Predictors of poor prognosis in patients with COVID-19

Authors

Keywords:

COVID-19, coronavirus infections, risk factors, COVID-19 complications, hypertension, diabetes mellitus, myocardial ischemia, tobacco use disorder, renal insufficiency, chronic.

Abstract

Introduction: COVID-19 has been characterized by a wide spectrum of manifestations and clinical forms that range from mild illness to death. Identifying those most likely to develop complications is critical.
Objective: To identify risk factors for developing complications in patients treated with COVID-19.
Methods: 250 medical records of patients admitted for COVID-19 were reviewed. Age, sex, personal pathological history, laboratory tests and the presence or absence of complications were collected. Chi-square was used to identify the relationship between complications and sex. The Odds Ratio (OR) was calculated for complications by age groups, personal pathological history, and humoral parameters.
Results: Respiratory distress was more frequent in men (p=0.023). The most affected age groups were 60 to 79 years and 80 years and over (OR=4.85 and 30.53 respectively). Risk factors were the history of arterial hypertension, ischemic heart disease, diabetes mellitus, chronic kidney insufficiency and dementia (OR=4.48, 4.22, 8.75, 17.98 and 10.39 respectively). Low hematocrit and lymphocytes were predisposed to complications, as well as high neutrophils, glycaemia, creatinine, ASAT, GGT and LDH.
Conclusions: The highest risk of complications was in patients older than 60 years, with cardiovascular diseases, diabetes mellitus, kidney insufficiency and dementia. The presence of low hematocrit and lymphocytes, or high neutrophils, glycaemia, creatinine, ASAT, GGT and LDH, alerts you to possible complications.

Downloads

Download data is not yet available.

Author Biography

Rubén González Tabares, Hospital Militar de Ejército "Dr. Mario Muñoz Monroy". Matanzas.

Especialista en Endocrinología, médico asistencial, Hospital Clínico Quirúrgico Docente ¨ Dr. Mario Muñoz Monroy¨

References

1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. New England Journal of Medicine. 2020 [acceso: 17/08/2020]; 382(8):727-33. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMoa2001017

2. Adhanom T. Intervención del Director General de la OMS en la conferencia de prensa sobre el 2019-nCoV del 11 de febrero de 2020 . Ginebra: OMS; 2020. [acceso: 17/08/2020]. Disponible en: https://www.who.int/es/dg/speeches/detail/Who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020

3. Zhang SY, Lian JS, Hu JH, Zhang XL, Lu YF, Cai H, et al. Clinical characteristics of different subtypes and risk factors for the severity of illness in patients with COVID-19 in Zhejiang, China. Infectious diseases of poverty. 2020 [acceso: 17/08/2020]; 9(1):10p. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85087732326&doi=10.1186%2fs40249-020-00710-6&partnerID=40&md5=affb07616d30aee3cb018b5390fdeb87

4. World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard 2020 . [actualizado 2020/8/17; acceso: 17/08/2020]. Disponible en: https://covid19.who.int/?gclid=EAIaIQobChMI99fZpbKi6wIV9f3jBx3mlAk7EAA-YASAAEgLSX_D_BwE

5. Rastad H, Karim H, Ejtahed HS, Tajbakhsh R, Noorisepehr M, Babaei M, et al. Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease. Diabetology and Metabolic Syndrome. 2020 [acceso: 17/08/2020]; 12(1):11p. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85088011066&doi=10.1186%2fs13098-020-00565-9&partnerID=40&md5=8b932cc30dcc834e426208ebc16f8e05

6. Hou W, Zhang W, Jin R, Liang L, Xu B, Hu Z. Risk factors for disease progression in hospitalized patients with COVID-19: a retrospective cohort study. Infectious Diseases. 2020 [acceso: 17/08/2020]; 52(7):498-505. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85084347301&doi=10.1080%2f23744235.2020.1759817&partnerID=-40&md5=8e1ea0c09e1b55bf6923e35e7c0aac47

7. Zhu S, Tao J, Gao H, He D. Age, source, and future risk of COVID-19 infections in two settings of Hong Kong and Singapore. BMC research notes. 2020 [acceso: 17/08/2020]; 13(1):3p. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85088021697&doi=10.1186%2fs13104-020-05178-z&partnerID=40&md5=df704fa9c61290894e48f65833085f05

8. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020 [acceso: 17/08/2020]; 395(10229):1054-62. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85081901579&doi=10.1016%2fS0140-6736%2820%2930566-3&partnerID=40&md5=60b48cc828061e7b65a326e43414171d

9. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Internal Medicine. 2020 [acceso: 17/08/2020]; 180(7):934-43. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85081683293&doi=10.1001%2fjamainternmed.2020.0994&partnerID=40&m-d5=ac099e7fdae821edd1a7983519bc6fc4

10. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiology. 2020 [acceso: 17/08/2020]; 5(7):811-18. Disponible en: https://doi.org/10.1001/jamacardio.2020.1017

11. Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiology. 2020 [acceso: 17/08/2020]; 5(7):802-10. Disponible en: https://doi.org/10.1001/jamacardio.2020.0950

12. Xu J, Yang X, Yang L, Zou X, Wang Y, Wu Y, et al. Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: A multicenter retrospective study from Wuhan, China. Critical Care. 2020 [acceso: 17/08/2020]; 24(1):11p. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85087663356&doi=10.1186%2fs13054-020-03098-9&partnerID=40&md5=a5ac00dd1b932c9d5c815961e6114e89

13. Bess Constantén S, Alonso Alomá I, Sánchez Sordo E, Martínez Morales MÁ, López Nistal LM, Alonso Expósito I, et al. Anuario Estadístico de Salud 2019. La Habana Ministerio de Salud Pública Dirección de Registros Médicos y Estadísticas de Salud; 2020. Disponible en: http://files.sld.cu/bvscuba/files/2020/05/Anuario-Electr%C3%B3nico-Espa%C3%B1ol-2019-ed-2020.pdf

14. Zhang Y, Cui Y, Shen M, Zhang J, Liu B, Dai M, et al. Association of diabetes mellitus with disease severity and prognosis in COVID-19: A retrospective cohort study. Diabetes Research and Clinical Practice. 2020 [acceso: 17/08/2020]; 8p. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85085763427&doi=10.1016%2fj.diabres.2020.108227&partnerID=40&md5-=ae17ce73d1687129b84e48659620a479

15. Shi Q, Zhang X, Jiang F, Zhang X, Hu N, Bimu C, et al. Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study. Diabetes Care. 2020 [acceso: 17/08/2020]; 43(7):1382-91. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85086792869&doi=10.2337%2fdc20-0598&partnerID=40&md5=98144d1b276222d9d667cffb3e501b90

16. Chen Y, Yang D, Cheng B, Chen J, Peng A, Yang C, et al. Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication. Diabetes Care. 2020 [acceso: 17/08/2020]; 43(7):1399-407. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85086089021&doi=10.2337%2fdc20-0660&partnerID=40&md5=057a60ad986eea195342a5b37716c79b

17. Bello-Chavolla OY, Bahena-López JP, Antonio-Villa NE, Vargas-Vázquez A, González-Díaz A, Márquez-Salinas A, et al. Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico. The Journal of clinical endocrinology and metabolism. 2020 [acceso: 17/08/2020]; 105(8):10p . Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85087530202&doi=10.1210%2fclinem%2fdgaa346&partnerID=40&md5=-f26b0bc716ff2c4e6c867ebeb5a01cab

18. Oakes JM, Fuchs RM, Gardner JD, Lazartigues E, Yue X. Nicotine and the renin-angiotensin system. American journal of physiology Regulatory, integrative and comparative physiology. 2018 [acceso: 17/08/2020]; 315(5):895-906. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295500/

19. Underner M, Peiffer G, Perriot J, Jaafari N. Smoking and coronavirus disease 2019 (COVID-19). Rev Mal Respir. 2020 [acceso: 17/08/2020]; 37(5):433-6. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141481/

20. Henry BM, Lippi G. Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection. International urology and nephrology. 2020 [acceso: 17/08/2020]; 52(6):1193-4. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103107/

21. Ding X, Yu Y, Lu B, Huo J, Chen M, Kang Y, et al. Dynamic profile and clinical implications of hematological parameters in hospitalized patients with coronavirus disease 2019. Clinical chemistry and laboratory medicine. 2020 [acceso: 17/08/2020]; 58(8):1365-71. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85085648159&doi=10.1515%2fcclm-2020-0411&partnerID=40&md5=38ff22ce164e207adaa90b66758ab62f

22. Bonetti G, Manelli F, Patroni A, Bettinardi A, Borrelli G, Fiordalisi G, et al. Laboratory predictors of death from coronavirus disease 2019 (COVID-19) in the area of Valcamonica, Italy. Clinical chemistry and laboratory medicine. 2020 [acceso: 17/08/2020]; 58(7):1100-5. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85084800047&doi=10.1515%2fcclm-2020-0459&partnerID=40&md5=a213f3efe02b6cbbcb611b3f885a47d4

23. Yao Y, Cao J, Wang Q, Shi Q, Liu K, Luo Z, et al. D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: A case control study. Journal of Intensive Care. 2020[acceso: 17/08/2020]; 8(1):11p. Disponible en: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85088020747&doi=10.1186%2fs40560-020-00466-z&partnerID=40&md5=c5090eaa41aa142afba068c05e179c4c

Downloads

Published

2020-12-06

How to Cite

1.
González Tabares R, Acosta González FA, Oliva Villa E, Rodríguez Reyes SF, Cabeza Echevarría I. Predictors of poor prognosis in patients with COVID-19. Rev Cubana Med Milit [Internet]. 2020 Dec. 6 [cited 2025 May 30];49(4):e0200918. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/918

Issue

Vol. 49 No. 4 (2020): October - December

Section

Research Article

License

Authors who have publications with this Journal accept the following terms:

  • The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
  • The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
  • Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.