Mortality risk assessment in Spain and Italy, insights of the HOPE COVID‑19 registry

Recently the coronavirus disease (COVID-19) outbreak has been declared a pandemic. Despite its aggressive extension and significant morbidity and mortality, risk factors are poorly characterized outside China. We designed a registry, HOPE COVID-19 (NCT04334291), assessing data of 1021 patients disch...

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Detalles Bibliográficos
Autores: Núñez‑Gil, Iván J., Fernández‑Pérez, Cristina, Estrada, Vicente, Becerra‑Muñoz, Víctor M., El‑Battrawy, Ibrahim, Uribarri, Aitor, Fernández‑Rozas, Inmaculada, Feltes, Gisela, Viana‑Llamas, María C., Trabattoni, Daniela, López‑País, Javier, Pepe, Martino, Romero, Rodolfo, Castro‑Mejía, Alex F., Cerrato, Enrico, Capel Astrua, Thamar, D’Ascenzo, Fabrizio, Fabregat Andrés, Óscar, Moreu, José, Guerra, Federico, Signes‑Costa, Jaime, Marín, Francisco, Buosenso, Danilo, Bardají, Alfredo, Raposeiras‑Roubín, Sergio, Elola, Javier, Molino, Ángel, Gómez‑Doblas, Juan J., Abumayyaleh, Mohammad, Aparisi, Álvaro, Molina, María, Guerri, Asunción, Arroyo‑Espliguero, Ramón, Assanelli, Emilio, Mapelli, Massimo, García‑Acuña, José M., Brindicci, Gaetano, Manzone, Edoardo, Ortega‑Armas, María E., Bianco, Matteo, Trung, Chinh Pham, Núñez, María José, Castellanos‑Lluch, Carmen, García‑Vázquez, Elisa, Cabello‑Clotet, Noemí, Jamhour‑Chelh, Karim, Tellez, María J., Fernández‑Ortiz, Antonio, Macaya, Carlos
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Católica de Valencia San Vicente Mártir
Repositorio:RIUCV. Repositorio de la Universidad Católica de Valencia San Vicente Mártir
Idioma:inglés
OAI Identifier:oai:riucv.ucv.es:20.500.12466/6964
Acceso en línea:https://hdl.handle.net/20.500.12466/6964
Access Level:acceso abierto
Palabra clave:COVID-19
Mortality
Score
Registry
Prognosis
32 Ciencias Médicas
Descripción
Sumario:Recently the coronavirus disease (COVID-19) outbreak has been declared a pandemic. Despite its aggressive extension and significant morbidity and mortality, risk factors are poorly characterized outside China. We designed a registry, HOPE COVID-19 (NCT04334291), assessing data of 1021 patients discharged (dead or alive) after COVID-19, from 23 hospitals in 4 countries, between 8 February and 1 April. The primary end-point was all-cause mortality aiming to produce a mortality risk score calculator. The median age was 68 years (IQR 52–79), and 59.5% were male. Most frequent comorbidities were hypertension (46.8%) and dyslipidemia (35.8%). A relevant heart or lung disease were depicted in 20%. And renal, neurological, or oncological disease, respectively, were detected in nearly 10%. Most common symptoms were fever, cough, and dyspnea at admission. 311 patients died and 710 were discharged alive. In the death-multivariate analysis, raised as most relevant: age, hypertension, obesity, renal insufficiency, any immunosuppressive disease, 02 saturation < 92% and an elevated C reactive protein (AUC = 0.87; Hosmer–Lemeshow test, p > 0.999; bootstrap-optimist: 0.0018). We provide a simple clinical score to estimate probability of death, dividing patients in four grades (I–IV) of increasing probability. Hydroxychloroquine (79.2%) and antivirals (67.6%) were the specific drugs most commonly used. After a propensity score adjustment, the results suggested a slight improvement in mortality rates (adjusted-OR hydroxychloroquine 0.88; 95% CI 0.81–0.91, p = 0.005; adjusted-OR antiviral 0.94; 95% CI 0.87–1.01; p = 0.115). COVID-19 produces important mortality, mostly in patients with comorbidities with respiratory symptoms. Hydroxychloroquine could be associated with survival benefit, but this data need to be confirmed with further trials. Trial Registration: NCT04334291/EUPAS34399.

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