Factores de riesgo asociados con la ocurrencia de choque en pacientes graves con la COVID-19
Palabras clave:
COVID-19, SARS-CoV-2, choque, predictores de la COVID-19, creatinina, cardiopatía isquémica.Resumen
Introducción: Las alteraciones provocadas por el nuevo coronavirus, así como otros factores como la edad, sus antecedentes patológicos personales y determinados resultados de laboratorio, contribuyen al estado de choque.
Objetivo: Determinar si existe relación entre el estado de choque provocado por la infección por la COVID-19 con los antecedentes patológicos personales, los índices de INL y la escala qSOFA.
Material y Método: Estudio de cohorte longitudinal prospectivo en 302 pacientes con el diagnóstico positivo de la COVID-19 que ingresaron en el Hospital Docente Clínico-Quirúrgico Comandante Manuel Fajardo (La Habana, Cuba) entre marzo y octubre de 2021.
Resultados: El 27,8 % de los pacientes evolucionó al choque, principalmente el choque séptico (25,2 %), la mediana de edad fue de 69 con RIC (57-77), mientras los antecedentes personales más frecuentes fueron: hipertensión arterial (71,5 %), obesidad (29,5 %) y Diabetes Mellitus (24,8 %), respectivamente. Los análisis de regresión logística identificaron como variables predictoras de choque los antecedentes de cardiopatía con un RR: 2,16; (IC 95 %: 1,15-4,04; p=0,02) y el valor de la creatinina con un RR: 1,01: (IC 95 %: 1,00-1,01; p=0,03).
Conclusiones: Los antecedentes de cardiopatía isquémica y el valor de la creatinina representan variables predictoras independientes de la ocurrencia de choque; por otro lado, la supervivencia de los pacientes con diagnóstico positivo de la COVID-19 que desarrollan un estado de choque durante su hospitalización, es significativamente menor.
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