Article ; Online: Fatality and risk features for prognosis in COVID-19 according to the care approach - a retrospective cohort study.
PloS one
2021 Volume 16, Issue 3, Page(s) e0248869
Abstract: ... prognosis, on major outcomes and explanators in patients hospitalized for COVID-19 pneumonia in an academic ... in the cohort was 15% but markedly varied regarding the decided approach (maximum care versus LTE), translating ... 22.2%), none received IMV and fatality was 48.5%. Independent risk factors of mortality under maximum ...
| Abstract | Introduction: This study analyzed the impact of a categorized approach, based on patients' prognosis, on major outcomes and explanators in patients hospitalized for COVID-19 pneumonia in an academic center in Spain. Methods: Retrospective cohort study (March 3 to May 2, 2020). Patients were categorized according to the followed clinical management, as maximum care or limited therapeutic effort (LTE). Main outcomes were all-cause mortality and need for invasive mechanical ventilation (IMV). Baseline factors associated with outcomes were analyzed by multiple logistic regression, estimating odds ratios (OR; 95%CI). Results: Thirty-hundred and six patients were hospitalized, median age 65.0 years, 57.8% males, 53.3% Charlson index ≥3. The overall all-cause fatality rate was 15.0% (n = 46). Maximum care was provided in 238 (77.8%), IMV was used in 38 patients (16.0%), and 5.5% died. LTE was decided in 68 patients (22.2%), none received IMV and fatality was 48.5%. Independent risk factors of mortality under maximum care were lymphocytes <790/mm3, troponin T >15ng/L and hypotension. Advanced age, lymphocytes <790/mm3 and BNP >240pg/mL independently associated with IMV requirement. Conclusion: Overall fatality in the cohort was 15% but markedly varied regarding the decided approach (maximum care versus LTE), translating into nine-fold higher mortality and different risk factors. |
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| MeSH term(s) | Age Factors ; Aged ; COVID-19/mortality ; COVID-19/pathology ; COVID-19/virology ; Cohort Studies ; Comorbidity ; Female ; Hospital Mortality ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Prognosis ; RNA, Viral/metabolism ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; SARS-CoV-2/genetics ; SARS-CoV-2/isolation & purification ; Survival Rate |
| Chemical Substances | RNA, Viral |
| Language | English |
| Publishing date | 2021-03-23 |
| Publishing country | United States |
| Document type | Journal Article |
| ISSN | 1932-6203 |
| ISSN (online) | 1932-6203 |
| DOI | 10.1371/journal.pone.0248869 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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