Supervivencia a Largo Plazo y Factores Asociados con la Mortalidad en Pacientes con Neumonía Adquirida en la Comunidad y COVID 19: Un Estudio de Cohorte Retrospectivo
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Introducción: La neumonía adquirida en la comunidad (NAC) se ha convertido en la principal causa de muerte infecciosa a nivel mundial 1. En Estados Unidos, la incidencia estimada de NAC oscila entre 106 y 164 casos por 10.000 habitantes. El objetivo principal de este estudio es evaluar las tasas de supervivencia y los factores asociados con la mortalidad en pacientes diagnosticados con Neumonía Adquirida en la Comunidad (NAC) y Enfermedad por Coronavirus 2019 (COVID 19) tras su hospitalización en Colombia. Materiales y métodos: Se llevó a cabo un estudio de cohorte retrospectivo para evaluar la supervivencia a 12 meses en pacientes con NAC y COVID 19, utilizando el método de Kaplan Meier. Se realizaron estratificaciones por edad, sexo, comorbilidades y gravedad de la enfermedad. Además, se realizó un análisis multivariado utilizando regresión de Cox para investigar los factores de riesgo que pueden haber influido en la supervivencia a 12 meses. Resultados: Se incluyó a un total de 4697 pacientes, de los cuales el 52,5% tenía NAC (2464/4697), el 32,5% tenía COVID 19 (1528/4697) y el 15% no presentaba ni NAC ni COVID 19 (705/4697). La tasa de supervivencia a 12 meses fue del 46,2% para los pacientes con NAC, del 74.9% para los pacientes con COVID 19 y del 64,4% para los pacientes sin ninguna de las condiciones. El análisis de regresión de Cox reveló que ser hombre (HR: 1,142; IC del 95%: 1,042-1,252; p=0,004), tener más de 65 años (HR: 2,622; IC del 95%: 2,324-2,959; p<0,001), un Índice de Comorbilidad de Charlson >3 (HR: 1,770; IC del 95%: 1,604-1,954; p<0,001), CURB-65 >2 (HR: 2,081; IC del 95%: 1,874-2,313; p<0,001) y tener antecedentes de NAC (HR: 1,569; IC del 95%: 1,420-1,735; p<0,001) se asociaron con una mayor mortalidad a los 12 meses. Discusión: La supervivencia entre los pacientes con NAC a los 12 meses de seguimiento fue más baja, con factores identificados asociados a una mayor mortalidad, incluyendo ser hombre, tener más de 65 años, presentar comorbilidades y la gravedad de la enfermedad medida por CURB 65.
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