Frecuencia respiratoria como predictor de gravedad en el paciente ambulatorio con infección por SARS-CoV-2

Résumé

OBJECTIVE. To evaluate the usefulness of respiratory rate (RR) as a predictor of severity in community-treated SARS-CoV-2 infection and to analyze the association of RR with course of disease. MATERIAL AND METHODS. We included case records for 4019 patients with SARS-CoV-2 infection diagnosed in the community who were over the age of 60 years and/or were considered at high risk. The following clinical data were recorded for all patients: baseline oxygen saturation, blood pressure, temperature, heart rate, RR, and symptoms. Routine laboratory analyses and chest x-rays were also ordered for patients who were admitted to hospital. RESULTS. Three hundred thirty-six patients (8.4%) were transferred to an emergency department, 293 (7.3%) were admitted, and 3726 were followed during treatment in the community. RR was associated with the number of days hospitalized (ρ, 0.15; P = .014). Tachypnea was associated with higher comorbidity, more symptoms (P < .001 for all symptoms evaluated), admission to an intensive care unit (46.6% vs 28.0%; χ2 = 6.49; P = .011) with elevated markers of inflammation. None of the community-treated patients died (vs 28 of the hospitalized patients). Tachypnea observed during community treatment was associated with higher mortality (in 43% vs 2.9%; χ2 = 133.29; P < .001). RR was a predictor of admission to hospital (area under the receiver operating characteristic curve, 0.789 ± 0.015; 95% CI, 0.759-0.818; P < .001). CONCLUSIONS. RR is a useful as a clinical sign that predicts hospital admission and mortality.