Figure 1
RIMAC Registry. Participating regions, countries and institutions (1,435 patients).
Table 1
Demographic variables and baseline comorbidities.
| GLOBAL (n = 1,435) | MEXICO (MX) (n = 262) | CENTRAL AMERICA AND CARIBBEAN (CAC) (n = 428) | SOUTH AMERICA (SAM) (n = 745) | p-VALUE* | |
|---|---|---|---|---|---|
| Demographic Variables | |||||
| Age (years) | 57.95 (SD 16.62) | 55.56 (SD 15.41) | 59.86 (SD 16.91) | 57.69 (SD 16.77) | 0.002 0.003 0.094 0.222 |
| Male gender | 64.46% (925) | 58.40% (153) | 70.33% (301) | 63.22% (471) | 0.004 0.001 0.014 0.166 |
| Baseline Comorbidities | |||||
| Overweight/obesity (BMI ≥ 25) | 61.25% (879) | 80.92% (212) | 64.95% (278) | 52.21% (389) | 0.001 0.001 0.001 0.001 |
| Overweight (BMI 25–29) | 35.75% (513) | 38.55% (101) | 43.93% (188) | 30.07% (224) | 0.001 0.165 0.001 0.012 |
| Obesity(BMI ≥ 30) | 25.51% (366) | 42.37% (111) | 21.03% (90) | 22.15% (165) | 0.001 0.001 0.654 0.001 |
| HBP | 45.37% (651) | 36.26% (95) | 60.28% (258) | 40.00% (298) | 0.001 0.001 0.001 0.286 |
| DBT | 26.83% (385) | 34.35% (90) | 33.64% (144) | 20.27% (151) | 0.001 0.849 0.001 0.001 |
| Former tobacco use | 14.15% (203) | 6.87% (18) | 19.63% (84) | 13.56% (101) | 0.001 0.001 0.006 0.004 |
| Active tobacco use | 8.43% (121) | 13.74% (36) | 7.94% (34) | 6.85% (51) | 0.002 0.014 0.485 0.001 |
| Ischemic heart disease | 6.76% (97) | 4.96% (13) | 9.58% (41) | 5.77% (43) | 0.019 0.028 0.015 0.623 |
| COPD | 6.62% (95) | 2.67% (7) | 2.10% (9) | 10.60% (79) | 0.001 0.630 0.001 0.001 |
| Renal failure | 4.32% (62) | 1.91% (5) | 2.80% (12) | 6.04% (45) | 0.003 0.462 0.013 0.008 |
| Myocardiopathy | 4.74% (68) | 0.00% (0) | 9.11% (39) | 3.89% (29) | 0.001 0.001 0.001 0.001 |
| Valvular heart disease | 1.74% (25) | 2.29% (6) | 2.57% (11) | 1.07% (8) | 0.128 N/A |
| HIV | 0.42% (6) | 0.38% (1) | 0.00% (0) | 0.67% (5) | 0.229 N/A |
[i] Notes: * Each cell contains four p-values. The first p-value corresponds to chi-squared test (for categorical variables) or one-way ANOVA test (for numerical variables). Only a p ≤ 0.016 was considered statistically significance.
The second, third, and fourth p-values correspond to multiple comparisons between groups: Mx and CAC, CAC and SAm, and SAm and Mx, respectively. We used multiple chi-squared tests and ANOVA with Bonferroni correction.
HBP: high blood pressure; DBT: diabetes; COPD: chronic obstructive pulmonary disease; HIV: human immunodeficiency virus.
Table 2
Image modalities used.
| GLOBAL (n = 1,435) | MEXICO (MX) (n = 262) | CENTRAL AMERICA AND CARIBBEAN (CAC) (n = 428) | SOUTH AMERICA (SAM) (n = 745) | p-VALUE* | |
|---|---|---|---|---|---|
| Chest computed tomography (cCT) | 61.53% (883) | 69.08% (181) | 32.24% (138) | 75.70% (564) | 0.001 0.001 0.001 0.036 |
| Chest X-ray (cX-ray) | 45.99% (660) | 38.55% (101) | 91.12% (390) | 22.68% (169) | 0.001 0.001 0.001 0.001 |
| Echocardiogram (cEcho) | 18.54% (266) | 24.43% (64) | 18.93% (81) | 16.24% (121) | 0.013 0.085 0.241 0.003 |
| Lung ultrasound (LUS) | 7.25% (104) | 22.14% (58) | 0.23% (1) | 6.04% (45) | 0.001 0.001 0.001 0.001 |
| Electrocardiogram (ECG) | 24.32% (349) | 41.22% (108) | 37.62% (161) | 10.74% (80) | 0.001 0.346 0.001 0.001 |
[i] Notes: * Each cell contains four p-values.
The first p-value corresponds to chi-squared test (for categorical variables) or one-way ANOVA test (for numerical variables). Only a p ≤ 0.016 was considered statistically significance.
The second, third, and fourth corresponds to multiple comparisons between groups: Mx and CAC, CAC and SAm, and SAm and Mx, respectively. We used multiple chi-squared tests and ANOVA with Bonferroni correction.
Table 3
Image patterns, global and regional.
| GLOBAL (n = 1,435) | MEXICO (MX) (n = 262) | CENTRAL AMERICA AND CARIBBEAN (CAC) (n = 428) | SOUTH AMERICA (SAM) (n = 745) | p-VALUE* | |
|---|---|---|---|---|---|
| Chest computed tomography (cCT) | 61.53% (883) | 69.08% (181) | 32.24% (138) | 75.70% (564) | 0.001 0.001 0.001 0.036 |
| Infiltrates in ground glass | 89.35% (789/883) | 99.45% (180/181) | 87.68% (121/138) | 86.52% (488/564) | 0.001 0.001 0.719 0.001 |
| _______% of pulmonary involvement <25% 25–50% >50% | 21,29%(168/789) 32.95% (260/789) 45.75% (361/789) | 13.33% (24/180) 18.33% (33/180) 68.33% (123/180) | 33.06% (40/121) 41.32% (50/121) 25.62% (31/121) | 21.31% (104/488) 36.27% (177/488) 42.42% (207/488) | 0.001 N/A |
| Crazy Paving | 30.01%(618/883) | 20.99% (38/181) | 45.65% (63/138) | 29.08% (164/564) | 0.001 0.001 0.001 0.033 |
| Alveolar Consolidation | 36.58% (323/883) | 35.36% (64/181) | 42.75% (59/138) | 35.46% (200/564) | 0.261 N/A |
| Pleural Effusion | 10.76% (95/883) | 12.71% (23/181) | 18.84% (26/138) | 8.16% (46/564) | 0.001 0.132 0.001 0.066 |
| Chest X-Ray (cX-ray) | 45.99% (660) | 38.55% (101) | 91.12% (390) | 22.68% (169) | 0.001 0.001 0.001 0.001 |
| Basal infiltrates | 51.97% (343/660) | 83.17% (84/101) | 41.28% (161/390) | 57.99% (98/169) | 0.001 0.001 0.001 0.001 |
| Peripheral infiltrates | 63.33% (418/660) | 89.11% (90/101) | 58.97% (230/390) | 57.99% (98/169) | 0.001 0.001 0.828 0.001 |
| Hilar infiltrates | 39.24% (259/660) | 54.46% (55/101) | 44.87% (175/390) | 17.16% (29/169) | 0.001 0.085 0.001 0.001 |
| Ground glass pattern | 45.00% (297/660) | 74.26% (75/101) | 43.59% (170/390) | 30.77% (52/169) | 0.001 0.001 0.004 0.004 |
| Consolidation | 25.15% (166/660) | 57.43% (58/101) | 19.23% (75/390) | 19.53% (33/169) | 0.001 0.001 0.935 0.001 |
| Echocardiogram (cEcho) | 18.54% (266) | 24.43% (64) | 18.93% (81) | 16.24% (121) | 0.013 0.085 0.241 0.003 |
| Left ventricular ejection fraction (LVEF) (n = 266) | 56.89 (SD 11.89) | 57.40 (SD 9.78) | 54.48 (SD 13.97) | 58.23 (SD 11.22) | 0.008 0.421 0.083 1.000 |
| Right ventricular fractional area (FaRV) (n = 166) | 38.17 (SD 10.61) | 34.71 (SD 7.87) | 30.33 (SD 6.80) | 40.20 (SD 11.41) | 0.002 1.000 0.311 0.004 |
| Left ventricular global longitudinal strain (GLS LV) (n = 57) | –17.31 (SD 5.18) | –13 (SD 0) | –11.2 (SD 3.65) | –18.74 (SD 4.47) | 0.001 1.000 0.001 0.591 |
| Right ventricular free wall strain (FWSRV) (n = 18) | –24.85 (SD 6.85) | –15 (SD 0) | N/A | –25.42 (SD 6.60) | 0.144 |
| Transmitral pattern | 0.001 | ||||
| LV impaired relaxation | 41.73% (111/266) | 68.75% (44/64) | 30.86% (25/81) | 34.71% (42/121) | N/A |
| Atrial fibrillation | 7.89% (21/266) | 3.12% (2/64) | 4.94% (4/81) | 12.40% (15/121) | |
| Normal | 42.48%(113/266) | 26.56% (17/64) | 51.85% (42/81) | 44.63% (54/121) | |
| Restrictive pattern | 2.63% (7/266) | 0.00% (0) | 4.94% (4/81) | 2.48% (3/121) | |
| Pseudoformal pattern | 5.26% (14/266) | 1.56% (1/64) | 7.41% (6/81) | 5.79% (7/121) | |
| Abnormal motility | 15.79% (42/266) | 9.38% (6/64) | 25.93% (21/81) | 12.40% (15/121) | 0.010 0.011 0.014 0.538 |
| Pericardial effusion | 10.90% (29/266) | 3.12% (2/64) | 4.94% (4/81) | 19.01% (23/121) | 0.001 0.586 0.004 0.003 |
| Lung ultrasound (LUS) | 7.25% (104) | 22.14% (58) | 0.23% (1) | 6.04% (45) | 0.001 0.001 0.001 0.001 |
| Interstitial syndrome | 55.77% (58/104) | 96.55% (56/58) | 100.00% (1/1) | 2.22% (1/45) | 0.001 0.850 0.001 0.001 |
| Consolidation | 10.57% (11/104) | 18.96% (11/58) | 0.00% (0) | 0.00% (0) | 0.426 N/A |
| Pleural effusion | 9.62% (10/104) | 5.17% (3/58) | 0.00% (0) | 15.56% (7/45) | 0.197 N/A |
[i] Notes: * Each cell contains four p-values.
The first p-value corresponds to chi-squared test (for categorical variables) or one-way ANOVA test (for numerical variables). Only a p ≤ 0.016 was considered statistically significance.
The second, third, and fourth corresponds to multiple comparisons between groups: Mx and CAC, CAC and SAm, and SAm and Mx, respectively. We used multiple chi-squared tests and ANOVA with Bonferroni correction.
Figure 2
Image patterns. (A) cTC: infiltrates in ground glass >50%, crazy paving and alveolar consolidation bilateral; (B) cTC: infiltrates in ground glass >50% bilateral; (C) cTC: infiltrates in ground glass 25–50% and pleural effusion bilateral; (D) cTC: infiltrates in ground glass <25% and pleural effusion unilateral; € cX-ray: peripheral, basal, and hilar infiltrates; ground glass pattern; and consolidation; (F) cX-ray: basal and peripheral infiltrates, and ground glass pattern.
Figure 3
Left ventricle and right ventricle echocardiographic systolic analysis.
Table 4
Complications and evolution.
| GLOBAL (n = 1,435) | MEXICO (MX) (n = 262) | CENTRAL AMERICA AND CARIBBEAN (CAC) (n = 428) | SOUTH AMERICA (SAM) (n = 745) | p-VALUE* | |
|---|---|---|---|---|---|
| Complications | |||||
| Renal failure | 20.14% (289) | 22.52% (59) | 13.32% (57) | 23.22% (173) | 0.001 0.002 0.001 0.816 |
| Heart failure RV LV RV + LV | 13.13% (191) 20.41% (39/191) 45.54% (87/191) 34.05% (65/191) | 16.79% (44) | 19.86% (85) | 8.32% (62) | 0.001 0.316 0.001 0.001 |
| Cardiac arrest | 4.81% (69) | 0.76% (2) | 9.58% (41) | 3.49% (26) | 0.001 0.001 0.001 0.021 |
| Myocardial infarction | 4.04% (58) | 2.29% (6) | 7.94% (34) | 2.42% (18) | 0.001 0.002 0.001 0.908 |
| Myocarditis | 3.41% (49) | 3.44% (9) | 7.71% (33) | 0.94% (7) | 0.001 0.023 0.001 0.005 |
| Lung thromboembolism | 3.34% (48) | 10.69% (28) | 1.40% (6) | 1.88% (14) | 0.001 0.001 0.543 0.001 |
| Deep venous thrombosis | 0.56% (8) | 0.38% (1) | 0.70% (3) | 0.54% (4) | 0.856 N/A |
| Takotsubo | 0.21% (3) | 0.38% (1) | 0.23% (1) | 0.13% (1) | 0.746 N/A |
| Evolution | |||||
| Ward admission | 49.34% (708) | 61.07% (160) | 47.90 (205) | 46.04% (343) | 0.001 0.001 0.539 0.001 |
| ICU admission | 50.66% (727) | 38.93% (102) | 52.10% (223) | 53.96% (402) | 0.001 0.001 0.539 0.001 |
| ICU during hospitalization | 58.26% (836) | 60.69% (159) | 57.48% (246) | 57.85% (431) | 0.672 N/A |
| Hospitalization days | 17.49 (SD 17.24) | 16.01 (SD 261) | 15.39 (SD16.04) | 19.21 (SD 19.02) | 0.001 1.000 0.001 0.028 |
| ICU days | 13.56 (SD 14.2) | 13.35 (SD12.68) | 7.94 (SD 8.36) | 16.73 (SD 16.09) | 0.001 0.003 0.001 0.079 |
| Mechanical ventilation, total patients | 37.91% (544) | 51.53% (135) | 29.91% (128) | 37.72% (281) | 0.001 0.001 0.007 0.001 |
| Mechanical ventilation, ICU patients | 65.07% (544/836) | 84.91% (135/159) | 52.03% (128/246) | 65.20% (281/431) | 0.001 0.001 0.001 0.001 |
| Mechanical ventilation duration (hours) | 356.61 (SD 298.12) | 308.26 (SD 271.15) | 241.89 (SD 198.75) | 432.11 (SD 326.17) | 0.001 0.185 0.001 0.001 |
| Mechanical ventilation duration (days) | 14.85 (SD 12.42) | 12.84 (SD 11.29) | 10.07 (SD 8.28) | 18.01 (SD 13.59) | 0.001 0.185 0.001 0.001 |
| Prone/total patients | 22.37% (321) | 41.98% (110) | 7.24% (31) | 24.16% (180) | 0.001 0.001 0.007 0.001 |
| Prone, ICU patients | 37.80% (316/836) | 67.30% (107/159) | 11.79% (29/246) | 41.76% (180/431) | 0.001 0.001 0.001 0.001 |
| Prone, mechanical ventilation | 50.18% (273/544) | 72.59% (98/135) | 18.75% (24/128) | 53.74% (151/281) | 0.001 0.001 0.001 0.001 |
| Prone duration (hours) | 137.09 (SD 94.74) | 141.6 (SD 91.19) | 61.93 (SD 56.71) | 147.28 (SD 96.68) | 0.004 0.001 0.001 1.000 |
| CPAP, total patients | 13.17% (189) | 12.21% (32) | 10.28% (44) | 15.17% (113) | 0.051 N/A |
| CPAP, mechanical ventilation | 17.83% (97/544) | 9.63% (13/135) | 13.28% (17/128) | 23.84% (67/281) | 0.001 |
| CPAP duration (hours) | 120.42 (SD 120.63) | 98.25 (SD 93.32) | 83.45 (SD 96.48) | 141.10 (SD 131.65) | 0.012 1.000 0.020 0.218 |
| Nasal cannula | 49.69% (713) | 66.41% (174) | 49.07% (210) | 44.16% (329) | 0.001 0.001 0.105 0.001 |
| Nasal cannula duration (hours) | 150.90 (SD 149.49) | 214.20 (SD 161.48) | 80.11 (SD 76.38) | 162.60 (SD 159.90) | 0.001 0.001 0.001 0.001 |
| ECMO | 0.56% (8) | 0.38% (1) | 0.00% (0) | 0.94% (7) | 0.105 N/A |
| ECMO (hours) | 237 (SD 208.61) | 504 (SD N/A) | – | 198.85 (SD 192.85) | 0.189 N/A |
| Mortality/total patients | 27.60% (396) | 37.40% (98) | 24.07% (103) | 26.17% (195) | 0.001 0.001 0.424 0.001 |
| Mortality/mechanical ventilation | 56.07% (305/544) | 57.78% (78/135) | 59.38% (76/128) | 53.74% (151/281) | 0.510 N/A |
| Mortality/ICU patients | 39.83% (333/836) | 52.20% (83/159) | 36.18% (89/246) | 37.35%(161/431) | 0.002 0.001 0.760 0.001 |
[i] Notes: * Each cell contains four p-values.
The first p-value corresponds to chi-squared test (for categorical variables) or one-way ANOVA test (for numerical variables). Only a p ≤ 0.016 was considered statistically significance.
The second, third, and fourth corresponds to multiple comparisons between groups: Mx and CAC, CAC and SAm, and SAm and Mx, respectively. We used multiple chi-squared tests and ANOVA with Bonferroni correction.
RV: right ventricular; LV: left ventricular; ICU: intensive care unit; prone: pronation; CPAP: continuous positive airway pressure; ECMO: extracorporeal membrane oxygenation.