Clinical Risk Factors for Mortality Among Critically ill Mexican Patients With COVID-19

Abstract BackgroundLittle literature exists about the experience with critically ill COVID-19 patients from Latin America, despite this is the current epicenter of the pandemic. Here, we aimed to describe the clinical characteristics and risk factors for mortality in mechanically-ventilated COVID-19 patients from Mexico. MethodsClinical data from sixty-seven consecutive, mechanically-ventilated COVID-19 patients were analyzed. Patients were grouped according to their clinical outcome (survival vs. death). Clinical risk factors for mortality were identified by machine-learning algorithms and traditional regression analyses. ResultsThe median age of study participants was 42 years and 65% were men. The most common comorbidity observed in our study was obesity (49.2%). Fever was the most frequent symptom of illness (88%), followed by dyspnea (84%), and cough (62%). Multilobe ground-glass opacities were observed in 76% of patients by thoracic CT scan. Fifty-two percent of study participants were ventilated in prone position, and 59% required cardiovascular support with norepinephrine. Furthermore, 49% of participants had a coinfection with a second pathogen. Two-thirds of COVID-19 patients developed acute kidney injury (AKIN). Thirty deaths occurred during the study (44.7%). Levels of uric acid, creatinine, bilirubin, and SOFA score, were significantly higher among deceased patients, whereas survivors showed higher PaO 2 /FiO 2 values at admission. AKIN, uric acid, LDH, and a longitudinal increase in ventilatory ratio were associated with mortality. Baseline PaO2/FiO2 values and a longitudinal recovery of lymphocytes were protective factors against mortality.ConclusionsOur study provides reference data about the clinical phenotype and risk factors for COVID-19-assocaited mortality among mechanically-ventilated Mexican patients.