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?:abstract
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Background: Currently, Mexico ranks 3rd worldwide in mortality due to COVID-19 and reliable information is scarce with available data focused on epidemiological characteristics. This study aimed to identify risk factors associated with mortality and outcomes among hospitalized Mexican patients with COVID-19. Methods: We prospectively assessed patients admitted to a COVID-19 reference center in the southeast of Mexico between March 28th and June 30th, 2020. Mortality was defined as survivor or non-survivor and univariate and multivariate logistic regression analysis were performed to explore the association of clinical characteristics and laboratory parameters with mortality. Results: We included 200 patients with a mean age of 55 years, 69% were men, 72% had at least one chronic comorbidity. Eighty-six patients required invasive mechanical ventilation (IMV) with an overall mortality rate of 82.5%. Only 51% of patients with IMV had Intensive Care Unit (ICU) admission, with a survival rate of 27.3%, but only 7.2% for Non-ICU admission (p<0.014). The multivariate analysis found that Neutrophil-to-Lymphocyte Ratio ≥ 9 (OR 4.64, 95% CI 2.05-10.53) albumin < 3.5gr/dL (OR 3.76, 95% CI 1.56-9.07), LDH ≥ 725 U/L (OR 5.45, 95% CI 2.36-12.57) and IMV (OR 64.7; 95% CI 15.20-275.39) were independent risk factors associated with mortality. Conclusion: NLR, LDH, albumin and IMV are independent risk factors for mortality in Mexican patients with COVID-19. Also, availability of ICU resources is invaluable for better outcomes of critically ill patients. Our results could provide clinical information for timely decision-making in low and middle-income countries to overcome the pandemic.
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