masterThesis
Mortalidad en pacientes con infección respiratoria aguda por SARS-CoV-2 según índice de oxigenación SpO2/FiO2 y valores hematométricos de ingreso a 2500 m s.n.m.
Author
Patiño Aldana, Andrés Felipe
Rodríguez Alvarino, Estefanía Paula
Sanclemente Mariño, Isabella
Institutions
Abstract
Introduction: Acute respiratory infection (ARIs) due to SARS-CoV-2 is responsible for COVID 19. Its main manifestations occur at a respiratory level and its most severe expression is the Adult respiratory distress syndrome (ARDS). The development of AIRs and ARDS at altitude is a physiological challenge in which hemodynamic adaptive and ventilatory mechanisms to hypobaric hypoxia converge with the pathophysiological and compensatory processes against the disease; as the altitude increases, the oxygen's partial pressure decreases. The environmental hypoxia could be related to more severe hypoxemia that worsens the prognosis of the disease, however, it has been proposed that the adaptive mechanisms to hypobaric hypoxia may generate resistance to hypoxemia improving the delivery and efficient use of O2. It is unknown which are the pathophysiological and prognostic implications in AIRs due to SARS-CoV-2 of the hematological characteristics of patients chronically exposed to hypobaric hypoxia.
Objectives: This study seeks to explore the relationship between the hematometric and oxygenation entry and the mortality of the patients with an acute respiratory infection due to SARS-CoV-2 that were admitted to the Hospital Universitario Mayor Mederi between March and July 2020.
Methodology: A descriptive observational study with an analytical component from a secondary source was carried out about the database of the study “Acute respiratory distress síndrome (ARDS) due to SARS-CoV-2 and clinical results at 2500 meters high” which included the first thousand patients that consult to Hospital Universitario Mayor Mederi. The sociodemographic, clinical, and paraclinical information of entrance was described and the outcome of the hospital residency until de live discharge or death. The population characteristics were described and measures of association with mortality outcome were established according to the type of variable, afterwards, exploratory multivariate models were made to control the confusion or to evaluate the interaction between the variables related to mortality.
Results:
In this study, sociodemographic, clinical and paraclinical admissions characteristics have been described; the exploratory analysis that establish associations between age, sex, hypertension history, and no lineal relations of the SpO2/FiO2, hemoglobin and neutrophil/lymphocytes relation were reported whit the mortality of the patients with ARI due to SARS-CoV2 admitted to HUM between March and July of 2020. In addition, the groups with the patients with higher and lower probability of dying during hospital stay were described according to their oxygen levels, hemoglobin, age, and neutrophil/lymphocytes admission relation.