Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Jan-Feb;50(1):28-32.
doi: 10.1016/j.hrtlng.2020.10.013. Epub 2020 Oct 21.

Outcomes of patients with COVID-19 in the intensive care unit in Mexico: A multicenter observational study

Silvio A Ñamendys-Silva  1 , Pedro E Alvarado-Ávila  2 , Guillermo Domínguez-Cherit  3 , Eduardo Rivero-Sigarroa  2 , Luis A Sánchez-Hurtado  4 , Alan Gutiérrez-Villaseñor  5 , Juan P Romero-González  5 , Heber Rodríguez-Bautista  2 , Alondra García-Briones  5 , César E Garnica-Camacho  6 , Néstor G Cruz-Ruiz  7 , María O González-Herrera  8 , Francisco J García-Guillén  9 , Manuel A Guerrero-Gutiérrez  9 , José D Salmerón-González  10 , Laura Romero-Gutiérrez  4 , José L Canto-Castro  11 , Victor H Cervantes  12 ; Mexico COVID-19 Critical Care Collaborative Group
Affiliations
Observational Study

Outcomes of patients with COVID-19 in the intensive care unit in Mexico: A multicenter observational study

Silvio A Ñamendys-Silva et al. Heart Lung. 2021 Jan-Feb.

Abstract

Background: As of June 15, 2020, a cumulative total of 7,823,289 confirmed cases of COVID-19 have been reported across 216 countries and territories worldwide. However, there is little information on the clinical characteristics and outcomes of critically ill patients with severe COVID-19 who were admitted to intensive care units (ICUs) in Latin America. The present study evaluated the clinical characteristics and outcomes of critically ill patients with severe COVID-19 who were admitted to ICUs in Mexico.

Methods: This was a multicenter observational study that included 164 critically ill patients with laboratory-confirmed COVID-19 who were admitted to 10 ICUs in Mexico, from April 1 to April 30, 2020. Demographic data, comorbid conditions, clinical presentation, treatment, and outcomes were collected and analyzed. The date of final follow-up was June 4, 2020.

Results: A total of 164 patients with severe COVID-19 were included in this study. The mean age of patients was 57.3 years (SD 13.7), 114 (69.5%) were men, and 6.0% were healthcare workers. Comorbid conditions were common in patients with critical COVID-19: 38.4% of patients had hypertension and 32.3% had diabetes. Compared to survivors, nonsurvivors were older and more likely to have diabetes, hypertension or other conditions. Patients presented to the hospital a median of 7 days (IQR 4.5-9) after symptom onset. The most common presenting symptoms were shortness of breath, fever, dry cough, and myalgias. One hundred percent of patients received invasive mechanical ventilation for a median time of 11 days (IQR 6-14). A total of 139 of 164 patients (89.4%) received vasopressors, and 24 patients (14.6%) received renal replacement therapy during hospitalization. Eighty-five (51.8%) patients died at or before 30 days, with a median survival of 25 days. Age (OR, 1.05; 95% CI, 1.02-1.08; p<0.001) and C-reactive protein levels upon ICU admission (1.008; 95% CI, 1.003-1.012; p<0.001) were associated with a higher risk of in-hospital death. ICU length of stay was associated with reduced in-hospital mortality risk (OR, 0.89; 95% CI, 0.84-0.94; p<0.001).

Conclusions: This observational study of critically ill patients with laboratory-confirmed COVID-19 who were admitted to the ICU in Mexico demonstrated that age and C-reactive protein level upon ICU admission were associated with in-hospital mortality, and the overall hospital mortality rate was high.

Trial registration: ClinicalTrials.gov, NCT04336345.

Keywords: COVID-19; Coronavirus; Intensive care unit; Mexico; Outcomes; SARS-CoV-2 infection.

PubMed Disclaimer

Conflict of interest statement

Declarations of Competing Interest The authors state that there are no conflicts of interest related to this study.

Figures

Fig. 1
Fig. 1
Flow chart of the study and included patients with critical COVID-2019.
Fig. 2
Fig. 2
Survival of critically ill patients with COVID-19.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Coronavirus Disease (COVID-19): Situation Report-147. Geneva: World Health Organization (https://www.who.int/docs/default-source/coronaviruse/situation-reports/2... ).
    1. Conferencia 15 De Junio: Comunicado Técnico Diario. Mexico: Secretaría de Salud Federal (https://coronavirus.gob.mx/2020/06/15/conferencia-15-de-junio/).
    1. Knaus W.A., Draper E.A., Wagner D.P., Zimmerman J.E. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818–829. - PubMed
    1. Vincent J.L., Moreno R., Takala J. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European society of intensive care medicine. Intensive Care Med. 1996;22(7):707–710. - PubMed
    1. Namendys-Silva S.A., Silva-Medina M.A., Vásquez-Barahona G.M. Application of a modified sequential organ failure assessment score to critically ill patients. Braz J Med Biol Res. 2013;46(2):186–193. - PMC - PubMed

Publication types

Associated data