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. 2022 May 21;15(1):22.
doi: 10.1186/s12245-022-00426-4.

Clinical characteristics and mortality associated with COVID-19 at high altitude: a cohort of 5161 patients in Bogotá, Colombia

David Rene Rodriguez Lima  1   2 , Ángela María Pinzón Rondón  3 , Cristhian Rubio Ramos  4 , Darío Isaías Pinilla Rojas  4 , Maria José Niño Orrego  3 , Mateo Andrés Díaz Quiroz  3 , Nicolás Molano-González  3 , Jorge Enrique Ceballos Quintero  5 , Alex Francisco Arroyo Santos  5 , Ángela María Ruiz Sternberg  3
Affiliations

Clinical characteristics and mortality associated with COVID-19 at high altitude: a cohort of 5161 patients in Bogotá, Colombia

David Rene Rodriguez Lima et al. Int J Emerg Med. .

Abstract

Background: There are few data on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) in cities over 1000 m above sea level (masl).

Objectives: To describe the clinical characteristics and mortality of patients with COVID-19 treated at a high complexity hospital in Bogotá, Colombia, at 2640 masl.

Methods: This was an observational study of a cohort including 5161 patients with confirmed COVID-19 infection from 19 March 2020 to 30 April 2021. Demographic data, laboratory values, comorbidities, oxygenation indices, and clinical outcomes were collected. Data were compared between survivors and nonsurvivors. An independent predictive model was performed for mortality and invasive mechanical ventilation (IMV) using classification and regression trees (CART).

Results: The median cohort age was 66 years (interquartile range (IQR) 53-77), with 1305 patients dying (25%) and 3856 surviving (75%). The intensive care unit (ICU) received 1223 patients (24%). Of 898 patients who received IMV, 613 (68%) of them perished. The ratio of partial pressure arterial oxygen (PaO2) to fraction inspired oxygen (FiO2), or the P/F ratio, upon ICU admission was 105 (IQR 77-146) and 137 (IQR 91-199) in the deceased and survivors, respectively. The CART model showed that the need for IMV, age greater than 79 years, ratio of oxygen saturation (SaO2) to FiO2, or the S/F ratio, less than 259, and lactate dehydrogenase (LDH) greater than 617 U/L at admission were associated with a greater probability of death.

Conclusion: Among more than 5000 patients with COVID-19 treated in our hospital, mortality at hospital discharge was 25%. Older age, low S/F ratio, and high LDH at admission were predictors of mortality.

Keywords: Altitude; COVID-19; Clinical outcomes; Mortality; SARS-CoV-2.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Need for invasive mechanical ventilation in patients with COVID-19, classification and regression tree (CART) risk groups: this method built a predictive model and five clinical profiles using the oxygen saturation to inspired oxygen fraction (SaO2/FiO2) ratio at 48 h after admission, age, lactate dehydrogenase (LDH), and chronic obstructive pulmonary disease (COPD) as predictor variables
Fig. 2
Fig. 2
Mortality in patients with COVID-19, classification and regression tree (CART) risk groups: this method built a predictive model and five clinical profiles using the need for invasive mechanical ventilation (IMV), age, the oxygen saturation to inspired oxygen fraction (SaO2/FiO2) ratio on admission, and initial lactate dehydrogenase (LDH) as predictor variables
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References

    1. Luks AM, Auerbach PS, Freer L, Grissom CK, Keyes LE, McIntosh SE, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of acute altitude illness: 2019 update. Wilderness Environ Med. 2019;30(4):S3–18. doi: 10.1016/j.wem.2019.04.006. - DOI - PubMed
    1. Penaloza D. Efectos de la exposición a grandes alturas en la circulación pulmonar. Rev Esp Cardiol. 2012;65(12):1075–1078. doi: 10.1016/j.recesp.2012.06.027. - DOI - PubMed
    1. Sharma P, Misra K. Management of High Altitude Pathophysiology. Elsevier; 2018. High altitude and hypoxia; pp. 3–8.
    1. Netzer N, Strohl K, Faulhaber M, Gatterer H, Burtscher M. Hypoxia-related altitude illnesses. J Travel Med. 2013;20(4):247–255. doi: 10.1111/jtm.12017. - DOI - PubMed
    1. Lasso Apráez MD, JI. Interpretación de los gases arteriales en Bogotá (2.640 msnm) basada en el nomograma de Siggaard-Andersen. Una propuesta para facilitar y unificar la lectura. Rev Colomb Neumol. 2014;26(1) Available from: http://sena.metarevistas.org/index.php/rcneumologia/article/view/56 [cited 23 Jul 2021].

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