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Risk factors for mortality in hospitalized patients with COVID-19 from three hospitals in Peru: a retrospective
Cristian Díaz-Vélez1,2, Diego Urrunaga-Pastor3, Anthony Romero-Cerdán4
1Universidad Señor de Sipán, Escuela de Medicina, Chiclayo, Peru.
Insights
Older age, multiple comorbidities, and low oxygen saturation were key risk factors for COVID-19 mortality in Peruvian hospitalized patients. Identifying these vulnerable groups is crucial for reducing deaths during pandemics.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Peru experienced high COVID-19 mortality during the initial pandemic phase.
- Evaluating risk factors for in-hospital mortality in COVID-19 patients is essential.
Purpose of the Study:
- To identify risk factors associated with in-hospital mortality among COVID-19 patients in Peru.
- To analyze sociodemographic, clinical, and laboratory data to predict mortality risk.
Main Methods:
- Retrospective cohort study of 493 adult patients hospitalized for COVID-19 in Peru (March-May 2020).
- Cox regression models were used to assess risk factors for in-hospital mortality.
- Variables included demographics, comorbidities, symptoms, vital signs, and lab parameters.
Main Results:
- The overall in-hospital mortality rate was 60.2%.
- Risk factors for mortality included age (≥60 years), ≥2 comorbidities, low oxygen saturation (<85%), and elevated neutrophil-to-lymphocyte ratio.
- Patients with oxygen saturation <80% had a 4.59-fold increased risk of mortality.
Conclusions:
- Identified risk factors align with existing literature, confirming vulnerable patient groups.
- Prioritizing monitoring and early symptom identification in at-risk populations can help reduce COVID-19 mortality.
- Findings support targeted public health interventions for high-risk individuals during infectious disease outbreaks.
Background:
Peru was one of the countries with the highest COVID-19 mortality worldwide during the first stage of the pandemic. It is then relevant to evaluate the risk factors for mortality in patients hospitalized for COVID-19 in three hospitals in Peru in 2020, from March to May, 2020. Methods: We carried out a retrospective cohort study. The population consisted of patients from three Peruvian hospitals hospitalized for a diagnosis of COVID-19 during the March-May 2020 period. Independent sociodemographic variables, medical history, symptoms, vital functions, laboratory parameters and medical treatment were evaluated. In-hospital mortality was assessed as the outcome. We performed Cox regression models (crude and adjusted) to evaluate risk factors for in-hospital mortality. Hazard ratios (HR) with their respective 95% confidence intervals (95% CI) were calculated. Results: We analyzed 493 hospitalized adults; 72.8% (n=359) were male and the mean age was 63.3 ± 14.4 years. COVID-19 symptoms appeared on average 7.9 ± 4.0 days before admission to the hospital, and the mean oxygen saturation on admission was 82.6 ± 13.8. While 67.6% (n=333) required intensive care unit admission, only 3.3% (n=16) were admitted to this unit, and 60.2% (n=297) of the sample died. In the adjusted regression analysis, it was found that being 60 years old or older (HR=1.57; 95% CI: 1.14-2.15), having two or more comorbidities (HR=1.53; 95% CI: 1.10-2.14), oxygen saturation between 85-80% (HR=2.52; 95% CI: 1.58-4.02), less than 80% (HR=4.59; 95% CI: 3.01-7.00), and being in the middle (HR=1.65; 95% CI: 1.15-2.39) and higher tertile (HR=2.18; 95% CI: 1.51-3.15) of the neutrophil-to-lymphocyte ratio, increased the risk of mortality. Conclusions: The risk factors found agree with what has been described in the literature and allow the identification of vulnerable groups in whom monitoring and early identification of symptoms should be prioritized in order to reduce mortality.