{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:11:14Z","timestamp":1760235074087,"version":"build-2065373602"},"reference-count":44,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T00:00:00Z","timestamp":1626307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009068","name":"Consejo Nacional de Innovaci\u00f3n, Ciencia y Tecnolog\u00eda","doi-asserted-by":"publisher","award":["311880"],"award-info":[{"award-number":["311880"]}],"id":[{"id":"10.13039\/501100009068","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>(1) Background: Latin America has been harshly hit by SARS-CoV-2, but reporting from this region is still incomplete. This study aimed at identifying and comparing clinical characteristics of patients with COVID-19 at different stages of disease severity. (2) Methods: Cross-sectional multicentric study. Individuals with nasopharyngeal PCR were categorized into four groups: (1) negative, (2) positive, not hospitalized, (3) positive, hospitalized with\/without supplementary oxygen, and (4) positive, intubated. Clinical and laboratory data were compared, using group 1 as the reference. Multivariate multinomial logistic regression was used to compare adjusted odds ratios. (3) Results: Nine variables remained in the model, explaining 76% of the variability. Men had increased odds, from 1.90 (95%CI 0.87\u20134.15) in the comparison of 2 vs. 1, to 3.66 (1.12\u201311.9) in 4 vs. 1. Diabetes and obesity were strong predictors. For diabetes, the odds for groups 2, 3, and 4 were 1.56 (0.29\u20138.16), 12.8 (2.50\u201365.8), and 16.1 (2.87\u201390.2); for obesity, these were 0.79 (0.31\u20132.05), 3.38 (1.04\u201310.9), and 4.10 (1.16\u201314.4), respectively. Fever, myalgia\/arthralgia, cough, dyspnea, and neutrophilia were associated with the more severe COVID-19 group. Anosmia\/dysgeusia were more likely to occur in group 2 (25.5; 2.51\u2013259). (4) Conclusion: The results point to relevant differences in clinical and laboratory features of COVID-19 by level of severity that can be used in medical practice.<\/jats:p>","DOI":"10.3390\/healthcare9070895","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T09:32:07Z","timestamp":1626341527000},"page":"895","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Factors Associated with COVID-19 Severity in Mexican Patients: Cross-Sectional Analysis from a Multicentric Hospital Study"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0695-5356","authenticated-orcid":false,"given":"Joel","family":"Mon\u00e1rrez-Espino","sequence":"first","affiliation":[{"name":"Department of Health Research, Christus Muguerza del Parque Hospital, Chihuahua 31000, Mexico"},{"name":"Vice Presidency of Health Sciences, Medical Specialties Program, University of Monterrey, San Pedro Garza Garc\u00eda 66238, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina Ivette","family":"Zub\u00eda-Nev\u00e1rez","sequence":"additional","affiliation":[{"name":"Vice Presidency of Health Sciences, Medical Specialties Program, University of Monterrey, San Pedro Garza Garc\u00eda 66238, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorena","family":"Reyes-Silva","sequence":"additional","affiliation":[{"name":"Department of Health Research, Christus Muguerza del Parque Hospital, Chihuahua 31000, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Pablo","family":"Castillo-Palencia","sequence":"additional","affiliation":[{"name":"General Hospital of Soledad de Graciano S\u00e1nchez, San Luis Potos\u00ed Health Services, Soledad de Graciano S\u00e1nchez 78435, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2124-2036","authenticated-orcid":false,"given":"Julio Enrique","family":"Casta\u00f1eda-Delgado","sequence":"additional","affiliation":[{"name":"Biomedical Research Unit, Mexican Institute of Social Security, Zacatecas 98000, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5198-6100","authenticated-orcid":false,"given":"Ana Sof\u00eda","family":"Herrera van-Oostdam","sequence":"additional","affiliation":[{"name":"Biochemistry Department, San Luis Potos\u00ed Autonomous University, San Luis Potos\u00ed 78290, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1068-603X","authenticated-orcid":false,"given":"Yamil\u00e9","family":"L\u00f3pez-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Metabolomics and Proteomics Laboratory, Mexican Council of Science and Technology, Zacatecas Autonomous University, Zacatecas 98000, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.bj.2020.04.007","article-title":"COVID-19: The first documented coronavirus pandemic in history","volume":"43","author":"Liu","year":"2020","journal-title":"Biomed. J."},{"key":"ref_2","unstructured":"Johns Hopkins University & Medicine (2021, June 17). Coronavirus Resource Center: COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE). Available online: https:\/\/coronavirus.jhu.edu\/map.html."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1152\/physiol.00019.2020","article-title":"Pathophysiology of COVID-19: Mechanisms Underlying Disease Severity and Progression","volume":"35","author":"Bohn","year":"2020","journal-title":"Physiology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jaci.2020.08.031","article-title":"Characterization of the cytokine storm reflects hyperinflammatory endothelial dysfunction in COVID-19","volume":"147","author":"Sims","year":"2021","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1111\/jth.14975","article-title":"Coagulopathy in COVID-19","volume":"18","author":"Iba","year":"2020","journal-title":"J. Thromb. Haemost."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1080\/1744666X.2021.1847640","article-title":"Natural history of COVID-19 and therapeutic options","volume":"16","author":"Gautret","year":"2020","journal-title":"Expert Rev. Clin. Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12916-020-01735-2","article-title":"Considerations for target oxygen saturation in COVID-19 patients: Are we under-shooting?","volume":"18","author":"Shenoy","year":"2020","journal-title":"BMC Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1001\/jama.2020.12839","article-title":"Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review","volume":"324","author":"Wiersinga","year":"2020","journal-title":"JAMA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.annemergmed.2020.07.035","article-title":"Excess Out-of-Hospital Mortality and Declining Oxygen Saturation: The Sentinel Role of Emergency Medical Services Data in the COVID-19 Crisis in Tijuana, Mexico","volume":"76","author":"Friedman","year":"2020","journal-title":"Ann. Emerg. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s11739-020-02616-5","article-title":"A narrative review of coronavirus disease 2019 (COVID-19): Clinical, epidemiological characteristics, and systemic manifestations","volume":"16","author":"Krishnan","year":"2021","journal-title":"Intern. Emerg. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Gandhi, R.T., Lynch, J.B., and Del Rio, C. (2020). Mild or Moderate Covid-19. N. Engl. J. Med.","DOI":"10.1056\/NEJMcp2009249"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Teslya, A., Pham, T.M., Godijk, N.G., Kretzschmar, M.E., Bootsma, M.C.J., and Rozhnova, G. (2020). Impact of self-imposed prevention measures and short-term government-imposed social distancing on mitigating and delaying a COVID-19 epidemic: A modelling study. PLoS Med., 17.","DOI":"10.1101\/2020.03.12.20034827"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2000250","DOI":"10.2807\/1560-7917.ES.2020.25.40.2000250","article-title":"Epidemiological parameters of COVID-19 and its implication for infectivity among patients in China, 1 January to 11 February 2020","volume":"25","author":"Lu","year":"2020","journal-title":"Eurosurveillance"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/joim.13063","article-title":"Early antiviral treatment contributes to alleviate the severity and improve the prognosis of patients with novel coronavirus disease (COVID-19)","volume":"288","author":"Wu","year":"2020","journal-title":"J. Intern. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1007\/s11606-020-05762-w","article-title":"Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19)","volume":"35","author":"Jiang","year":"2020","journal-title":"J. Gen. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jinf.2020.04.011","article-title":"Current epidemiological and clinical features of COVID-19; A global perspective from China","volume":"81","author":"Tu","year":"2020","journal-title":"J. Infect."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"582932","DOI":"10.3389\/fpubh.2020.582932","article-title":"Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation","volume":"8","author":"Mehta","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.ijid.2020.04.061","article-title":"Mild versus severe COVID-19: Laboratory markers","volume":"95","author":"Velavan","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/ijlh.13229","article-title":"COVID-19 and the clinical hematology laboratory","volume":"42","author":"Frater","year":"2020","journal-title":"Int. J. Lab. Hematol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Elshazli, R.M., Toraih, E.A., Elgaml, A., El-Mowafy, M., El-Mesery, M., Amin, M., Hussein, M.H., Killackey, M.T., Fawzy, M.S., and Kandil, E. (2020). Diagnostic and prognostic value of hematological and immunological markers in COVID-19 infection: A meta-analysis of 6320 patients. PLoS ONE, 15.","DOI":"10.1101\/2020.07.08.20141218"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"109192","DOI":"10.1016\/j.ejrad.2020.109192","article-title":"Chest CT accuracy in diagnosing COVID-19 during the peak of the Italian epidemic: A retrospective correlation with RT-PCR testing and analysis of discordant cases","volume":"130","author":"Falaschi","year":"2020","journal-title":"Eur. J. Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"E32","DOI":"10.1148\/radiol.2020200642","article-title":"Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases","volume":"296","author":"Ai","year":"2020","journal-title":"Radiology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.diii.2020.03.014","article-title":"COVID-19 pneumonia: A review of typical CT findings and differential diagnosis","volume":"101","author":"Hani","year":"2020","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.clinimag.2020.10.035","article-title":"Chest CT findings of coronavirus disease 2019 (COVID-19): A comprehensive meta-analysis of 9907 confirmed patients","volume":"70","author":"Zarifian","year":"2021","journal-title":"Clin. Imaging"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"E97","DOI":"10.1148\/radiol.2020201473","article-title":"CO-RADS: A Categorical CT Assessment Scheme for Patients Suspected of Having COVID-19\u2014Definition and Evaluation","volume":"296","author":"Prokop","year":"2020","journal-title":"Radiology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jaci.2020.05.012","article-title":"Clinical testing for COVID-19","volume":"146","author":"Ward","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Hosmer, D.W., and Lemeshow, S. (2005). Model-Building Strategies and Methods for Logistic Regression. Applied Logistic Regression, Wiley.","DOI":"10.1002\/0470011815.b2a10030"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"7429","DOI":"10.21037\/jtd-20-1743","article-title":"Risk factors and predictors associated with the severity of COVID-19 in China: A systematic review, meta-analysis, and meta-regression","volume":"12","author":"Zhang","year":"2020","journal-title":"J. Thorac. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ajic.2020.06.008","article-title":"Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia","volume":"49","author":"Li","year":"2021","journal-title":"Am. J. Infect. Control."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"154262","DOI":"10.1016\/j.metabol.2020.154262","article-title":"Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York","volume":"108","author":"Palaiodimos","year":"2020","journal-title":"Metabolic"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Molinero, A., G\u00e1lvez-Barr\u00f3n, C., Mi\u00f1arro, A., Macho, O., L\u00f3pez, G.F., Robles, M.T., Dapena, M.D., Mart\u00ednez, S., R\u00e0fols, N.M., and Monaco, E.E. (2020). Association between COVID-19 prognosis and disease presentation, comorbidities and chronic treatment of hospitalized patients. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0239571"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.jinf.2020.03.041","article-title":"Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis","volume":"80","author":"Fu","year":"2020","journal-title":"J. Infect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e24","DOI":"10.1016\/S2213-2600(20)30119-3","article-title":"COVID-19, ECMO, and lymphopenia: A word of caution","volume":"8","author":"Henry","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1001\/jamainternmed.2020.0994","article-title":"Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China","volume":"180","author":"Wu","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1002\/jmv.25770","article-title":"Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19","volume":"92","author":"Gao","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1007\/s00134-020-05991-x","article-title":"Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China","volume":"46","author":"Ruan","year":"2020","journal-title":"Intensiv. Care Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0140-6736(20)30628-0","article-title":"COVID-19: Consider cytokine storm syndromes and immunosuppression","volume":"395","author":"Mehta","year":"2020","journal-title":"Lancet"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"E30","DOI":"10.1148\/radiol.2020202708","article-title":"Diagnostic Performance of Chest CT for SARS-CoV-2 Infection in Individuals with or without COVID-19 Symptoms","volume":"298","author":"Ryckaert","year":"2021","journal-title":"Radiology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"E98","DOI":"10.1148\/radiol.2020203465","article-title":"Chest CT in the Emergency Department for Diagnosis of COVID-19 Pneumonia: Dutch Experience","volume":"298","author":"Schalekamp","year":"2021","journal-title":"Radiology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"20200574","DOI":"10.1259\/bjr.20200574","article-title":"Structured reporting of chest CT provides high sensitivity and specificity for early diagnosis of COVID-19 in a clinical routine setting","volume":"94","author":"Gross","year":"2021","journal-title":"Br. J. Radiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/0194599820926473","article-title":"The Prevalence of Olfactory and Gustatory Dysfunction in COVID-19 Patients: A Systematic Review and Meta-analysis","volume":"163","author":"Tong","year":"2020","journal-title":"Otolaryngol. Neck Surg."},{"key":"ref_44","first-page":"1","article-title":"Diagnostic accuracy of symptoms as a diagnostic tool for SARS-CoV 2 infection: A cross-sectional study in a cohort of 2173 patients","volume":"21","year":"2021","journal-title":"BMC Infect. Dis."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/9\/7\/895\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:30:56Z","timestamp":1760164256000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/9\/7\/895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,15]]},"references-count":44,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["healthcare9070895"],"URL":"https:\/\/doi.org\/10.3390\/healthcare9070895","relation":{},"ISSN":["2227-9032"],"issn-type":[{"type":"electronic","value":"2227-9032"}],"subject":[],"published":{"date-parts":[[2021,7,15]]}}}