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Article

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

by
Fátima Concha-Velasco
1,2,
Ana G. Moncada-Arias
2,
María K. Antich
2,3,
Carolina J. Delgado-Flores
4,
Cesar Ramírez-Escobar
2,
Marina Ochoa-Linares
5,
Lucio Velásquez-Cuentas
6,
Homero Dueñas de la Cruz
7 and
Steev Loyola
3,8,*
1
Universidad Continental, Cusco 08000, Peru
2
Dirección de Epidemiología e Investigación, Gerencia Regional de Salud (GERESA), Cusco 08200, Peru
3
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima 150135, Peru
4
Instituto de Evaluación de Tecnologías en Salud e Investigación, EsSalud, Lima 15072, Peru
5
Hospital Regional del Cusco, Cusco 08003, Peru
6
Hospital Nacional Adolfo Guevara Velasco—EsSalud, Cusco 08002, Peru
7
Hospital Antonio Lorena, Cusco 08001, Peru
8
Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias 130014, Colombia
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2023, 8(3), 133; https://doi.org/10.3390/tropicalmed8030133
Submission received: 13 December 2022 / Revised: 27 January 2023 / Accepted: 30 January 2023 / Published: 22 February 2023
(This article belongs to the Special Issue COVID-19: Current Situation and Future Trends)
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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.
Keywords: COVID-19; risk factors; death; hospitalization; intensive care units; mechanical ventilator; high altitude; Cusco; Peru COVID-19; risk factors; death; hospitalization; intensive care units; mechanical ventilator; high altitude; Cusco; Peru

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MDPI and ACS Style

Concha-Velasco, F.; Moncada-Arias, A.G.; Antich, M.K.; Delgado-Flores, C.J.; Ramírez-Escobar, C.; Ochoa-Linares, M.; Velásquez-Cuentas, L.; Dueñas de la Cruz, H.; Loyola, S. 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. Trop. Med. Infect. Dis. 2023, 8, 133. https://doi.org/10.3390/tropicalmed8030133

AMA Style

Concha-Velasco F, Moncada-Arias AG, Antich MK, Delgado-Flores CJ, Ramírez-Escobar C, Ochoa-Linares M, Velásquez-Cuentas L, Dueñas de la Cruz H, Loyola S. 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. Tropical Medicine and Infectious Disease. 2023; 8(3):133. https://doi.org/10.3390/tropicalmed8030133

Chicago/Turabian Style

Concha-Velasco, Fátima, 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, and Steev Loyola. 2023. "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" Tropical Medicine and Infectious Disease 8, no. 3: 133. https://doi.org/10.3390/tropicalmed8030133

APA Style

Concha-Velasco, F., Moncada-Arias, A. G., Antich, M. K., Delgado-Flores, C. J., Ramírez-Escobar, C., Ochoa-Linares, M., Velásquez-Cuentas, L., Dueñas de la Cruz, H., & Loyola, S. (2023). 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. Tropical Medicine and Infectious Disease, 8(3), 133. https://doi.org/10.3390/tropicalmed8030133

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