COVID-19 severe pneumonia in Mexico City – First experience in a Mexican hospital

  1. B Valente-Acosta
  2. I Hoyo-Ulloa
  3. L Espinosa-Aguilar
  4. R Mendoza-Aguilar
  5. J Garcia-Guerrero
  6. D Ontañon-Zurita
  7. B Gomez-Gomez
  8. O Fueyo-Rodríguez
  9. JM Vera-Zertuche
  10. RJ Anzola-Arias
  11. JV Jiménez-Ceja
  12. D Horta-Carpinteyro
  13. C Olvera-Guzman
  14. J Aguirre-Sanchez
  15. J Franco-Granillo
  16. L Jauregui-Camargo
  17. E Sada-Díaz
  18. R Saavedra-Perez-Salas
  19. A Palomar-Lever
  20. F Moreno-Sánchez

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Abstract

Background

Coronavirus Disease 2019 (Covid-19) pandemic since its first confirmed case, has changed the world. The need for accurate and truthful information is vital. Mexico and Latin America have been widely affected, so having local epidemiological data, will be of great clinical utility.

Methods

A total of 33 hospitalized patients with Covid-19 pneumonia (either severe or critical) were identified from electronic health record in a third level care private hospital in Mexico City from March 13rd to April 13rd, 2020. We conducted a descriptive study of patients for characterization of the clinical, laboratory and radiologic findings, as well as complications.

Results

The mean age was 60.6±12.68 years and 23 (69.7%) were males. Twenty-three patients (69.6%) were overweight or obese. The median duration of symptoms before admission was 7 days. All the patients required mechanical invasive ventilation. The median duration of the mechanical ventilation was 12±2.6 days and all patients were extubated except one. All patients were started on antiviral treatment in the first 24 hours after admission once the diagnosis of Covid19 pneumonia was made. There was no difference between the treatment option and the length of stay. The extubation rate was higher (91.6%) than in other series, with no fatalities even though they were treated with different regimens.

Conclusions

This one-centre experience describes the epidemiology, treatment and outcome of 33 patients with severe or critical COVID pneumonia admitted to the ICU. Most patients in our series were overweight or obese male, which we observed were of higher risk to present critical pneumonia, as well as high levels of Interleukin-6. The foregoing is relevant, due to the high incidence of these comorbidities in our country.

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    SciScore for 10.1101/2020.04.26.20080796: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Informed consent was waived.
    IACUC: The institutional ethics and research committee approved the protocol.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablePregnant women and children younger than 18 years of age were excluded from the study.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All statistical analyses were performed using SPSS version 22.0 (IBM Corp., Armonk, NY, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our patients were managed following these recommendations.(23,24) Our study has several limitations: it is a small descriptive case series report, and there may be confounders in the analysis of the results, in concordance with most described data in the current literature. Another disadvantage is the lack of generalisability and the fact that 9 patients remained in the hospital at the time of data censoring on April 19, 2020.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  2. Version published to 10.1101/2020.04.26.20080796v1 on medRxiv