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Title: | Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona |
Author: | 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 |
Keywords: | COVID-19 Barcelona (Catalunya : Àrea metropolitana) Pronòstic mèdic COVID-19 Barcelona (Catalonia : Metropolitan area) Prognosis |
Issue Date: | 21-Aug-2020 |
Publisher: | Public Library of Science (PLoS) |
Abstract: | 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. |
Note: | Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0237960 |
It is part of: | PLoS One, 2020, vol. 15, num. 8, p. e0237960 |
URI: | http://hdl.handle.net/2445/184215 |
Related resource: | https://doi.org/10.1371/journal.pone.0237960 |
ISSN: | 1932-6203 |
Appears in Collections: | Articles publicats en revistes (Medicina) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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