Características clínicoepidemiológicas de pacientes fallecidos por COVID-19 en un hospital nacional de Lima, Perú

Introduccion: La pandemia debida a enfermedad por coronavirus 2019 (COVID-19) ha producido mas de 70 mil muertes en el mundo Objetivo: Describir las caracteristicas de pacientes fallecidos por COVID-19 en un hospital terciario Metodos: Estudio descriptivo realizado en el servicio de emergencia del hospital Rebagliati Lima-Peru, que incluye los pacientes fallecidos con resultado positivo a infeccion por SARS-CoV-2 mediante PCR-TR hasta el 4 de abril de 2020 Se reviso la historia clinica y registros hospitalarios buscando variables sociodemograficas, antecedentes, manifestaciones clinicas, radiologicas, tratamiento y evolucion Resultados: Se identificaron 14 casos, 78,6% de sexo masculino, edad promedio 73,4 anos (rango 26 a 97) Adquirieron la infeccion en el exterior del pais el 21,4% de casos Se encontro factores de riesgo en 92,9% de pacientes (mas frecuentes adulto mayor, hipertension arterial y obesidad) Los sintomas mas frecuentes fueron disnea, fiebre y tos, con tiempo de enfermedad 8 dias (+/- 3,0);los signos polipnea y estertores respiratorios Los hallazgos de laboratorio mas frecuentes fueron proteina C reactiva elevada (promedio 22 mg/dL) e hipoxemia La presentacion radiologica predominante fue infiltrado pulmonar intersticial bilateral en vidrio esmerilado Ingresaron a ventilacion mecanica 78,6% (11 de 14 casos);recibio azitromicina 71,4%, hidroxicloroquina 64,3% y antibioticos de amplio espectro 57,1% de los casos;con estancia hospitalaria de 4,7 dias (+/-2,4) Conclusion: Los fallecidos por COVID-19 presentaron neumonia grave bilateral, mas frecuentes en varones, con factores de riesgo (adulto mayor, hipertension arterial y obesidad), con alta necesidad de asistencia ventilatoria Introduction: The COVID-19 pandemic has caused more than 70 thousand deaths worldwide Objective: To describe the characteristics of COVID-19 patients who died in a tertiary hospital Methods: A descriptive study was carried out in the emergency service of the Hospital Rebagliati in Lima, Peru, which includes deceased patients with a positive result for SARS-CoV-2 infection diagnosed by PCR-TR until April 4, 2020 The medical history was reviewed and hospital records looking for sociodemographic variables, clinical characteristics, radiological manifestations, treatment and evolution Results: 14 cases were identified, 78 6% were male, average age 73 4 years (range 26 to 97) 21 4% of cases acquired the infection out of Peru Risk factors were found in 92 9% of patients (more frequent elderly, hypertension and obesity) The most frequent symptoms were dyspnea, fever and cough, with illness time 8 days (+/- 3);signs of polypnea and respiratory rales The most frequent laboratory findings were elevated C-reactive protein (average 22 mg / dL) and hypoxemia The predominant radiological presentation was bilateral interstitial pulmonary infiltration in ground glass 78 6% (11 of 14 cases) entered mechanical ventilation;71 4% of the cases received azithromycin, 64 3% hydroxychloroquine and 57 1% broad-spectrum antibiotics;with a 4 7 day hospital stay (+/- 2 4) Conclusion: Those who died from COVID-19 presented bilateral severe pneumonia, more frequent in men, with risk factors (elderly, hypertension and obesity), with a high need for ventilatory assistance