Mortality risk assessment in Spain and Italy, insights of the HOPE COVID-19 registry View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-11-09

AUTHORS

Iván J. Núñez-Gil, Cristina Fernández-Pérez, Vicente Estrada, Víctor M. Becerra-Muñoz, Ibrahim El-Battrawy, Aitor Uribarri, Inmaculada Fernández-Rozas, Gisela Feltes, María C. Viana-Llamas, Daniela Trabattoni, Javier López-País, Martino Pepe, Rodolfo Romero, Alex F. Castro-Mejía, Enrico Cerrato, Thamar Capel Astrua, Fabrizio D’Ascenzo, Oscar Fabregat-Andres, José Moreu, Federico Guerra, Jaime Signes-Costa, Francisco Marín, Danilo Buosenso, Alfredo Bardají, Sergio Raposeiras-Roubín, Javier Elola, Ángel Molino, Juan J. Gómez-Doblas, Mohammad Abumayyaleh, Álvaro Aparisi, María Molina, Asunción Guerri, Ramón Arroyo-Espliguero, Emilio Assanelli, Massimo Mapelli, José M. García-Acuña, Gaetano Brindicci, Edoardo Manzone, María E. Ortega-Armas, Matteo Bianco, Chinh Pham Trung, María José Núñez, Carmen Castellanos-Lluch, Elisa García-Vázquez, Noemí Cabello-Clotet, Karim Jamhour-Chelh, María J. Tellez, Antonio Fernández-Ortiz, Carlos Macaya,

ABSTRACT

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-ORhydroxychloroquine 0.88; 95% CI 0.81-0.91, p = 0.005; adjusted-ORantiviral 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. More... »

PAGES

1-10

Journal

TITLE

Internal and Emergency Medicine

ISSUE

4

VOLUME

16

Author Affiliations

  • Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Prof Martin Lagos St., 28040 Madrid, Spain
  • Fundación Instituto para la Mejora de la Asistencia Sanitaria (IMAS), Madrid, Spain
  • Unidad de Gestión Clínica Área del Corazón, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de La Victoria, Universidad de Málaga (UMA), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Málaga, Spain
  • University Mannheim, Mannheim, Germany
  • Hospital Clínico Universitario de Valladolid, Valladolid, Spain
  • Hospital Severo Ochoa, Leganés, Spain
  • Hospital Nuestra Señora de América, Madrid, Spain
  • Hospital Universitario Guadalajara, Guadalajara, Spain
  • Centro Cardiologico Monzino, IRCCS, Milan, Italy
  • Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
  • Azienda Ospedaliero-Universitaria Consorziale Policlinico Di Bari, Bari, Italy
  • Hospital Universitario Getafe, Madrid, Spain
  • Hospital General del Norte de Guayaquil IESS Los Ceibos, Guayaquil, Ecuador
  • Rivoli Infermi Hospital, Rivoli, Turin Italy
  • Hospital Virgen del Mar, Madrid, Spain
  • San Giovanni Battista, Turin, Italy
  • Hospital IMED, Valencia, Spain
  • Complejo hospitalario de Toledo, Toledo, Spain
  • Cardiology and Arrhythmology Clinic, Ospedali Riuniti “Umberto I-Lancisi-Salesi”, Ancona, Italy
  • Hospital Clínico Universitario, Incliva, Universidad de Valencia, Valencia, Spain
  • IMIB-Arreixaca, Universidad de Murcia, Murcia, Spain
  • Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  • University Hospital Joan XXIII, Tarragona, Spain
  • University Hospital Álvaro Cunqueiro, Vigo, Spain
  • Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
  • Cardiology Division, San Luigi Gonzaga University Hospital, Orbassano, Turin Italy
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11739-020-02543-5

    DOI

    http://dx.doi.org/10.1007/s11739-020-02543-5

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1132440571

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33165755


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