Risk Categories in COVID-19 Based on Degrees of Inflammation: Data on More Than 17,000 Patients from the Spanish SEMI-COVID-19 Registry

(1) Background: The inflammation or cytokine storm that accompanies COVID-19 marks the prognosis. This study aimed to identify three risk categories based on inflammatory parameters on admission. (2) Methods: Retrospective cohort study of patients diagnosed with COVID-19, collected and followed-up f...

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Authors: Rubio-Rivas, M, Corbella, X, Formiga, F, Fernandez, EM, Escalante, MDM, Fernandez, IB, Fernandez, FA, Del Corral-Beamonte, E, Lalueza, A, Virto, AP, Vallejo, ER, Loureiro-Amigo, J, Suarez, AMA, Abadia-Otero, J, De La Chica, MN, Gonzalez, RE, Milian, AH, Manrique, MA, Encinar, JCB, Noya, AG, Ferrer, RG, Aguilera, MP, Sanchez, RG, Nunez-Cortes, JM, Casas-Rojo, JM, SEMI-COVID-19 Network
Format: article
Status:Published version
Publication Date:2021
Country:España
Institution:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repository:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p10990
Online Access:https://fisabio.portalinvestigacion.com/publicaciones/10990
Access Level:Open access
Keyword:COVID-19
cytokine storm
prognosis
risk factors
mortality
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spelling Risk Categories in COVID-19 Based on Degrees of Inflammation: Data on More Than 17,000 Patients from the Spanish SEMI-COVID-19 RegistryRubio-Rivas, MCorbella, XFormiga, FFernandez, EMEscalante, MDMFernandez, IBFernandez, FADel Corral-Beamonte, ELalueza, AVirto, APVallejo, ERLoureiro-Amigo, JSuarez, AMAAbadia-Otero, JDe La Chica, MNGonzalez, REMilian, AHManrique, MAEncinar, JCBNoya, AGFerrer, RGAguilera, MPSanchez, RGNunez-Cortes, JMCasas-Rojo, JMSEMI-COVID-19 NetworkCOVID-19cytokine stormprognosisrisk factorsmortality(1) Background: The inflammation or cytokine storm that accompanies COVID-19 marks the prognosis. This study aimed to identify three risk categories based on inflammatory parameters on admission. (2) Methods: Retrospective cohort study of patients diagnosed with COVID-19, collected and followed-up from 1 March to 31 July 2020, from the nationwide Spanish SEMI-COVID-19 Registry. The three categories of low, intermediate, and high risk were determined by taking into consideration the terciles of the total lymphocyte count and the values of C-reactive protein, lactate dehydrogenase, ferritin, and D-dimer taken at the time of admission. (3) Results: A total of 17,122 patients were included in the study. The high-risk group was older (57.9 vs. 64.2 vs. 70.4 years; p < 0.001) and predominantly male (37.5% vs. 46.9% vs. 60.1%; p < 0.001). They had a higher degree of dependence in daily tasks prior to admission (moderate-severe dependency in 10.8% vs. 14.1% vs. 17%; p < 0.001), arterial hypertension (36.9% vs. 45.2% vs. 52.8%; p < 0.001), dyslipidemia (28.4% vs. 37% vs. 40.6%; p < 0.001), diabetes mellitus (11.9% vs. 17.1% vs. 20.5%; p < 0.001), ischemic heart disease (3.7% vs. 6.5% vs. 8.4%; p < 0.001), heart failure (3.4% vs. 5.2% vs. 7.6%; p < 0.001), liver disease (1.1% vs. 3% vs. 3.9%; p = 0.002), chronic renal failure (2.3% vs. 3.6% vs. 6.7%; p < 0.001), cancer (6.5% vs. 7.2% vs. 11.1%; p < 0.001), and chronic obstructive pulmonary disease (5.7% vs. 5.4% vs. 7.1%; p < 0.001). They presented more frequently with fever, dyspnea, and vomiting. These patients more frequently required high flow nasal cannula (3.1% vs. 4.4% vs. 9.7%; p < 0.001), non-invasive mechanical ventilation (0.9% vs. 3% vs. 6.3%; p < 0.001), invasive mechanical ventilation (0.6% vs. 2.7% vs. 8.7%; p < 0.001), and ICU admission (0.9% vs. 3.6% vs. 10.6%; p < 0.001), and had a higher percentage of in-hospital mortality (2.3% vs. 6.2% vs. 23.9%; p < 0.001). The three risk categories proved to be an independent risk factor in multivariate analyses. (4) Conclusion: The present study identifies three risk categories for the requirement of high flow nasal cannula, mechanical ventilation, ICU admission, and in-hospital mortality based on lymphopenia and inflammatory parameters.MDPI2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/10990Journal of Clinical MedicineISSN: 20770383reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p109902026-06-11T12:45:17Z
dc.title.none.fl_str_mv Risk Categories in COVID-19 Based on Degrees of Inflammation: Data on More Than 17,000 Patients from the Spanish SEMI-COVID-19 Registry
title Risk Categories in COVID-19 Based on Degrees of Inflammation: Data on More Than 17,000 Patients from the Spanish SEMI-COVID-19 Registry
spellingShingle Risk Categories in COVID-19 Based on Degrees of Inflammation: Data on More Than 17,000 Patients from the Spanish SEMI-COVID-19 Registry
Rubio-Rivas, M
COVID-19
cytokine storm
prognosis
risk factors
mortality
title_short Risk Categories in COVID-19 Based on Degrees of Inflammation: Data on More Than 17,000 Patients from the Spanish SEMI-COVID-19 Registry
title_full Risk Categories in COVID-19 Based on Degrees of Inflammation: Data on More Than 17,000 Patients from the Spanish SEMI-COVID-19 Registry
title_fullStr Risk Categories in COVID-19 Based on Degrees of Inflammation: Data on More Than 17,000 Patients from the Spanish SEMI-COVID-19 Registry
title_full_unstemmed Risk Categories in COVID-19 Based on Degrees of Inflammation: Data on More Than 17,000 Patients from the Spanish SEMI-COVID-19 Registry
title_sort Risk Categories in COVID-19 Based on Degrees of Inflammation: Data on More Than 17,000 Patients from the Spanish SEMI-COVID-19 Registry
dc.creator.none.fl_str_mv Rubio-Rivas, M
Corbella, X
Formiga, F
Fernandez, EM
Escalante, MDM
Fernandez, IB
Fernandez, FA
Del Corral-Beamonte, E
Lalueza, A
Virto, AP
Vallejo, ER
Loureiro-Amigo, J
Suarez, AMA
Abadia-Otero, J
De La Chica, MN
Gonzalez, RE
Milian, AH
Manrique, MA
Encinar, JCB
Noya, AG
Ferrer, RG
Aguilera, MP
Sanchez, RG
Nunez-Cortes, JM
Casas-Rojo, JM
SEMI-COVID-19 Network
author Rubio-Rivas, M
author_facet Rubio-Rivas, M
Corbella, X
Formiga, F
Fernandez, EM
Escalante, MDM
Fernandez, IB
Fernandez, FA
Del Corral-Beamonte, E
Lalueza, A
Virto, AP
Vallejo, ER
Loureiro-Amigo, J
Suarez, AMA
Abadia-Otero, J
De La Chica, MN
Gonzalez, RE
Milian, AH
Manrique, MA
Encinar, JCB
Noya, AG
Ferrer, RG
Aguilera, MP
Sanchez, RG
Nunez-Cortes, JM
Casas-Rojo, JM
SEMI-COVID-19 Network
author_role author
author2 Corbella, X
Formiga, F
Fernandez, EM
Escalante, MDM
Fernandez, IB
Fernandez, FA
Del Corral-Beamonte, E
Lalueza, A
Virto, AP
Vallejo, ER
Loureiro-Amigo, J
Suarez, AMA
Abadia-Otero, J
De La Chica, MN
Gonzalez, RE
Milian, AH
Manrique, MA
Encinar, JCB
Noya, AG
Ferrer, RG
Aguilera, MP
Sanchez, RG
Nunez-Cortes, JM
Casas-Rojo, JM
SEMI-COVID-19 Network
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
cytokine storm
prognosis
risk factors
mortality
topic COVID-19
cytokine storm
prognosis
risk factors
mortality
description (1) Background: The inflammation or cytokine storm that accompanies COVID-19 marks the prognosis. This study aimed to identify three risk categories based on inflammatory parameters on admission. (2) Methods: Retrospective cohort study of patients diagnosed with COVID-19, collected and followed-up from 1 March to 31 July 2020, from the nationwide Spanish SEMI-COVID-19 Registry. The three categories of low, intermediate, and high risk were determined by taking into consideration the terciles of the total lymphocyte count and the values of C-reactive protein, lactate dehydrogenase, ferritin, and D-dimer taken at the time of admission. (3) Results: A total of 17,122 patients were included in the study. The high-risk group was older (57.9 vs. 64.2 vs. 70.4 years; p < 0.001) and predominantly male (37.5% vs. 46.9% vs. 60.1%; p < 0.001). They had a higher degree of dependence in daily tasks prior to admission (moderate-severe dependency in 10.8% vs. 14.1% vs. 17%; p < 0.001), arterial hypertension (36.9% vs. 45.2% vs. 52.8%; p < 0.001), dyslipidemia (28.4% vs. 37% vs. 40.6%; p < 0.001), diabetes mellitus (11.9% vs. 17.1% vs. 20.5%; p < 0.001), ischemic heart disease (3.7% vs. 6.5% vs. 8.4%; p < 0.001), heart failure (3.4% vs. 5.2% vs. 7.6%; p < 0.001), liver disease (1.1% vs. 3% vs. 3.9%; p = 0.002), chronic renal failure (2.3% vs. 3.6% vs. 6.7%; p < 0.001), cancer (6.5% vs. 7.2% vs. 11.1%; p < 0.001), and chronic obstructive pulmonary disease (5.7% vs. 5.4% vs. 7.1%; p < 0.001). They presented more frequently with fever, dyspnea, and vomiting. These patients more frequently required high flow nasal cannula (3.1% vs. 4.4% vs. 9.7%; p < 0.001), non-invasive mechanical ventilation (0.9% vs. 3% vs. 6.3%; p < 0.001), invasive mechanical ventilation (0.6% vs. 2.7% vs. 8.7%; p < 0.001), and ICU admission (0.9% vs. 3.6% vs. 10.6%; p < 0.001), and had a higher percentage of in-hospital mortality (2.3% vs. 6.2% vs. 23.9%; p < 0.001). The three risk categories proved to be an independent risk factor in multivariate analyses. (4) Conclusion: The present study identifies three risk categories for the requirement of high flow nasal cannula, mechanical ventilation, ICU admission, and in-hospital mortality based on lymphopenia and inflammatory parameters.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/10990
url https://fisabio.portalinvestigacion.com/publicaciones/10990
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Journal of Clinical Medicine
ISSN: 20770383
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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