Clinical behavior of COVID-19 in a reference public hospital in Mexico City during SARS-CoV-2 epidemiological waves.
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INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic presented a unique behavior in each of the epidemiological waves in terms of clinical presentation, severity, and transmissibility; in Mexico, as in the rest of the world. The objective of this study was to describe the clinical severity and risk factors associated with mortality in patients hospitalized with coronavirus disease 2019 (COVID-19), by comparing each epidemiological wave in a reference public hospital in Mexico City. METHODOLOGY: The Kaplan-Meier and logistic regression analyses were performed to determine the mortality and odds ratio of 1,752 patients according to their specific comorbidity and during each epidemiological wave. RESULTS: The average age of the patients was 54 years. Each patient presented at least one comorbidity; such as, diabetes mellitus (33.3%), systemic arterial hypertension (28.3%), chronic kidney disease (8.67%), chronic obstructive pulmonary disease (1.35%), and cancer (4.82%). The average length of hospital stay was 11.93 days. General mortality was 29%, with the percentage of deaths being higher in the first and second waves of COVID-19. Admission to the intensive care unit and mechanical ventilation were required in 21.6% and 5%, respectively. CONCLUSIONS: Chronic diseases such as diabetes mellitus and arterial hypertension were associated with a higher risk of death in patients hospitalized with COVID-19. This phenomenon was more evident during the first and second epidemiological waves of the pandemic in Mexico.