}",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = dec,

doi = "10.1186/s12245-022-00426-4",

language = "English (US)",

volume = "15",

journal = "International Journal of Emergency Medicine",

issn = "1865-1372",

publisher = "Springer London",

number = "1",

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Rodriguez Lima, DR, Pinzón Rondón, ÁM, Rubio Ramos, C, Pinilla Rojas, DI, Niño Orrego, MJ, Díaz Quiroz, MA, Molano-González, N, Ceballos Quintero, JE, Arroyo Santos, AF & Ruiz Sternberg, ÁM 2022, 'Clinical characteristics and mortality associated with COVID-19 at high altitude: a cohort of 5161 patients in Bogotá, Colombia', International Journal of Emergency Medicine, vol. 15, n.º 1, 22. https://doi.org/10.1186/s12245-022-00426-4

Clinical characteristics and mortality associated with COVID-19 at high altitude: a cohort of 5161 patients in Bogotá, Colombia. / Rodriguez Lima, David Rene; Pinzón Rondón, Ángela María; Rubio Ramos, Cristhian et al.
En: International Journal of Emergency Medicine, Vol. 15, N.º 1, 22, 12.2022.

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

TY - JOUR

T1 - Clinical characteristics and mortality associated with COVID-19 at high altitude

T2 - a cohort of 5161 patients in Bogotá, Colombia

AU - Rodriguez Lima, David Rene

AU - Pinzón Rondón, Ángela María

AU - Rubio Ramos, Cristhian

AU - Pinilla Rojas, Darío Isaías

AU - Niño Orrego, Maria José

AU - Díaz Quiroz, Mateo Andrés

AU - Molano-González, Nicolás

AU - Ceballos Quintero, Jorge Enrique

AU - Arroyo Santos, Alex Francisco

AU - Ruiz Sternberg, Ángela María

PY - 2022/12

Y1 - 2022/12

N2 - Background: There are few data on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) in cities over 1000 m above sea level (masl). Objectives: To describe the clinical characteristics and mortality of patients with COVID-19 treated at a high complexity hospital in Bogotá, Colombia, at 2640 masl. Methods: This was an observational study of a cohort including 5161 patients with confirmed COVID-19 infection from 19 March 2020 to 30 April 2021. Demographic data, laboratory values, comorbidities, oxygenation indices, and clinical outcomes were collected. Data were compared between survivors and nonsurvivors. An independent predictive model was performed for mortality and invasive mechanical ventilation (IMV) using classification and regression trees (CART). Results: The median cohort age was 66 years (interquartile range (IQR) 53–77), with 1305 patients dying (25%) and 3856 surviving (75%). The intensive care unit (ICU) received 1223 patients (24%). Of 898 patients who received IMV, 613 (68%) of them perished. The ratio of partial pressure arterial oxygen (PaO2) to fraction inspired oxygen (FiO2), or the P/F ratio, upon ICU admission was 105 (IQR 77–146) and 137 (IQR 91–199) in the deceased and survivors, respectively. The CART model showed that the need for IMV, age greater than 79 years, ratio of oxygen saturation (SaO2) to FiO2, or the S/F ratio, less than 259, and lactate dehydrogenase (LDH) greater than 617 U/L at admission were associated with a greater probability of death. Conclusion: Among more than 5000 patients with COVID-19 treated in our hospital, mortality at hospital discharge was 25%. Older age, low S/F ratio, and high LDH at admission were predictors of mortality.

AB - Background: There are few data on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) in cities over 1000 m above sea level (masl). Objectives: To describe the clinical characteristics and mortality of patients with COVID-19 treated at a high complexity hospital in Bogotá, Colombia, at 2640 masl. Methods: This was an observational study of a cohort including 5161 patients with confirmed COVID-19 infection from 19 March 2020 to 30 April 2021. Demographic data, laboratory values, comorbidities, oxygenation indices, and clinical outcomes were collected. Data were compared between survivors and nonsurvivors. An independent predictive model was performed for mortality and invasive mechanical ventilation (IMV) using classification and regression trees (CART). Results: The median cohort age was 66 years (interquartile range (IQR) 53–77), with 1305 patients dying (25%) and 3856 surviving (75%). The intensive care unit (ICU) received 1223 patients (24%). Of 898 patients who received IMV, 613 (68%) of them perished. The ratio of partial pressure arterial oxygen (PaO2) to fraction inspired oxygen (FiO2), or the P/F ratio, upon ICU admission was 105 (IQR 77–146) and 137 (IQR 91–199) in the deceased and survivors, respectively. The CART model showed that the need for IMV, age greater than 79 years, ratio of oxygen saturation (SaO2) to FiO2, or the S/F ratio, less than 259, and lactate dehydrogenase (LDH) greater than 617 U/L at admission were associated with a greater probability of death. Conclusion: Among more than 5000 patients with COVID-19 treated in our hospital, mortality at hospital discharge was 25%. Older age, low S/F ratio, and high LDH at admission were predictors of mortality.

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DO - 10.1186/s12245-022-00426-4

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Clinical characteristics and mortality associated with COVID-19 at high altitude: a cohort of 5161 patients in Bogotá, Colombia

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