Introduction Peru is among the top ten countries with the highest number of coronavirus disease 2019 (COVID-19) cases worldwide. The aim of the study was to describe the clinical features of hospitalized adult patients with COVID-19 and to determine the prognostic factors associated with in-hospital mortality. Methods We conducted a retrospective cohort study among adult patients with COVID-19 admitted to Hospital Cayetano Heredia; a tertiary care hospital in Lima, Peru. The primary outcome was in-hospital mortality. Multivariate Cox proportional hazards regression was used to identify factors independently associated with in-hospital mortality. Results A total of 369 patients (median age 59 years [IQR:49–68]; 241 (65.31%) male) were included. Most patients (68.56%) reported at least one comorbidity; more frequently: obesity (42.55%), diabetes mellitus (21.95%), and hypertension (21.68%). The median duration of symptoms prior to hospital admission was 7 days (IQR: 5–10). Reported in-hospital mortality was 49.59%. By multiple Cox regression, oxygen saturation (SaO2) values of less than 90% on admission correlated with mortality, presenting 1.86 (95%CI: 1.02–3.39), 4.44 (95%CI: 2.46–8.02) and 7.74 (95%CI: 4.54–13.19) times greater risk of death for SaO2 of 89–85%, 84–80% and <80%, respectively, when compared to patients with SaO2 >90%. Additionally, age >60 years was associated with 1.88 times greater mortality. Conclusions Oxygen saturation below 90% on admission is a strong predictor of in-hospital mortality in patients with COVID-19. In settings with limited resources, efforts to reduce mortality in COVID-19 should focus on early identification of hypoxemia and timely access to hospital care.

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This paper presents a way of modelling turbulence in multiphase flows within the context of the Reynolds-Stress Model. The model has been implemented in the general-purpose unstructured finite volume code Fluent V6. Two multiphase turbulence approaches were considered: mixture and dispersed models. The mixture model solves the Reynolds-stress transport equations on the mixture level only. The dispersed approach solves the Reynolds-stress transport equations for the continuous phase, while the turbulence closure for the dispersed phases is achieved by an extension of the theory of dispersion of discrete particles by homogeneous turbulence. The dispersed model was used to calculate bubbly flow over a cylindrical back-step and the flow in an unbaffled stirred vessel. The mixture approach was used to calculate an industrially relevant cyclone flow.

Contribuciones de autoría: FM ha participado en la concepción recolección de datos, diseño, análisis e interpretación de datos, revisión del artículo y aprobación de la versión final. CM, AS han participado en la concepción y el diseño del artículo, análisis e interpretación de datos, revisión crítica del artículo, y aprobación de la versión final. EM, EC, SV, JA y GM han participado en análisis e interpretación de datos, revisión crítica del artículo, y aprobación de la versión final. Financiamiento: Autofinanciado. Conflictos de interés:Los autores declaran no tener conflictos de interés.

The present paper concerns the development and validation of an Eulerian multiphase boiling model to predict boiling and critical heat flux within the general-purpose computational fluid dynamics (CFD) solver FLUENT. The governing equations solved are generalized phase continuity, momentum and energy equations. Turbulence effects are accounted for using mixture, dispersed or per-phase multiphase turbulence models. Wall boiling phenomena are modeled using the baseline mechanistic nucleate boiling model, developed in Rensselaer Polytechnic Institute (RPI). Modifications have been introduced to the quenching heat flux model to achieve mesh-independent solutions. The influences of boiling model parameters have also been systematically investigated. To model non-equilibrium boiling and critical heat flux, the PRI model is extended to the departure from nucleate boiling (DNB) by partitioning wall heat flux to both liquid and vapor phases and considering the existence of thin liquid wall film. Topological functions are introduced to consider the wall boiling regime transition from the nucleate boiling to critical heat flux (CHF), and the corresponding flow regime change from bubbly flows to mist flows. A range of sub-models are implemented to model the interfacial momentum, mass and heat transfer and turbulence-bubble interactions. To validate the Eulerian multiphase boiling model, it has been used to predict nucleating boiling and critical heat flux in a range of 2D and 3D boiling flows. The examples presented in the paper include: (1). Nucleate boiling of sub-cooled water in an upward heated pipe; (2) R113 liquid flows through a vertical annulus with internal heated walls; (3). 3D boiling flows in a rectangular-sectioned duct; and (4). Critical heat flux and post dryout in vertical pipes. The results demonstrate that the model is able to predict reasonably well the distributions of wall temperature, the bulk fluid sub-cooling temperature and cross-sectional averaged vapor volume fraction in the vertical pipe. The computed profiles of the vapor volume fraction, liquid temperature, and the liquid and vapor velocity profiles are generally in good agreement with available experiments in the 2D annular case. In the 3D rectangular duct, the cross-sectional averaged vapor volume fractions are well captured in all the ten cases under investigation. In the case of critical heat flux and post dryout, the model is also able to predict reasonably well the location and the temperature rise under critical heat flux conditions. The computed wall temperature distributions along the pipes are in overall good agreement with available experiments.