Impact of preemptive hospitalization on health outcomes at the temporary COVID-19 hospital in Mexico City: a prospective observational study

Introduction: In response to the evolution of the coronavirus disease 2019 (COVID-19) pandemic, the admission protocol for the temporary COVID-19 hospital in Mexico City has been updated to hospitalize patients preemptively with an oxygen saturation (SpO 2 ) of >90%. Methods: This prospective, ob...

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Main Authors: Rafael Ricardo Valdez Vazquez, Héctor Gallardo-Rincón, Julieta Lomelín-Gascon, Rodrigo Ville Benavides, Linda Morales Juárez, Héctor Herrera Bello, Lidia Moreno Castañeda, Adrian Palacios Chavarria, Pablo Escalera Castillo, Luis Esteban Ramirez Gonzalez, Mónica Arboleya Avendaño, Santiago Treviño Berlanga, Reyna Albertina Rosas Loza, Renate Victoria Álvarez Wyssmann, Erika Salinas Lezama, Alonso Gutiérrez Romero, María Dolores Niembro Ortega, Liudmila Villegas Acosta, Ailyn Cendejas Schotman, Jennifer Bertin Montoya, Andrea Gonzalez Rodriguez, Laura María Badel Ramos, Luis Alberto Martinez-Juarez, Rodrigo Saucedo-Martínez, Alejandra Montoya, Roberto Tapia-Conyer
Format: Article
Language:English
Published: SAGE Publishing 2021-08-01
Series:Therapeutic Advances in Infectious Disease
Online Access:https://doi.org/10.1177/20499361211040325
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Summary:Introduction: In response to the evolution of the coronavirus disease 2019 (COVID-19) pandemic, the admission protocol for the temporary COVID-19 hospital in Mexico City has been updated to hospitalize patients preemptively with an oxygen saturation (SpO 2 ) of >90%. Methods: This prospective, observational, single-center study compared the progression and outcomes of patients who were preemptively hospitalized versus those who were hospitalized based on an SpO 2 ⩽90%. We recorded patient demographics, clinical characteristics, COVID-19 symptoms, and oxygen requirement at admission. We calculated the risk of disease progression and the benefit of preemptive hospitalization, stratified by CALL Score: age, lymphocyte count, and lactate dehydrogenase (<8 and ⩾8) at admission. Results: Preemptive hospitalization significantly reduced the requirement for oxygen therapy (odds ratio 0.45, 95% confidence interval 0.31–0.66), admission to the intensive care unit (ICU) (0.37, 0.23–0.60), requirement for invasive mechanical ventilation (IMV) (0.40, 0.25–0.64), and mortality (0.22, 0.10–0.50). Stratification by CALL score at admission showed that the benefit of preemptive hospitalization remained significant for patients requiring oxygen therapy (0.51, 0.31–0.83), admission to the ICU (0.48, 0.27–0.86), and IMV (0.51, 0.28–0.92). Mortality risk remained significantly reduced (0.19, 0.07–0.48). Conclusion: Preemptive hospitalization reduced the rate of disease progression and may be beneficial for improving COVID-19 patient outcomes.
ISSN:2049-937X