Clinical - epidemiological characteristics of patients deceased by COVID-19 in a national hospital in Lima, Peru
Características clínicoepidemiológicas de pacientes fallecidos por COVID-19 en un hospital nacional de Lima, Perú
Keywords:SARS virus, Viral Pneumonia, Emergency Medical Services, Death
Introduction: The COVID-19 pandemic has caused more than 70 thousand deaths worldwide. Objective: To describe the characteristics of COVID-19 patients who died in a tertiary hospital. Methods: A descriptive study was carried out in the emergency service of the Hospital Rebagliati in Lima, Peru, which includes deceased patients with a positive result for SARS-CoV-2 infection diagnosed by PCR-TR until April 4, 2020. The medical history was reviewed. and hospital records looking for sociodemographic variables, clinical characteristics, radiological manifestations, treatment and evolution. Results: 14 cases were identified, 78.6% were male, average age 73.4 years (range 26 to 97). 21.4% of cases acquired the infection out of Peru. Risk factors were found in 92.9% of patients (more frequent elderly, hypertension and obesity). The most frequent symptoms were dyspnea, fever and cough, with illness time 8 days (+/- 3); signs of polypnea and respiratory rales. The most frequent laboratory findings were elevated C-reactive protein (average 22 mg / dL) and hypoxemia. The predominant radiological presentation was bilateral interstitial pulmonary infiltration in ground glass. 78.6% (11 of 14 cases) entered mechanical ventilation; 71.4% of the cases received azithromycin, 64.3% hydroxychloroquine and 57.1% broad-spectrum antibiotics; with a 4.7 day hospital stay (+/- 2.4). Conclusion: Those who died from COVID-19 presented bilateral severe pneumonia, more frequent in men, with risk factors (elderly, hypertension and obesity), with a high need for ventilatory assistance.
2. Wu F, Zhao S, Yu B, Chen Y-M, Wang W, Song Z-G, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579:265–9. DOI: 10.1038/s41586-020-2008-3
3. World Health Organization. Alocución de apertura del Director General de la OMS en la rueda de prensa sobre la COVID-19 celebrada el 11 de marzo de 2020 [Internet]. Discursos del Director General de la OMS. 2020 [cited 2020 Mar 18].
4. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395(10223):507–13. DOI: 10.1016/S0140-6736(20)30211-7
5. World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 77 [Internet]. 2020 [cited 2020 Abr 6].
6. Ministerio de Salud - Perú. Minsa: Casos confirmados por coronavirus COVID-19 son 2561 en Perú Comunicado N°56. 2020 [cited 2020 Apr 6].
7. Zhang J, Dong X, Cao Y, Yuan Y, Yang Y, Yan Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy Eur J Allergy Clin Immunol. 2020;(February):1–12. DOI: 10.1111/all.14238
8. Guan W, Ni Z, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020 Feb 28;1–13 [Epub ahead of print]. DOI: 10.1056/NEJMoa2002032
9. Bernard S, Rolland P, Silue Y, Mailles A, Campese C, Simondon A, et al. First cases of coronavirus disease 2019 (COVID-19) in France: surveillance, investigations and control measures, January 2020. Euro Surveill. 2020;25(6). DOI: 10.2807/1560-7917.ES.2020.25.6.2000094
10. Bhatraju PK, Ghassemieh BJ, Nichols M, Kim R, Jerome KR, Nalla AK, et al. Covid-19 in Critically Ill Patients in the Seattle Region - Case Series. N Engl J Med 2020 Mar 30; [Epub ahead of print]. DOI: 10.1056/NEJMoa2004500
11. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;(20):1–7 [Epub ahead of print]. DOI: 10.1016/S2213-2600(20)30079-5
12. Ramos JGR, Da Hora R, Teixeira MB, Gobatto ALN, Coutinho RVDS, Caldas JR, et al. Prognostic ability of quick-SOFA across different age groups of patients with suspected infection outside the intensive care unit: A cohort study. J Crit Care. 2018;47:178–84. DOI: 10.1016/j.jcrc.2018.07.008
13. Shi F, Yu Q, Huang W, Tan C. 2019 Novel Coronavirus (COVID-19) Pneumonia with Hemoptysis as the Initial Symptom: CT and Clinical Features. Korean J Radiol. 2020;21:2–5.
14. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med [Internet]. 2020;(20):19–21 [Epub ahead of print]. Available from: http://dx.doi.org/10.1016/S2213-2600(20)30076-X
15. Shi H, Han X, Zheng C. Evolution of CT Manifestations in a Patient Recovered from 2019 Novel Coronavirus (2019-nCoV) Pneumonia in Wuhan, China. Radiology. 2020;295(1):20. DOI: 10.3348/kjr.2020.0181
16. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis 2020;20(4):425-34. DOI: 10.1016/S1473-3099(20)30086-4
17. Yoon SH, Lee KH, Kim JY, Lee YK, Ko H, Kim KH, et al. Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Korea. Korean J Radiol 2020;21(4):494. DOI: 10.3348/kjr.2020.0132
18. World Health Organization. Clinical management of severe acute respiratory infection when COVID-19 is suspected. Interim guidance 13 march 2020.
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