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Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain

Abstract: Objectives: To analyse the characteristics and predictors of death in hospitalized patients with coronavirus disease 2019 (COVID-19) in Spain. Methods: A retrospective observational study was performed of the first consecutive patients hospitalized with COVID-19 confirmed by real-time PCR assay in 127 Spanish centres until 17 March 2020. The follow-up censoring date was 17 April 2020. We collected demographic, clinical, laboratory, treatment and complications data. The primary endpoint was all-cause mortality. Univariable and multivariable Cox regression analyses were performed to identify factors associated with death. Results: Of the 4035 patients, male subjects accounted for 2433 (61.0%) of 3987, the median age was 70 years and 2539 (73.8%) of 3439 had one or more comorbidity. The most common symptoms were a history of fever, cough, malaise and dyspnoea. During hospitalization, 1255 (31.5%) of 3979 patients developed acute respiratory distress syndrome, 736 (18.5%) of 3988 were admitted to intensive care units and 619 (15.5%) of 3992 underwent mechanical ventilation. Virus- or host-targeted medications included lopinavir/ritonavir (2820/4005, 70.4%), hydroxychloroquine (2618/3995, 65.5%), interferon beta (1153/3950, 29.2%), corticosteroids (1109/3965, 28.0%) and tocilizumab (373/3951, 9.4%). Overall, 1131 (28%) of 4035 patients died. Mortality increased with age (85.6% occurring in older than 65 years). Seventeen factors were independently associated with an increased hazard of death, the strongest among them including advanced age, liver cirrhosis, low age-adjusted oxygen saturation, higher concentrations of C-reactive protein and lower estimated glomerular filtration rate. Conclusions: Our findings provide comprehensive information about characteristics and complications of severe COVID-19, and may help clinicians identify patients at a higher risk of death.

 Fuente: Clin Microbiol Infect . 2020 Nov;26(11):1525-1536

Editorial: Elsevier

 Año de publicación: 2020

Nº de páginas: 13

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.cmi.2020.07.024

ISSN: 1198-743X,1469-0691

Url de la publicación: https://doi.org/10.1016/j.cmi.2020.07.024

Autores/as

BERENGUER, JUAN

RYAN, PABLO

RODRÍGUEZ-BAÑO, JESÚS

JARRÍN, INMACULADA

CARRATALÀ, JORDI

PACHÓN, JERÓNIMO

YLLESCAS, MARÍA

ARRIBA, JOSÉ RAMÓN

COVID-19@SPAIN STUDY GROUP