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

ABSTRACT 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.

Bibliographic Details

Main Authors:	Martínez-Guerra,Bernardo A., Medrano-Borromeo,Carla, González-Lara,María F., Román-Montes,Carla M., Tamez-Torres,Karla M., Rajme-López,Sandra, Salgado-Guízar,Karla D., Juárez-Menéndez,Noe A., Ramos-Cervantes,Pilar, Ruiz-Palacios,Guillermo M., Ponce-de-León,Alfredo, Sifuentes-Osornio,José
Format:	Digital revista
Language:	English
Published:	Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán 2022
Online Access:	http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0034-83762022000500268
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