Mortality and associated risk factors in patients hospitalized due to COVID-19 in a Peruvian reference hospital
Soto et al.,
Mortality and associated risk factors in patients hospitalized due to COVID-19 in a Peruvian reference..,
PLOS ONE, doi:10.1371/journal.pone.0264789
Retrospective 1,418 very late stage (46% mortality) patients in Peru, showing no significant difference with HCQ. There is strong
confounding by indication, for example 48% of patients with baseline SpO
2 <70% were treated compared with 22% for SpO
2 >95%. There may also be significant
confounding by time with SOC changing substantially over the first few months of the pandemic.
This study is excluded in the after exclusion results of meta
analysis:
unadjusted results with no group details; substantial unadjusted
confounding by indication likely; substantial
confounding by time possible due to significant changes in SOC and treatment propensity near the start of the pandemic.
risk of death, 6.0% higher, HR 1.06, p = 0.46, treatment 292 of 590 (49.5%), control 362 of 828 (43.7%), Cox proportional hazards.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Soto et al., 2 Mar 2022, retrospective, Peru, peer-reviewed, median age 58.0, 10 authors, study period April 2020 - August 2020, dosage not specified.
Abstract: PLOS ONE
RESEARCH ARTICLE
Mortality and associated risk factors in
patients hospitalized due to COVID-19 in a
Peruvian reference hospital
Alonso Soto ID1,2*, Dante M. Quiñones-Laveriano ID1, Johan Azañero ID2,3,
Rafael Chumpitaz ID2, José Claros2, Lucia Salazar2, Oscar Rosales2, Liz Nuñez ID4,
David Roca4, Andres Alcantara2
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1 Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Faculty of Medicine, Universidad Ricardo
Palma, Lima, Peru, 2 Departament of Internal Medicine, Hospital Nacional Hipólito Unanue, Lima, Peru,
3 Universidad Cientı́fica del Sur, Lima, Peru, 4 Faculty of Medicine, Universidad Ricardo Palma, Lima, Peru
* alonso.soto@urp.edu.pe
Abstract
Objectives
OPEN ACCESS
Citation: Soto A, Quiñones-Laveriano DM, Azañero
J, Chumpitaz R, Claros J, Salazar L, et al. (2022)
Mortality and associated risk factors in patients
hospitalized due to COVID-19 in a Peruvian
reference hospital. PLoS ONE 17(3): e0264789.
https://doi.org/10.1371/journal.pone.0264789
Editor: Raffaele Serra, University Magna Graecia of
Catanzaro, ITALY
Received: October 20, 2021
Accepted: February 16, 2022
Published: March 2, 2022
Peer Review History: PLOS recognizes the
benefits of transparency in the peer review
process; therefore, we enable the publication of
all of the content of peer review and author
responses alongside final, published articles. The
editorial history of this article is available here:
https://doi.org/10.1371/journal.pone.0264789
Copyright: © 2022 Soto et al. This is an open
access article distributed under the terms of the
Creative Commons Attribution License, which
permits unrestricted use, distribution, and
reproduction in any medium, provided the original
author and source are credited.
Data Availability Statement: All relevant data are
within the paper and its Supporting Information
files.
To determine the risk factors for in-hospital mortality in patients with COVID-19 from a Peruvian national hospital.
Methods
Retrospective cohort study of medical records of patients with COVID-19 hospitalized at
Hospital Nacional Hipólito Unanue (HNHU) during the months of April to August 2020. The
dependent variable was in-hospital mortality. Independent variables included sociodemographic and clinical characteristics, physical examination findings, oxygen saturation (SaO2)
at admission, treatment received during hospitalization and laboratory results at admission.
A Cox regression model was used to evaluate the crude and adjusted hazard ratios for associated factors.
Results
We included 1418 patients. Median age was 58 years (IQR 47–68 years) and 944 (66.6%)
were male. The median length of hospitalization was 7 (4–13) days, and the mortality rate
was 46%. The most frequent comorbidities were type 2 diabetes mellitus, hypertension, and
obesity. In the adjusted analysis, mortality was associated with age (HR 1.02; 95%CI 1.02–
1.03), history of surgery (HR 1.89; 95%CI 1.31–2.74), lower oxygen saturation at admission
(HR 4.08; CI95% 2.72–8.05 for SaO2<70% compared to SaO2>94%), the presence of poor
general condition (HR 1.81; 95% CI 1.29–2.53), altered state of consciousness (HR 1.58;
95%CI 1.18–2.11) and leukocyte levels (HR 1.01; 95%CI 1.00–1. 02). Treatment with ivermectin (HR 1.44; 95%CI 1.18–1.76) and azithromycin (HR 1.25; 95%CI 1.03–1.52) were
associated with higher mortality. Treatment with corticosteroids at low to moderate doses
was associated with lower..
Late treatment
is less effective
soto
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