Comorbilidades en los pacientes fallecidos por Covid - 19 en el Hospital Santa Rosa de Piura durante el periodo 2020 - 2021

Abstract

Determinar la relación entre la presencia de comorbilidades con la mortalidad por COVID-19. MÉTODO: Se realizó un estudio analítico, retrospectivo de casos y controles en pacientes hospitalizados con diagnóstico de COVID-19 confirmado por laboratorio en el Hospital de la Amistad Perú – Corea Santa Rosa de Piura en Perú, Se trabajó con 4624 registros estadísticos e historias clínicas de pacientes de los años 2020-2021. Los códigos CIE X fueron reagrupados en 22 códigos, 10 correspondieron a la COVID-19 acompañada de otras comorbilidades y 12 a enfermedades o situación de salud que se acompañaba de COVID-19 asintomático o sub-sintomático. RESULTADOS: La prevalencia de comorbilidades fue de 30.5%(1411), y tuvo asociación estadística significativa Chi-cuadrado de 53,203, con un p-valor de 0.00 (p<0.05), un OR de 1,604 (IC:1,412; 1,823), Se asociaron con un p<0.05 las: enfermedades respiratorias crónicas (OR = 29.665, su IC: 3.957-22412), obesidad (OR = 17.529, su IC: 6.275-48.968) enfermedades infecciosas (OR = 14.358, su IC: 7.866 – 26.210), enfermedades hematológicas (OR = 12.199, su IC: 6.060-24.558), hipertensión arterial (OR = 8.277, su IC: 5.823- 11.764), insuficiencia renal aguda y crónica (OR = 6.092, su IC: 3.362 – 11.038), diabetes mellitus (OR = 5.356, su IC: 3.832 – 7.487), patología cardiovascular que no es Hipertensión arterial, ni infarto agudo de miocardio (OR = 3.699, su IC: 1.605 – 8.525). Evaluando la asociación de la enfermedad o situación de salud que se acompañan de la COVID-19 y la mortalidad; se encontró que las enfermedades reumáticas, urológicas, los tumores benignos, patología dermatológica y la patología renal (sin Insuficiencia renal aguda o crónica) no se relacionan con la mortalidad de los pacientes hospitalizados (p>0.05). Las patologías quirúrgicas, del embarazo, parto y puerperio; y los traumatismos y fracturas, presentan un OR < 1 (asociación negativa). Adicionalmente se encontró que la mortalidad es mayor en el sexo masculino proporción 2:1 y en los mayores de 60 años. CONCLUSIONES: La presencia de comorbilidades se relaciona con más probabilidad de morir por la COVID-19. A lo cual se suma, la edad mayor de 60 años y el sexo masculino. Para el análisis de la mortalidad, es importante diferenciar a la COVID-19 con comorbilidades; de las enfermedades o situaciones de salud que se acompañan de COVID-19.

To determine the relationship between the presence of comorbidities and mortality due to COVID-19. METHOD: An analytical, retrospective case-control study was conducted in hospitalized patients with a laboratory-confirmed diagnosis of COVID-19 at the Hospital de la Amistad Perú - Corea Santa Rosa in Piura, Peru. 4624 statistical records and medical records of patients from the years 2020-2021 were used. ICD X codes were regrouped into 22 codes, 10 corresponded to COVID 19 accompanied by other comorbidities and 12 to diseases or health situation that was accompanied by asymptomatic or sub-symptomatic COVID-19. RESULTS: The prevalence of comorbidities was 30.5% (1411), and had a significant statistical Chi-square association of 53,203, with a p-value of 0.00 (p<0.05), an OR of 1,604 (CI: 1,412; 1,823), The following were associated with a p<0. 05 the: chronic respiratory diseases (OR = 29.665, its CI: 3.957-22412), obesity (OR = 17.529, its CI: 6.275-48.968) infectious diseases (OR = 14.358, its CI: 7. 866 - 26.210), hematological diseases (OR = 12.199, its CI: 6.060-24.558), arterial hypertension (OR = 8.277, its CI: 5.823-11.764), acute and chronic renal failure (OR = 6.092 , its CI: 3. 362 - 11.038), diabetes mellitus (OR = 5.356, its CI: 3.832 - 7.487), cardiovascular pathology other than arterial hypertension, nor acute myocardial infarction (OR = 3.699, its CI: 1.605 - 8.525). Evaluating the association of the disease or health situation accompanied by COVID-19 and mortality, it was found that rheumatic diseases, urological diseases, benign tumors, dermatological pathology and renal pathology (without acute or chronic renal failure) were not related to mortality in hospitalized patients (p>0.05). Surgical pathologies, pregnancy, childbirth and puerperium; and trauma and fractures, present an OR < 1 (negative association). Additionally, mortality was found to be higher in the male sex ratio 2:1 and in those over 60 years of age. CONCLUSIONS: The presence of comorbidities is related to a higher probability of dying from COVID-19. In addition, age over 60 years and male sex were also associated with a higher probability of dying from COVID-19. For the analysis of mortality, it is important to differentiate COVID-19 with comorbidities from diseases or health situations that are accompanied by COVID-19.