Clinical characteristics and outcomes of 1,331 patients with COVID-19: HM Spanish Cohort

Abstract

Background. Spain is one of the European countries most affected by the COVID-19 pandemic. Epidemiologic studies are warranted to improve the disease understanding, evaluate the care procedure and prepare for futures waves. The aim of the study was to describe epidemiologic characteristics associated with hospitalized patients with COVID-19. Methods. This real-world, observational, multicenter and retrospective study screened all consecutive patients admitted to 8 Spanish private hospitals. Inclusion criteria: hospitalized adults (age≥18 years old) with clinically and radiologically findings compatible with COVID-19 disease from March 1st to April 5th, 2020. Exclusion criteria: patients presenting negative PCR for SARS-CoV-2 during the first 7 days from hospital admission, transfer to a hospital not belonging to the HM consortium, lack of data and discharge against medical advice in emergency departments. Results. One thousand and three hundred thirty-one COVID-19 patients (medium age 66.9 years old; males n= 841, medium length of hospital stayed 8 days, non-survivors n=233) were analyzed. One hundred and fifteen were admitted to intensive care unit (medium length of stay 16 days, invasive mechanical ventilation n= 95, septic shock n= 37 and renal replacement therapy n= 17). Age, male gender, leukocytes, platelets, oxygen saturation, chronic therapy with steroids and treatment with hydroxychloroquine/azithromycin were independent factors associated with mortality. The proportion of patients that survive and received tocilizumab and steroids were lesser and higher respectively than those that die, but their association was not significant. Conclusions. Overall crude mortality rate was 17.5%, rising up to 36.5% in the subgroup of patients that were admitted to the intensive care unit. Seven factors impact in hospital mortality. No immunomodulatory intervention were associated with in-hospital mortality.

SERPINE1 rs6092 Variant Is Related to Plasma Coagulation Proteins in Patients with Severe COVID-19 from a Tertiary Care Hospital

“…Activated monocytes produce inflammatory cytokines and chemokines, which stimulate neutrophils, lymphocytes, platelets, vascular endothelial cells, and monocytes to express tissue factors and phosphatidylserine and trigger coagulation [37,47]. Moreover, abnormal platelet count has previously been related to IMV requirement and different complications in patients with community-acquired pneumonia admitted to intensive care units [48,49] and COVID-19, in which increased platelet consumption has been suggested [48].…”

“…Regarding blood cells, we found significant differences in leukocytes and platelets counts among IMV and non-IMV groups, but not for lymphocytes. Higher leukocytes levels can be due to a coinfection, as observed in patients with COVID-19 and a positive culture for bacteria and fungus, associated with high mortality risk in COVID-19 patients [49,50]. It has been reported that the enhanced inflammatory state, thrombi formation, and platelet consumption can lead to thrombocytopenia, while the cytokine storm causes thrombocytosis [37].…”

Biomarkers as Prognosis of COVID-19 Disease: Retrospective Cohort Study

“…It has also generated critical social problems throughout the world. This infection continues to spread, with more than 200 million confirmed cases and 223 countries, areas, or territories [2].Spain has been one of the European countries most affected by the COVID-19 pandemic as of Mach 17th, with more than 11 000 cases and 491 deaths [3]. Spain had one of the highest…”

“…Spain has been one of the European countries most affected by the COVID-19 pandemic as of Mach 17th, with more than 11 000 cases and 491 deaths [3]. Spain had one of the highest…”