Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru

• Published in: PloS one 2020-12, Vol.15 (12), p.e0244171-e0244171
• Main Authors: Mejía, Fernando, Medina, Carlos, Cornejo, Enrique, Morello, Enrique, Vásquez, Sergio, Alave, Jorge, Schwalb, Alvaro, Málaga, Germán
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biology and Life Sciences; Comorbidity; Coronaviruses; COVID-19; COVID-19 - metabolism; COVID-19 - mortality; Demographic aspects; Diabetes mellitus; Diabetes Mellitus - metabolism; Diabetes Mellitus - mortality; Fatalities; Female; Forecasts and trends; Hazard identification; Hospital Mortality; Hospitalization; Hospitals, Public - methods; Humans; Humboldt, Alexander von (1769-1859); Hypertension; Hypertension - metabolism; Hypertension - mortality; Hypoxemia; Male; Medicine and Health Sciences; Middle Aged; Mortality; Obesity; Obesity - metabolism; Obesity - mortality; Oxygen; Oxygen - metabolism; Oxygen content; Oxygen saturation; Patients; People and places; Peru; Physical Sciences; Retrospective Studies; Risk Factors; SARS-CoV-2 - pathogenicity; Saturation; Signs and symptoms; Viral diseases
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0244171

Peru is among the top ten countries with the highest number of coronavirus disease 2019 (COVID-19) cases worldwide. The aim of the study was to describe the clinical features of hospitalized adult patients with COVID-19 and to determine the prognostic factors associated with in-hospital mortality. We conducted a retrospective cohort study among adult patients with COVID-19 admitted to Hospital Cayetano Heredia; a tertiary care hospital in Lima, Peru. The primary outcome was in-hospital mortality. Multivariate Cox proportional hazards regression was used to identify factors independently associated with in-hospital mortality. A total of 369 patients (median age 59 years [IQR:49-68]; 241 (65.31%) male) were included. Most patients (68.56%) reported at least one comorbidity; more frequently: obesity (42.55%), diabetes mellitus (21.95%), and hypertension (21.68%). The median duration of symptoms prior to hospital admission was 7 days (IQR: 5-10). Reported in-hospital mortality was 49.59%. By multiple Cox regression, oxygen saturation (SaO2) values of less than 90% on admission correlated with mortality, presenting 1.86 (95%CI: 1.02-3.39), 4.44 (95%CI: 2.46-8.02) and 7.74 (95%CI: 4.54-13.19) times greater risk of death for SaO2 of 89-85%, 84-80% and 90%. Additionally, age >60 years was associated with 1.88 times greater mortality. Oxygen saturation below 90% on admission is a strong predictor of in-hospital mortality in patients with COVID-19. In settings with limited resources, efforts to reduce mortality in COVID-19 should focus on early identification of hypoxemia and timely access to hospital care.