Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona

Background In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community. Aim To determine clinical factors of a poor prognosis in patients with COVID-19 infection. Design and setting D...

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Autores: Sisó Almirall, Antoni, Kostov, Belchin, Mas Heredia, Minerva, Vilanova Rotllan, Sergi, Sequeira Aymar, Ethel, Sans Corrales, Mireia, Sant Arderiu, Elisenda, Cayuelas Redondo, Laia, Martinez Pérez, Angela, Garcia Plana, Noemi, Anguita Guimet, August, Benavent Àreu, Jaume
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/184215
Acceso en línea:https://hdl.handle.net/2445/184215
Access Level:acceso abierto
Palabra clave:COVID-19
Barcelona (Catalunya : Àrea metropolitana)
Pronòstic mèdic
Barcelona (Catalonia : Metropolitan area)
Prognosis
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spelling Prognostic factors in Spanish COVID-19 patients: A case series from BarcelonaSisó Almirall, AntoniKostov, BelchinMas Heredia, MinervaVilanova Rotllan, SergiSequeira Aymar, EthelSans Corrales, MireiaSant Arderiu, ElisendaCayuelas Redondo, LaiaMartinez Pérez, AngelaGarcia Plana, NoemiAnguita Guimet, AugustBenavent Àreu, JaumeCOVID-19Barcelona (Catalunya : Àrea metropolitana)Pronòstic mèdicCOVID-19Barcelona (Catalonia : Metropolitan area)PrognosisBackground In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community. Aim To determine clinical factors of a poor prognosis in patients with COVID-19 infection. Design and setting Descriptive, observational, retrospective study in three primary healthcare centres with an assigned population of 100,000. Method Examination of the medical records of patients with COVID-19 infections confirmed by polymerase chain reaction. Logistic multivariate regression models adjusted for age and sex were constructed to analyse independent predictive factors associated with death, ICU admission and hospitalization. Results We included 322 patients (mean age 56.7 years, 50% female, 115 (35.7%) aged 65 years): 123 (38.2) were health workers (doctors, nurses, auxiliaries). Predictors of ICU admission or death were greater age (OR = 1.05; 95%CI = 1.03 to 1.07), male sex (OR = 2.94; 95%CI = 1.55 to 5.82), autoimmune disease (OR = 2.82; 95%CI = 1.00 to 7.84), bilateral pulmonary infiltrates (OR = 2.86; 95%CI = 1.41 to 6.13), elevated lactate-dehydrogenase (OR = 2.85; 95%CI = 1.28 to 6.90), elevated D-dimer (OR = 2.85; 95%CI = 1.22 to 6.98) and elevated C-reactive protein (OR = 2.38; 95%CI = 1.22 to 4.68). Myalgia or arthralgia (OR = 0.31; 95%CI = 0.12 to 0.70) was protective factor against ICU admission and death. Predictors of hospitalization were chills (OR = 5.66; 95%CI = 1.68 to 23.49), fever (OR = 3.33; 95%CI = 1.89 to 5.96), dyspnoea (OR = 2.92; 95%CI = 1.62 to 5.42), depression (OR = 6.06; 95%CI = 1.54 to 40.42), lymphopenia (OR = 3.48; 95%CI = 1.67 to 7.40) and elevated C-reactive protein (OR = 3.27; 95%CI = 1.59 to 7.18). Anosmia (OR = 0.42; 95%CI = 0.19 to 0.90) was the only significant protective factor for hospitalization after adjusting for age and sex. Conclusion Determining the clinical, biological and radiological characteristics of patients with suspected COVID-19 infection will be key to early treatment and isolation and the tracing of contacts.Public Library of Science (PLoS)2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/184215Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1371/journal.pone.0237960PLoS One, 2020, vol. 15, num. 8, p. e0237960https://doi.org/10.1371/journal.pone.0237960cc-by (c) Sisó Almirall, Antoni et al., 2020https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1842152026-05-27T06:46:51Z
dc.title.none.fl_str_mv Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona
title Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona
spellingShingle Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona
Sisó Almirall, Antoni
COVID-19
Barcelona (Catalunya : Àrea metropolitana)
Pronòstic mèdic
COVID-19
Barcelona (Catalonia : Metropolitan area)
Prognosis
title_short Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona
title_full Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona
title_fullStr Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona
title_full_unstemmed Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona
title_sort Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona
dc.creator.none.fl_str_mv Sisó Almirall, Antoni
Kostov, Belchin
Mas Heredia, Minerva
Vilanova Rotllan, Sergi
Sequeira Aymar, Ethel
Sans Corrales, Mireia
Sant Arderiu, Elisenda
Cayuelas Redondo, Laia
Martinez Pérez, Angela
Garcia Plana, Noemi
Anguita Guimet, August
Benavent Àreu, Jaume
author Sisó Almirall, Antoni
author_facet Sisó Almirall, Antoni
Kostov, Belchin
Mas Heredia, Minerva
Vilanova Rotllan, Sergi
Sequeira Aymar, Ethel
Sans Corrales, Mireia
Sant Arderiu, Elisenda
Cayuelas Redondo, Laia
Martinez Pérez, Angela
Garcia Plana, Noemi
Anguita Guimet, August
Benavent Àreu, Jaume
author_role author
author2 Kostov, Belchin
Mas Heredia, Minerva
Vilanova Rotllan, Sergi
Sequeira Aymar, Ethel
Sans Corrales, Mireia
Sant Arderiu, Elisenda
Cayuelas Redondo, Laia
Martinez Pérez, Angela
Garcia Plana, Noemi
Anguita Guimet, August
Benavent Àreu, Jaume
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
Barcelona (Catalunya : Àrea metropolitana)
Pronòstic mèdic
COVID-19
Barcelona (Catalonia : Metropolitan area)
Prognosis
topic COVID-19
Barcelona (Catalunya : Àrea metropolitana)
Pronòstic mèdic
COVID-19
Barcelona (Catalonia : Metropolitan area)
Prognosis
description Background In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community. Aim To determine clinical factors of a poor prognosis in patients with COVID-19 infection. Design and setting Descriptive, observational, retrospective study in three primary healthcare centres with an assigned population of 100,000. Method Examination of the medical records of patients with COVID-19 infections confirmed by polymerase chain reaction. Logistic multivariate regression models adjusted for age and sex were constructed to analyse independent predictive factors associated with death, ICU admission and hospitalization. Results We included 322 patients (mean age 56.7 years, 50% female, 115 (35.7%) aged 65 years): 123 (38.2) were health workers (doctors, nurses, auxiliaries). Predictors of ICU admission or death were greater age (OR = 1.05; 95%CI = 1.03 to 1.07), male sex (OR = 2.94; 95%CI = 1.55 to 5.82), autoimmune disease (OR = 2.82; 95%CI = 1.00 to 7.84), bilateral pulmonary infiltrates (OR = 2.86; 95%CI = 1.41 to 6.13), elevated lactate-dehydrogenase (OR = 2.85; 95%CI = 1.28 to 6.90), elevated D-dimer (OR = 2.85; 95%CI = 1.22 to 6.98) and elevated C-reactive protein (OR = 2.38; 95%CI = 1.22 to 4.68). Myalgia or arthralgia (OR = 0.31; 95%CI = 0.12 to 0.70) was protective factor against ICU admission and death. Predictors of hospitalization were chills (OR = 5.66; 95%CI = 1.68 to 23.49), fever (OR = 3.33; 95%CI = 1.89 to 5.96), dyspnoea (OR = 2.92; 95%CI = 1.62 to 5.42), depression (OR = 6.06; 95%CI = 1.54 to 40.42), lymphopenia (OR = 3.48; 95%CI = 1.67 to 7.40) and elevated C-reactive protein (OR = 3.27; 95%CI = 1.59 to 7.18). Anosmia (OR = 0.42; 95%CI = 0.19 to 0.90) was the only significant protective factor for hospitalization after adjusting for age and sex. Conclusion Determining the clinical, biological and radiological characteristics of patients with suspected COVID-19 infection will be key to early treatment and isolation and the tracing of contacts.
publishDate 2020
dc.date.none.fl_str_mv 2020
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://hdl.handle.net/2445/184215
url https://hdl.handle.net/2445/184215
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0237960
PLoS One, 2020, vol. 15, num. 8, p. e0237960
https://doi.org/10.1371/journal.pone.0237960
dc.rights.none.fl_str_mv cc-by (c) Sisó Almirall, Antoni et al., 2020
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Sisó Almirall, Antoni et al., 2020
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300724

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