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Mortalidad en pacientes con infección respiratoria aguda por SARS-CoV-2 según índice de oxigenación SpO2/FiO2 y valores hematométricos de ingreso a 2500 m s.n.m.

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dc.contributor.advisorPinzón Rondón, Ángela María
dc.contributor.advisorRodríguez Lima, David René
dc.contributor.advisorMolano González, Nicolás
dc.contributor.gruplacGrupo de Investigación Clínicaspa
dc.creatorPatiño Aldana, Andrés Felipe
dc.creatorRodríguez Alvarino, Estefanía Paula
dc.creatorSanclemente Mariño, Isabella
dc.creator.degreeMagíster en epidemiologíaspa
dc.creator.degreeLevelMaestría
dc.creator.degreetypePart timespa
dc.date.accessioned2021-07-12T16:38:30Z
dc.date.available2021-07-12T16:38:30Z
dc.date.created2021-07-01
dc.descriptionIntroducción: La infección respiratoria aguda (IRA) por el SARS-CoV-2 es responsable del COVID 19. Sus principales manifestaciones ocurren a nivel respiratorio y su expresión más grave es el síndrome de distrés respiratorio del adulto (SDRA). El desarrollo de IRA y SDRA en altitud, es un reto fisiológico en donde convergen mecanismos adaptativos, hemodinámicos y ventilatorios a la hipoxia hipobárica con los procesos fisiopatológicos y compensatorios frente a la enfermedad; a medida que aumenta la altitud, la presión parcial de oxígeno disminuye. La hipoxia ambiental podría asociarse con hipoxemia más severa lo que empeora el pronóstico de la enfermedad, sin embargo, se ha propuesto que los mecanismos adaptativos a la hipoxia hipobárica pueden generar resistencia a la hipoxemia mejorando la entrega y uso eficiente del O2. Se desconoce cuáles son las implicaciones fisiopatológicas y pronósticas en la IRA por SARS-CoV-2 de las características hematológicas de pacientes crónicamente expuestos a hipoxia hipobárica. Objetivos: En este estudio se busca caracterizar los pacientes con infección respiratoria aguda por SARS-CoV-2 según las variables hematométricas y de oxigenación al ingreso y su relación con la mortalidad en el Hospital Universitario Mayor Méderi entre marzo y julio de 2020. Metodología: Se realizó un estudio observacional descriptivo con componente analítico de fuente secundaria sobre la base de datos del estudio “Síndrome de Distrés Respiratorio Agudo (SDRA) por SARS-CoV-2 y resultados clínicos a 2500 metros de altura”. Se describió la información sociodemográfica, clínica y paraclínica de ingreso y el desenlace de la estancia hospitalaria hasta el egreso vivo o el fallecimiento. Se describieron las características de la población y se establecieron medidas de asociación con el desenlace de mortalidad según el tipo de variable, posteriormente se realizaron modelos multivariados exploratorios para controlar la confusión y/o evaluar la interacción de variables relacionadas con la mortalidad. Resultados: En este estudio se han descrito las características sociodemográficas, clínicas y paraclínicas de ingreso; se reportaron análisis exploratorios que establecen asociaciones de la edad, el sexo, la historia de hipertensión y relaciones no lineales de la SpO2/FiO2, hemoglobina y la relación neutrófilos/linfocitos, con la mortalidad de los pacientes con IRA por SARS-CoV-2 admitidos al HUM entre marzo y julio de 2020. Además, se describieron los grupos de pacientes con mayor y menor probabilidad de fallecer en la estancia hospitalaria, según sus niveles de oxigenación, hemoglobina, edad y relación neutrófilos/linfocitos de ingreso.spa
dc.description.abstractIntroduction: Acute respiratory infection (ARIs) due to SARS-CoV-2 is responsible for COVID 19. Its main manifestations occur at a respiratory level and its most severe expression is the Adult respiratory distress syndrome (ARDS). The development of AIRs and ARDS at altitude is a physiological challenge in which hemodynamic adaptive and ventilatory mechanisms to hypobaric hypoxia converge with the pathophysiological and compensatory processes against the disease; as the altitude increases, the oxygen's partial pressure decreases. The environmental hypoxia could be related to more severe hypoxemia that worsens the prognosis of the disease, however, it has been proposed that the adaptive mechanisms to hypobaric hypoxia may generate resistance to hypoxemia improving the delivery and efficient use of O2. It is unknown which are the pathophysiological and prognostic implications in AIRs due to SARS-CoV-2 of the hematological characteristics of patients chronically exposed to hypobaric hypoxia. Objectives: This study seeks to explore the relationship between the hematometric and oxygenation entry and the mortality of the patients with an acute respiratory infection due to SARS-CoV-2 that were admitted to the Hospital Universitario Mayor Mederi between March and July 2020. Methodology: A descriptive observational study with an analytical component from a secondary source was carried out about the database of the study “Acute respiratory distress síndrome (ARDS) due to SARS-CoV-2 and clinical results at 2500 meters high” which included the first thousand patients that consult to Hospital Universitario Mayor Mederi. The sociodemographic, clinical, and paraclinical information of entrance was described and the outcome of the hospital residency until de live discharge or death. The population characteristics were described and measures of association with mortality outcome were established according to the type of variable, afterwards, exploratory multivariate models were made to control the confusion or to evaluate the interaction between the variables related to mortality. Results: In this study, sociodemographic, clinical and paraclinical admissions characteristics have been described; the exploratory analysis that establish associations between age, sex, hypertension history, and no lineal relations of the SpO2/FiO2, hemoglobin and neutrophil/lymphocytes relation were reported whit the mortality of the patients with ARI due to SARS-CoV2 admitted to HUM between March and July of 2020. In addition, the groups with the patients with higher and lower probability of dying during hospital stay were described according to their oxygen levels, hemoglobin, age, and neutrophil/lymphocytes admission relation.spa
dc.format.extent81 pp.spa
dc.format.mimetypeapplication/pdf
dc.geoLocationBogotá, Colombiaspa
dc.identifier.doihttps://doi.org/10.48713/10336_31813
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/31813
dc.language.isospaspa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentEscuela de Medicina y Ciencias de la Saludspa
dc.publisher.programMaestría en Epidemiologíaspa
dc.rightsAtribución-NoComercial-CompartirIgual 2.5 Colombia*
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/2.5/co/
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectRelación entre las características hematométricas y de oxigenación con la mortalidad por Covid-19spa
dc.subjectDesarrollo de IRA y SDRA por Covid-19 en altitud de 2500 metrosspa
dc.subjectPresión arterial de oxígeno / Fracción inspirada de oxigeno (PaO2/FiO2) a 2500 metros de altura en pacientes con SARS-CoV-2spa
dc.subject.ddcFarmacología & terapéuticaspa
dc.subject.keywordRelationship between hematometric and oxygenation characteristics with mortality due to Covid-19spa
dc.subject.keywordDevelopment of IRA and ARDS by Covid-19 at an altitude of 2500 metersspa
dc.subject.keywordArterial oxygen pressure / Inspired oxygen fraction (PaO2 / FiO2) at an altitude of 2500 meters in patients with SARS-CoV-2spa
dc.titleMortalidad en pacientes con infección respiratoria aguda por SARS-CoV-2 según índice de oxigenación SpO2/FiO2 y valores hematométricos de ingreso a 2500 m s.n.m.spa
dc.title.TranslatedTitleMortality in patients with acute respiratory infection due to SARS-CoV-2 according to SpO2 / FiO2 oxygenation index and hematometric values ​​on admission at 2500 m a.s.l.spa
dc.typemasterThesiseng
dc.type.documentDescriptivo observacional retrospectivospa
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTesis de maestríaspa
local.department.reportEscuela de Medicina y Ciencias de la Saludspa
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Maestría en Epidemiología