Mortality by COVID-19 Before Vaccination - One Year Experience of Hospitalized Patients in Madrid

Moreno-Torres, Víctor; Muñoz, Alejandro; Calderón-Parra, Jorge; Mills-Sánchez, Patricia; Pintos-Pascual, Ilduara; Rodríguez-Olleros, Celia; Ibánez-Estéllez, Fátima; Tung‐Chen, Yale; Ramos‐Martínez, Antonio; Vargas-Núñez, Juan-Antonio; Cuervas-Mons, Valentín; Mendoza, Carmen de

doi:10.1016/j.ijid.2022.01.043

Cited by 12 publications

(16 citation statements)

References 25 publications

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“…Since the initial outbreak in December 2019, risk factors for developing acute respiratory distress syndrome (ARDS), central axis of its mortality and morbidity, have been identified. Besides age and comorbidities, parameters such as neutrophilia, lymphocytopenia and thrombopenia, data suggestive of organ injury [bilirubin, Aspartate Aminotransferase, urea, creatinine or lactate dehydrogenase (LDH)] and coagulation function abnormalities [D-dimer (DD) or prothrombin activity] have been associated with the risk of developing ARDS, intensive care unit (ICU) admission and death (2)(3)(4). Furthermore, and in relation to the "cytokine storm" that seems to determine the disease pathophysiology and ARDS, interleukin-6 (IL-6), IL-10, ferritin and C reactive protein (CRP) have been also identified as prognostic factors (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Red blood cell distribution width as a marker of hyperinflammation and mortality in COVID-19

Moreno-Torres¹,

Sánchez-Chica²,

Castejón³

et al. 2022

Ann Palliat Med

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Background: Red blood cell distribution width (RDW) could reflect interleukin-6 (IL-6) systemic activity since anisocytosis represents the inhibition of erythropoiesis, leaded by the hyperinflammatory background.Our objective was to analyze RDW performance to predict outcome in coronavirus disease 2019 acute respiratory distress syndrome (ARDS).Methods: Retrospective observational study including 173 patients with COVID-19-associated ARDS.Data was analyzed at hospital admission, inclusion in the TOCICOV Study (day 0), days 1, 3, 7 and 15 postinclusion.Results: Overall, 57% patients received tocilizumab. Overall mortality was 20.8%. RDW was higher in non-survivors compared to survivors at admission (13.53% vs. 14.35, P=0.0016), day 0 (13.60% vs. 14.42, P=0.026), day 3 (13.43% vs. 14.36, P<0.001) and day 7 (13.41% vs. 14.31, P=0.046), presenting better discrimination ability for mortality than other prognostic markers [area under the curve-receiver operating characteristic (AUC-ROC) =0.668 for admission RDW, 0.680 for day 0 RDW, 0.695 for day 3 RDW and 0.666 for day 7 RDW]. RDW values did not vary significantly according to tocilizumab treatment. When adjusted by hemoglobin and tocilizumab treatment, only RDW at admission, day 0, day 3 and C reactive protein (CRP) at day 0 and day 1 were associated with mortality (P<0.05). Only in non-tocilizumab treated patients, IL-6 levels at day 0 were correlated with day 3 RDW (r=0.733, P=0.004) and with day 3 CRP (r=0.727, P=0.022). Both parameters showed significant statistical correlation (r=0.255 for day 1 RDW and CRP in the overall cohort and r=0.358 for day 3 RDW and CRP in patients not treated with tocilizumab, P<0.015).Conclusions: RDW predicts COVID-19-associated ARDS mortality and reflects the hyperinflammatory background and the effects of cytokines such as IL-6, irrespective of tocilizumab treatment.

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Section: Introductionmentioning

confidence: 99%

Red blood cell distribution width as a marker of hyperinflammation and mortality in COVID-19

Moreno-Torres¹,

Sánchez-Chica²,

Castejón³

et al. 2022

Ann Palliat Med

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“…Fortunately, the experience accumulated during these two years has allowed an understanding of the wide clinical spectrum and heterogeneity of the disease. The importance of identifying populations at risk, and the subsequent need for individualizing medical care and surveillance, have been highlighted [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Systemic Autoimmune Diseases in Patients Hospitalized with COVID-19 in Spain: A Nation-Wide Registry Study

Moreno-Torres

Mendoza

Mellor‐Pita

et al. 2022

Viruses

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We aimed to evaluate the clinical outcome of Systemic Autoimmune Diseases (SADs) patients hospitalized with COVID-19 in Spain, before the introduction of SARS-CoV-2 vaccines. A nationwide, retrospective and observational analysis of the patients admitted during 2020, based on the ICD10 codes in the National Registry of Hospital Discharges, was performed. Among 117,694 patients, only 892 (0.8%) presented any type of SAD before COVID-19-related admission: Sjogren’s Syndrome constituted 25%, Systemic Vasculitides 21%, Systemic Lupus Erythematosus 19%, Sarcoidosis 17%, Systemic Sclerosis 11%, Mixed and Undifferentiated Connective Tissue Disease 4%, Behçet’s Disease 4% and Inflammatory Myopathies 2%. The in-hospital mortality rate was higher in SAD individuals (20% vs. 16%, p < 0.001). After adjustment by baseline conditions, SADs were not associated with a higher mortality risk (OR = 0.93, 95% CI 0.78–1.11). Mortality in the SADs patients was determined by age (OR = 1.05, 95% CI 1.04–1.07), heart failure (OR = 1.67, 95% CI 1.10–2.49), chronic kidney disease (OR = 1.29, 95% CI 1.05–1.59) and liver disease (OR = 1.97, 95% CI 1.13–3.44). In conclusion, the higher COVID-19 mortality rate seen in SADs patients hospitalized in Spain in 2020 was related to the higher burden of comorbidities, secondary to direct organ damage and sequelae of their condition. Whilst further studies should evaluate the impact of baseline immunosuppression on COVID-19 outcomes in this population, efforts should be focused on the optimal management of SAD to minimize the impact of the organ damage that has been shown to determine COVID-19 prognosis.

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“…Segundo, la edad promedio fue mayor en la cuarta ola, mientras que la proporción de pacientes masculinos, la gravedad de la enfermedad, la estadía intrahospitalaria, los ingresos a la UCI y la mortalidad disminuyeron progresivamente con el tiempo. Varios estudios han evaluado el cambio en el número de ingresos hospitalarios por COVID-19 en las primeras oleadas de la pandemia (9)(10)(11)13,14,(17)(18)(19) . En Estados Unidos un análisis del 2020 reportó 11901 pacientes ingresados entre marzo y abril, 4116 entre mayo y junio, 2709 entre julio y agosto, y 2010 entre septiembre y noviembre (10) .…”

Section: Discussionunclassified

“…En Estados Unidos un análisis del 2020 reportó 11901 pacientes ingresados entre marzo y abril, 4116 entre mayo y junio, 2709 entre julio y agosto, y 2010 entre septiembre y noviembre (10) . En general, los estudios europeos reportan un incremento en los ingresos hospitalarios por la COVID-19 durante dos períodos epidémicos del 2020 (9)(10)(11)13,14,(17)(18)(19) . Un estudio en España reportó 2547 pacientes hospitalizados en la primera ola (febrero y mayo del 2020) y 2673 en la segunda (junio y septiembre del 2020) (13) .…”

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“…Varios estudios han evaluado las características clínicas y desenlaces de los pacientes hospitalizados por COVID-19 en diferentes periodos de la pandemia (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) . Aunque en algunos estudios el número de pacientes hospitalizados fue relativamente similar (9,11,13,14,18) entre las oleadas, la gravedad de la enfermedad, los ingresos en las unidades de cuidados intensivos (UCI) y la mortalidad tienden a disminuir con el tiempo (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) .…”

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Cambios en las características clínicas y desenlaces de pacientes hospitalizados por COVID-19 durante dos años de pandemia: experiencia en un hospital venezolano

Arvelo¹,

Sánchez-Traslaviña³

et al. 2022

Rev Peru Med Exp Salud Publica

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Objetivos. Determinar los cambios en las características clínicas y desenlaces intrahospitalarios de los pacientes hospitalizados por COVID-19 en un hospital privado de Caracas durante dos años de pandemia. Materiales y métodos. Estudio retrospectivo, observacional, de pacientes hospitalizados por COVID-19. Se investigó la correspondencia entre las olas de ingresos hospitalarios con las variantes circulantes del SARS-CoV-2 en la población general del Distrito Capital y estado Miranda. Resultados. Se incluyeron 1025 pacientes (569 hombres y 456 mujeres), con edad promedio de 62,9 DE: 16,2 años. Cuatro olas de ingresos hospitalarios fueron identificadas: primera (marzo-noviembre 2020) 150/1025 (14,6%) casos; segunda (diciembre-2020 a mayo-2021) 415/1025 (40,5%) casos; tercera (junio-diciembre 2021) 344/1025 (33,6%) casos; cuarta (enero-febrero 2022) 116/1025 (11,3%) casos. La edad promedio fue mayor en la cuarta ola (primera 64,0±15,7, segunda 61,4±15,8, tercera 62,1±16,5, y cuarta ola 68,5±16,4), mientras que la proporción de pacientes masculinos (primera 66,7%, segunda 58,8%, tercera 50,3%, y cuarta 44,8%), los pacientes con enfermedad grave-crítica (primera 65,3%, segunda 57%, tercera 51,7% y cuarta 44,8%), la estadía intrahospitalaria (primera 9,1±6,0, segunda 9,0±7,3, tercera 8,8±7,7, y cuarta 6,9±5,0 días), los ingresos a la UCI (primera 23,3%, segunda 15,7%, tercera 14,0%, y cuarta 11,2%; p=0,027) y la mortalidad (primera 21.8%, segunda 10,7%, tercera 9,1%, y cuarta 7,1%; p<0,001) disminuyeron progresivamente con el tiempo. Conclusiones. Los resultados muestran menor frecuencia de casos severos y mejoría de los desenlaces intrahospitalarios en dos años de pandemia. Es probable que los cambios en las variantes circulantes, las mejoras del manejo de la enfermedad y la vacunación hayan influido sobre estos resultados.

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Mortality by COVID-19 Before Vaccination - One Year Experience of Hospitalized Patients in Madrid

Cited by 12 publications

References 25 publications

Red blood cell distribution width as a marker of hyperinflammation and mortality in COVID-19

Red blood cell distribution width as a marker of hyperinflammation and mortality in COVID-19

Systemic Autoimmune Diseases in Patients Hospitalized with COVID-19 in Spain: A Nation-Wide Registry Study

Cambios en las características clínicas y desenlaces de pacientes hospitalizados por COVID-19 durante dos años de pandemia: experiencia en un hospital venezolano

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