Factors Associated with COVID-19 Death in a High-Altitude Peruvian Setting during the First 14 Months of the Pandemic: A Retrospective Multicenter Cohort Study in Hospitalized Patients

Fátima Concha-Velasco, Ana G. Moncada-Arias, María K. Antich, Carolina J. Delgado-Flores, Cesar Ramírez-Escobar, Marina Ochoa-Linares, Lucio Velásquez-Cuentas, Homero Dueñas de la Cruz, Steev Loyola

Research output: Contribution to journalOriginal Articlepeer-review

Abstract

Risk factors for COVID-19 death in high-altitude populations have been scarcely described. This study aimed to describe risk factors for COVID-19 death in three referral hospitals located at 3399 m in Cusco, Peru, during the first 14 months of the pandemic. A retrospective multicenter cohort study was conducted. A random sample of ~50% (1225/2674) of adult hospitalized patients who died between 1 March 2020 and 30 June 2021 was identified. Of those, 977 individuals met the definition of death by COVID-19. Demographic characteristics, intensive care unit (ICU) admission, invasive respiratory support (IRS), disease severity, comorbidities, and clinical manifestation at hospital admission were assessed as risk factors using Cox proportional-hazard models. In multivariable models adjusted by age, sex, and pandemic periods, critical disease (vs. moderate) was associated with a greater risk of death (aHR: 1.27; 95%CI: 1.14–1.142), whereas ICU admission (aHR: 0.39; 95%CI: 0.27–0.56), IRS (aHR: 0.37; 95%CI: 0.26–0.54), the ratio of oxygen saturation (ROX) index ≥ 5.3 (aHR: 0.87; 95%CI: 0.80–0.94), and the ratio of SatO2/FiO2 ≥ 122.6 (aHR: 0.96; 95%CI: 0.93–0.98) were associated with a lower risk of death. The risk factors described here may be useful in assisting decision making and resource allocation.

Original languageAmerican English
Article number133
JournalTropical Medicine and Infectious Disease
Volume8
Issue number3
DOIs
StateIndexed - Mar 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

  • COVID-19
  • Cusco
  • Peru
  • death
  • high altitude
  • hospitalization
  • intensive care units
  • mechanical ventilator
  • risk factors

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