Revista de Investigación Clínica (Jan 2022)

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

  • Bernardo A. Martinez-Guerra,
  • Carla Medrano-Borromeo,
  • María F. González-Lara,
  • Carla M. Román-Montes,
  • Karla M. Tamez-Torres,
  • Sandra Rajme-López,
  • Karla D. Salgado-Guízar,
  • Noe A. Juárez-Menéndez,
  • Pilar Ramos-Cervantes,
  • Guillermo M. Ruiz-Palacios,
  • Alfredo Ponce-de-León,
  • José Sifuentes-Osornio

DOI
https://doi.org/10.24875/RIC.22000162
Journal volume & issue
Vol. 74, no. 5

Abstract

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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 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.

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