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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Autores: Nunez-Gil, IJ, Fernandez-Perez, C, Estrada, V, Becerra-Munoz, VM, El-Battrawy, I, Uribarri, A, Fernandez-Rozas, I, Feltes, G, Viana-Llamas, MC, Trabattoni, D, Lopez-Pais, J, Pepe, M, Romero, R, Castro-Mejia, AF, Cerrato, E, Astrua, TC, D'Ascenzo, F, Fabregat-Andres, O, Moreu, J, Guerra, F, Signes-Costa, J, Marin, F, Buosenso, D, Bardaji, A, Raposeiras-Roubin, S, Elola, J, Molino, A, Gomez-Doblas, JJ, Abumayyaleh, M, Aparisi, A, Molina, M, Guerri, A, Arroyo-Espliguero, R, Assanelli, E, Mapelli, M, Garcia-Acuna, JM, Brindicci, G, Manzone, E, Ortega-Armas, ME, Bianco, M, Trung, CP, Nunez, MJ, Castellanos-Lluch, C, Garcia-Vazquez, E, Cabello-Clotet, N, Jamhour-Chelh, K, Tellez, MJ, Fernandez-Ortiz, A, Macaya, C, HOPE COVID-19 Investigators
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p15093
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/15093
Access Level:acceso abierto
Palabra clave:COVID-19
Mortality
Prognosis
Registry
Score
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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