Features of patients that died for COVID-19 in a hospital in the south of Mexico: A observational cohort study

  1. Jesús Arturo Ruíz-Quiñonez
  2. Crystell Guadalupe Guzmán-Priego
  3. Germán Alberto Nolasco-Rosales
  4. Carlos Alfonso Tovilla-Zarate
  5. Oscar Israel Flores-Barrientos
  6. Víctor Narváez-Osorio
  7. Guadalupe del Carmen Baeza-Flores
  8. Thelma Beatriz Gonzalez-Castro
  9. Carlos Ramón López-Brito
  10. Carlos Alberto Denis-García
  11. Agustín Pérez-García
  12. Isela Esther Juárez-Rojop

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Abstract

Due to the wide spread of SARS-CoV2 around the world, the risk of death in individuals with metabolic comorbidities has dangerously increased. Mexico has a high number of infected individuals and deaths by COVID-19 as well as an important burden of metabolic diseases; nevertheless, reports about features of Mexican individuals with COVID-19 are scarce. The aim of this study was to evaluate demographic features, clinical characteristics and the pharmacological treatment of individuals who died by COVID-19 in the south of Mexico.

Methods

We performed an observational study including the information of 185 deceased individuals with confirmed diagnoses of COVID-19. Data were retrieved from medical records. Categorical data were expressed as proportions (%) and numerical data were expressed as mean ± standard deviation. Comorbidities and overlapping symptoms were plotted as Venn diagrams. Drug clusters were plotted as dendrograms.

Results

The mean age was 59.53 years. There was a male predominance (60.1%). The mean hospital stay was 4.75 ± 4.43 days. The most frequent symptoms were dyspnea (88.77%), fever (71.42%) and dry cough (64.28%). Present comorbidities included diabetes (60.63%), hypertension (59.57%) and obesity (43.61%). The main drugs used for treating COVID-19 were azithromycin (60.6%), hydroxychloroquine (53.0%) and oseltamivir (27.3%).

Conclusions

Mexican individuals who died of COVID-19 had shorter hospital stays, higher frequency of shortness of breath, and higher prevalence of diabetes than individuals from other countries. Also, there was a high frequency of off-label use of drugs for their treatment.

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  1. ScreenIT

    SciScore for 10.1101/2020.09.21.20199117: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The ethical approval was granted by the Research Ethics Committee of the Juárez Autonomous University of Tabasco (103/CIP-DACS/2020) in Mexico.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All data were analyzed using SPSS v.23.
    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 study has some limitations. First, we had limited information about some individuals because they died within minutes after their arrival to the emergency room. Second, we did not include surviving individuals so we could not compare characteristics between groups. Third, we included data of only one frontline hospital for treating COVID-19. Consequently, this report shows characteristics and handling of patients at the beginning of the COVID-19 pandemic at the south of Mexico; therefore, our data cannot be applied to the whole Mexican population. In conclusion, our study showed a high frequency of off-label use of drugs that have insufficient evidence of their efficacy against COVID-19. The individuals in our sample had shorter hospital stays, higher frequency of shortness of breath, and higher prevalence of diabetes compared with similar populations from other countries. It is important to do more clinical series and cohorts in Mexican population, as this population shows features that could differ of populations of other countries.

    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

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1371/journal.pone.0245394
  3. Version published to 10.1101/2020.09.21.20199117v1 on medRxiv