Factores asociados con una evolución desfavorable en pacientes diagnosticados de COVID-19 y seguidos en atención primaria en 2020

Abstract

AimTo know the factors associated with an unfavorable evolution (UE) of patients diagnosed with COVID-19 with total or partial follow-up in primary care. DesignA case series. SettingUrban health center. ParticipantsBy systematic sampling, patients ≥18 years, diagnosed with COVID-19, with analytical confirmation, in 2020 and followed up by their family doctors, were selected. Main measurementsDependent variable: hospital admission or death due to COVID-19. Independent variables: age, sex, medical background, clinical data and treatments related to the disease. Statistical analysis, with SPSS 25.0: descriptive analysis, comparison of proportions (chi square) and medians (Mann–Whitney U). The analysis is completed with logistic regression. Results610 patients were included in the study. The median age was 49 years (interquartile range: 35–61); 51.8% were women; 14.9% presented UE (95% CI: 12.0–17.8). The sociodemographic variables or the variables related to medical background that showed an independent association with UE were age (OR: 1.066; 95% CI: 1.038–1.095), sex (OR for men: 3.277; 95% CI: 1.304–8.235) and being a smoker or former smoker (OR: 2.565; 95% CI: 1.135–5.800). Regarding the clinical variables of the disease, an association was found for altered consciousness (OR: 62.829; 95% CI: 9.177–430.149), dyspnea (OR: 14.339; 95% CI: 6.046–34.009), expectoration (OR: 4.764; 95% CI: 1.858-12.213)) and asthenia (OR: 3.993; 95% CI: 1.705–9.351). Conclusions14.9% of the patients diagnosed with COVID-19 presented an UE. Older age, male sex and being a smoker or former smoker increased the probability of it. Altered consciousness, dyspnea, expectoration, and asthenia were the clinical data that best predicted UE.