Clinical Profile and Course of Patients with Acute Respiratory Distress Syndrome due to COVID-19 in a Middle-Income Region in Mexico

Fig. 1.

Fig. 2.

Incidence and mortality parameters of patients with ARDS due to COVID-19 in three tertiary care hospitals in the Mexican Republic_ (N = number of patients infected by COVID-19) *[22] **[21]

Hospital	N	ARDS (%)	Chi-2 Test	Mortality (%)	Chi-2 Test	Average age	Beds	COVID-19 Specialists	Comorbidity
HRAEV	220	108 (49%)	X2 =3255.13	67 (62%)	X2 =45.04	59	50	13	Diabetes
*CMNO – IMSS	1010	408 (40%)	df=2	364 (90%)	df=2	58	249	≈50	Hypertension
**INCMNSZ	800	241 (30%)	p < 0.05	159 (66%)	p < 0.05	52	168	≈36	Obesity

Respiratory variables in patients who developed ARDS due to COVID-19

Ventilatory parameters	All (n=)	Live patients (N=)	Deceased patients (N=)	p value
Days from symptom onset to mechanical ventilation	14±4.8	11±5.2	17±6.7	0.005**
Days on mechanical ventilation since IUC admission	23±8	19±5	27±11	0.004**
PaCO2 (mmHg)	55±14	48±11(45–87)	65±14 (55–105)	0.048*
FiO2 %	62±13 (50–90)	55±12 (35–70)	70±15 (50–100)	0.061
Plateau pressure (cm/H2O)	28.2±6.2	27.3±5(15–38)	29.5±7.3(16–49)	0.072
PaO2/FiO2 (mmHg)	115±66	153±57(66–304)	126±77(43–400)	0.045*
PEEP (cm/H2O)	13.6±2	13±1.7(8–14)	13±3.2(8–18)	0.781
Driving pressure cm/H2O	15±4 (11–38)	13±5(11–22)	18±7(11–38)	0.05*
Distensibility (ml-cm/H2O)	49±17 (13–76)	48±13 (36–76)	25±18(13–43)	0.061
Vt-predicted weight	7.2±1.7	6.8±1.2(5.5–7.1)	6.5±0.8(5.6–6.8)	0.23
TAC (pattern %) *. targeted	*70%	85%	*50%	0.24
Ç. CONsolidated	Ç50%	30%	Ç75%	0.067

Patient diagnostic data, vital signs, and laboratory values at baseline

Vital signs	All (n=)	Live Patients (N=)	Deceased Patients (N=)	p value
Mean blood pressure, mmHg	80±7	82±9 (65–88)	75±8(59–78)	0.12
Heart rate, bpm		97±12 (78–123)	97±11 (78–125)	0.83
Laboratory findings
Ferritin (ng/mL)	576±59	597±27 (345–789)	965±32 (489–1450)	0.01**
d-Dimer (ng/mL)	3739±1214	2905±975	6642±1868	0.01**
CRP (mg/dL)	107±23	89±35 (34–123)	116±45 (78–230)	0.07
Lymphocytes (%)	08±04 (01–16)	12±04 (05–19)	06±03 (01–20)	0.05*
Leukocytes (109/L)	19.4±23.7	17.6±18.5 (12–28)	24.5±23.7 (13–34)	0.10

Patient demographics and comorbidities at baseline

Variable	All (n= 108)	Live Patients (N=)	Deceased Patients (N=)	p-value
Age (N)	59±13	52±12.6	66±11.5	0.00**
Male	72 (67%)	27 (25%)	45 (42%)	0.88 (NS)
Female	36 (33%)	14 (13%)	22 (20%)
Body mass index, kg/m2 (n)	32.8±6.2	32±6.8	32±5.9	0.79 (NS)
Systemic Arterial Hypertension	62 (57%)	23 (21%)	39 (36%)	0.05 (NS)
Diabetes Mellitus 2	56 (52%)	19 (17%)	37 (34%)	0.04*
Heart Disease	12 (11%)	5 (4%)	7 (6%)	0.78 (NS)
Chronic Renal Failure	6 (5.6%)	2 (1%)	4 (3%)	0.67 (NS)
Number of patients with COPD (Chronic obstructive pulmonary disease)	52/108	17/42	35/66
Scores
NUTRIC-2	6.5±2.5	6.0±1.5	7±2	0.17 (NS)
SOFA	9±3	6.8±3.1	10.4±2.3	0.06 (NS)
APACHE II	23±7	18±7.6	26±5.3	0.017*