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

Mejía, Fernando; Medina, Carlos; Cornejo, Enrique; Morello, Enrique; Vásquez, Sergio; Alave Rosas, Jorge Luis; Schwalb, Alvaro; Málaga, Germán

doi:10.1371/journal.pone.0244171

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

Author(s)

Mejía, Fernando

Universidad Peruana Cayetano Heredia

Medina, Carlos

Universidad Peruana Cayetano Heredia

Cornejo, Enrique

Universidad Peruana Cayetano Heredia

Morello, Enrique

Hospital Nacional Cayetano Heredia

Vásquez, Sergio

Hospital Nacional Cayetano Heredia

Alave Rosas, Jorge Luis

Universidad Peruana Unión

Schwalb, Alvaro

Universidad Peruana Cayetano Heredia

Málaga, Germán

Hospital Nacional Cayetano Heredia

Date Issued

28 de diciembre de 2020

Type

Article

Volume

15

Issue

12

Series/Report No.

PLoS ONE

Start Page

e0244171

End Page

e0244171

DOI

10.1371/journal.pone.0244171

ISSN

1932-6203

Abstract

INTRODUCTION: 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. METHODS: 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. RESULTS: 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 <80%, respectively, when compared to patients with SaO2 >90%. Additionally, age >60 years was associated with 1.88 times greater mortality. CONCLUSIONS: 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.