Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

Maestre-Muñiz, Modesto M.; Arias, Ángel; Arias-González, Laura; Angulo-Lara, Basilio; Lucendo, Alfredo J.

doi:10.3390/jcm10020318

Cited by 7 publications

(8 citation statements)

References 41 publications

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“…Other studies have assessed the impact of COPD on mortality in hospitalized patients with SARS-CoV-2 infection. Taken together, these studies, like ours, indicate that the presence of COPD is associated with a 1.3–2.7 fold increased risk of in-hospital mortality [ [17] , [18] , [19] , [20] , [21] , [22] , [23] ]. But our own data shows that COPD is not associated with increased mortality in non-SARS-CoV-2 CAP in the short-term [ 4 ].…”

Section: Discussionsupporting

confidence: 80%

Clinical outcomes in patients with COPD hospitalized with SARS-CoV-2 versus non- SARS-CoV-2 community-acquired pneumonia

Sheikh

Tripathi

Chandler

et al. 2022

Respiratory Medicine

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Background Patients with chronic obstructive pulmonary disease (COPD) have poor outcomes in the setting of community-acquired pneumonia (CAP) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The primary objective is to compare outcomes of SARS-CoV-2 CAP and non-SARS-CoV-2 CAP in patients with COPD. The secondary objective is to compare outcomes of SARS-CoV-2 CAP with and without COPD. Methods In this analysis of two observational studies, three cohorts were analyzed: (1) patients with COPD and SARS-CoV-2 CAP; (2) patients with COPD and non-SARS-CoV-2 CAP; and (3) patients with SARS-CoV-2 CAP without COPD. Outcomes included length of stay, ICU admission, cardiac events, and in-hospital mortality. Results Ninety-six patients with COPD and SARS-CoV-2 CAP were compared to 1129 patients with COPD and non-SARS-CoV-2 CAP. 536 patients without COPD and SARS-CoV-2 CAP were analyzed for the secondary objective. Patients with COPD and SARS-CoV-2 CAP had longer hospital stay (15 vs 5 days, p < 0.001), 4.98 higher odds of cardiac events (95% CI: 3.74–6.69), and 7.31 higher odds of death (95% CI: 5.36–10.12) in comparison to patients with COPD and non-SARS-CoV-2 CAP. In patients with SARS-CoV-2 CAP, presence of COPD was associated with 1.74 (95% CI: 1.39–2.19) higher odds of ICU admission and 1.47 (95% CI: 1.05–2.05) higher odds of death. Conclusion In patients with COPD and CAP, presence of SARS-CoV-2 as an etiologic agent is associated with more cardiovascular events, longer hospital stay, and seven-fold increase in mortality. In patients with SARS-CoV-2 CAP, presence of COPD is associated with 1.5-fold increase in mortality.

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Section: Discussionsupporting

confidence: 80%

Clinical outcomes in patients with COPD hospitalized with SARS-CoV-2 versus non- SARS-CoV-2 community-acquired pneumonia

Sheikh

Tripathi

Chandler

et al. 2022

Respiratory Medicine

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“…Using a standardized approach, this study aims to evaluate, for the first time, the long-term consequences of the disease among survivors, after having characterized in detail a cohort of severe COVID-19 patients admitted to hospital during the first wave of the pandemic [15].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Patients with Coronavirus Disease 2019 at One Year after Hospital Discharge

Maestre-Muñiz

Arias

Mata-Vázquez

et al. 2021

JCM

Self Cite

136

126

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Background: The long-term effects of COVID-19 remain largely unclear. This study aims to investigate post-acute health consequences and mortality one year after hospital discharge. Methods: All surviving adult patients who were discharged after hospital admission due to acute COVID-19 in the first wave of the pandemic underwent a comprehensive interview. Functional assessment was performed in patients aged over 65. Clinical and hospital records were reviewed and mortality causes assessed. Results: A total of 587 patients with COVID-19 were discharged from hospital, including 266 after hospital admission and 321 from the emergency room. Mortality within the following year occurred in 34/266 (12.8%) and 10/321 (3.1%), respectively, due to causes directly or possibly related to COVID-19 in 20.5% and 25% of patients. Post-COVID-19 syndrome was assessed in 543 patients at one year from discharge. Any clinical complaint was reported by 90.1% of patients who needed hospitalization and 80.4% of those discharged from the emergency room (p = 0.002), with breathlessness (41.6%), tiredness (35.4%), ageusia (30.2%), and anosmia (26.3%) being the most common complaints. Ongoing symptoms attributed to COVID-19 were reported by 66.8% and 49.5% of patients, respectively (p < 0.001). Newly developed COPD, asthma, diabetes, heart failure, and arthritis—as well as worsening of preexisting comorbidities—were found. Conclusions: One-year mortality among survivors of acute COVID-19 was 7.5%. A significant proportion of COVID-19 patients experienced ongoing symptoms at 1 year from onset of the disease.

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“…Predicting variables included in 25 out of the 71 prognostic models identified in our systematic review were present in our local cohort of patients [ 11 , 12 , 15 , 16 , 22 , 25 , 26 , 28 , 30 , 34 , 35 , 37 , 39 , 40 , 45 , 47 , 48 , 49 , 50 , 56 , 60 , 62 , 71 , 81 ], thus allowing external validation on its performance in a separate clinical setting [ 9 ] to assess how the rule could be used in real-life. Prediction rules were validated on subcohorts that included 208 to 444 patients (depending on the number of cases that had all the variables incorporated in each model).…”

Section: Resultsmentioning

confidence: 99%

“…Data on 444 adults with confirmed SARS-CoV-2 infections, who were admitted to our hospital due to severe COVID-19 between 26 February to 31 May 2020 and with a 90-day follow-up period available, were used for the external validation of selected clinical prediction rules. Detailed methods and clinical and demographic characteristics of this patient series have been previously described [ 9 , 10 ]. All patients were independent from the data used in the derivation of any of the included clinical prediction rules.…”

Section: Methodsmentioning

confidence: 99%

Predicting In-Hospital Mortality in Severe COVID-19: A Systematic Review and External Validation of Clinical Prediction Rules

2022

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Multiple prediction models for risk of in-hospital mortality from COVID-19 have been developed, but not applied, to patient cohorts different to those from which they were derived. The MEDLINE, EMBASE, Scopus, and Web of Science (WOS) databases were searched. Risk of bias and applicability were assessed with PROBAST. Nomograms, whose variables were available in a well-defined cohort of 444 patients from our site, were externally validated. Overall, 71 studies, which derived a clinical prediction rule for mortality outcome from COVID-19, were identified. Predictive variables consisted of combinations of patients′ age, chronic conditions, dyspnea/taquipnea, radiographic chest alteration, and analytical values (LDH, CRP, lymphocytes, D-dimer); and markers of respiratory, renal, liver, and myocardial damage, which were mayor predictors in several nomograms. Twenty-five models could be externally validated. Areas under receiver operator curve (AUROC) in predicting mortality ranged from 0.71 to 1 in derivation cohorts; C-index values ranged from 0.823 to 0.970. Overall, 37/71 models provided very-good-to-outstanding test performance. Externally validated nomograms provided lower predictive performances for mortality in their respective derivation cohorts, with the AUROC being 0.654 to 0.806 (poor to acceptable performance). We can conclude that available nomograms were limited in predicting mortality when applied to different populations from which they were derived.

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Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

Cited by 7 publications

References 41 publications

Clinical outcomes in patients with COPD hospitalized with SARS-CoV-2 versus non- SARS-CoV-2 community-acquired pneumonia

Clinical outcomes in patients with COPD hospitalized with SARS-CoV-2 versus non- SARS-CoV-2 community-acquired pneumonia

Long-Term Outcomes of Patients with Coronavirus Disease 2019 at One Year after Hospital Discharge

Predicting In-Hospital Mortality in Severe COVID-19: A Systematic Review and External Validation of Clinical Prediction Rules

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