Clinical characteristics and risk factors associated with lethality in severe cases of COVID-19 in Culiacan, Sinaloa, Mexico

Abstract

Background: COVID-19 has saturated hospitalization services worldwide and remains a latent public health threat. Initial information on COVID-19 was erratic, but general risk factors associated with severe disease were known. However, the risk factors and clinical characteristics of the severely affected Culiacan, Sinaloa population are unclear. Objective: To determine the clinical features and risk factors of patients infected with COVID-19 hospitalized in the Intensive Care Unit (ICU) in Culiacan, Sinaloa. Material and methods: We analyzed 200 patients, 84 women and 116 men, with positive PCR tests (SARS-CoV-2 positive), hospitalized in the ICU from March 22 to June 12, 2020. This period was chosen because it was before the widespread use of home steroid treatment, and that modified the behavior of the clinical picture of COVID-19. Results: COVID-19 case lethality rate was 60.5%, with 79 survivors and 121 non-survivors, with mean age 56.5±14.9 and 67.2±13.4 years (p<0.0001), respectively, Systemic Arterial Hypertension (HAS) 53.5% and Diabetes Mellitus (DM) 35.5% were the most frequent comorbidities, only HAS was associated with higher case fatality n= 74 (61.2%), OR= 2.195, 95%IC= 1.232 to 3.911, dysgeusia and anosmia were associated with good early prognosis. First-week case lethality (premature death) due to HAS n= 38 (66.7%) increased to an OR= 3.176, 95%CI= 1.399 to 7.210; interestingly, HAS does not increase the risk for late death. Finally, Polypnea was the only symptom associated with early death (p= 0.0252). Conclusion: The study shows a high prevalence of HAS, and its determinant role in early vs. late death is evidenced since the risk of dying decreases with the time of evolution of COVID-19.