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Factores predictivos de evolución no satisfactoria en pacientes infectados por COVID-19 entre 20-65 años
Resumen
Introducción: Varios autores validaron el uso de indicadores clínicos, humorales y radiológicos como predictores de evolución no satisfactoria en pacientes con COVID-19.
Objetivo: Evaluar las variables clínica-humorales y los hallazgos del primer rayos-x de tórax, como predictores de evolución no satisfactoria en pacientes con COVID-19.
Material y Métodos: Se realizó un estudio observacional y retrospectivo de casos-controles, a 484 pacientes infectados con COVID-19 admitidos en el Hospital Cubano de Catar, entre marzo y julio de 2020. La muestra 60 pacientes. Casos: pacientes con insuficiencia respiratoria que necesitaron ventilación invasiva o muerte. Controles: enfermos con COVID-19 sin complicaciones. Variables de entrada: edad, sexo, IMC, presencia de comorbilidades, valor del leucocito e índice de severidad del primer rayos-x de tórax. Variable respuesta: evolución clínica. El análisis bi-variado se realizó mediante la prueba Chi-cuadrado. El análisis multivariado, mediante regresión logística binaria, p valores inferiores a 0,05 se consideraron como significativo. Los resultados se expresaron en Odd Ratio.
Resultados: La progresión de la edad, pertenecer al grupo de 61-65 años, el sexo femenino, padecer diabetes o hipertensión arterial, tener dos comorbilidades, leucograma anormal y el índice de severidad del primer Rx de tórax entre 2-6/6, estaban relacionados con la evolución no satisfactoria. El leucograma (ODD RATIO 68,634 p = 0.000) y el índice de severidad del primer rayos-x de tórax (ODD RATIO 12,201 p = 0.008) tienen influencia independiente, en pacientes con COVID-19.
Conclusión: Se demostró el valor predictor del leucograma y el índice de severidad en el primer rayos-x de tórax con la evolución no satisfactoria en estos pacientes.Palabras clave
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