Risk factors on admission and condition at discharge of 529 consecutive COVID-19 patients at a tertiary care center in Santiago, Chile

Abstract

<title>Abstract</title> <bold>Background</bold>: The first case of COVID-19 was reported in Chile on March 3, 2020. Public and private hospitals were managed in a centralized manner. On May 30, Chile had 99,668 cases, 1054 deaths, 1383 ICU patients, 1174 patients on invasive mechanical ventilation (IMV), and 51 patients on non-invasive ventilation (NIMV). <bold>Research question</bold>: What are the variables associated with condition at discharge?<bold>Method</bold>: We performed a retrospective cohort study of 529 patients with a positive RT-PCR for SARS CoV-2who were consecutively discharged between March 14 and June 4, 2020, at Clínica Dávila, Santiago. Patients were analyzed according to laboratory variables on admission, Quality-Adjusted Life Year (QALY) score, health insurance, and type of respiratory support. Condition at discharge was survivor, non-survivor, or transfer to another center. Differences were evaluated by Chi-square test, Student’s t test, or Mann–Whitney U test. Logistic regression analysis was performed to identify variables that were predictive of condition at discharge.<bold>Results</bold>: Median (interquartile range, IQR) age was 49 (37–62) years, and the median (IQR) stay in the hospital was 6 (3–10) days. A total of 352 patients (66.5%) had respiratory symptoms, 177 (33.4%) had other symptoms or diagnoses on admission, and 116 required ventilatory support; 448 (84.7%) were survivors, 54 (10.2%) were non-survivors, and 27 (5.1%) were transferred. The median ages of the survivors and non-survivors were 46 (36–59) and 75.5 (66–84), respectively.Having state health insurance increased the risk of death by 2.8-fold (OR, 2.825; 95% CI: 1.383–5.772; P = 0.004). Multivariate analysis revealed the following predictive variables: age ≥ 60 years (OR, 15.3; 95% CI: 7.25–32.2; P = .001); PaO₂/FiO₂ on admission ≤ 200 vs &gt; 200 (OR, 5,205; CI 95%: 1,942–13,94); high-sensitivity troponin, ≥ 15 vs &lt;15 ng /L (OR, 5,163; 95% CI: 1.95–13,64; P = .001); and QALY ≤ 15 vs &gt; 15 points (OR, 14,011; 95% CI: 4,826–40,679; P=.001).<bold>Interpretation:</bold> The variables analyzed and patient’s clinical evolution may allow assignment of ICU beds to patients with the greatest chance of survival, especially in countries or regions where this resource is limited.