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Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain
Clinical microbiology and infection, 2020-11, Vol.26 (11), p.1525-1536
2020
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Autor(en) / Beteiligte
Titel
Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain
Ist Teil von
  • Clinical microbiology and infection, 2020-11, Vol.26 (11), p.1525-1536
Ort / Verlag
England: Elsevier Ltd
Erscheinungsjahr
2020
Quelle
MEDLINE
Beschreibungen/Notizen
  • To analyse the characteristics and predictors of death in hospitalized patients with coronavirus disease 2019 (COVID-19) in Spain. A retrospective observational study was performed of the first consecutive patients hospitalized with COVID-19 confirmed by real-time PCR assay in 127 Spanish centres until 17 March 2020. The follow-up censoring date was 17 April 2020. We collected demographic, clinical, laboratory, treatment and complications data. The primary endpoint was all-cause mortality. Univariable and multivariable Cox regression analyses were performed to identify factors associated with death. Of the 4035 patients, male subjects accounted for 2433 (61.0%) of 3987, the median age was 70 years and 2539 (73.8%) of 3439 had one or more comorbidity. The most common symptoms were a history of fever, cough, malaise and dyspnoea. During hospitalization, 1255 (31.5%) of 3979 patients developed acute respiratory distress syndrome, 736 (18.5%) of 3988 were admitted to intensive care units and 619 (15.5%) of 3992 underwent mechanical ventilation. Virus- or host-targeted medications included lopinavir/ritonavir (2820/4005, 70.4%), hydroxychloroquine (2618/3995, 65.5%), interferon beta (1153/3950, 29.2%), corticosteroids (1109/3965, 28.0%) and tocilizumab (373/3951, 9.4%). Overall, 1131 (28%) of 4035 patients died. Mortality increased with age (85.6% occurring in older than 65 years). Seventeen factors were independently associated with an increased hazard of death, the strongest among them including advanced age, liver cirrhosis, low age-adjusted oxygen saturation, higher concentrations of C-reactive protein and lower estimated glomerular filtration rate. Our findings provide comprehensive information about characteristics and complications of severe COVID-19, and may help clinicians identify patients at a higher risk of death. [Display omitted]
Sprache
Englisch
Identifikatoren
ISSN: 1198-743X
eISSN: 1469-0691
DOI: 10.1016/j.cmi.2020.07.024
Titel-ID: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7399713
Format
–
Schlagworte
Aged, Aged, 80 and over, Antiviral Agents - therapeutic use, Betacoronavirus - isolation & purification, Cause of Death, Coronavirus, Coronavirus Infections - diagnosis, Coronavirus Infections - drug therapy, Coronavirus Infections - mortality, Coronavirus Infections - therapy, COVID-19, Female, Hospital Mortality, Hospitalization, Humans, Male, Middle Aged, Original, Pandemics, Pneumonia, Pneumonia, Viral - diagnosis, Pneumonia, Viral - mortality, Pneumonia, Viral - therapy, Respiratory distress syndrome, Retrospective Studies, Risk Factors, SARS-CoV-2, Spain - epidemiology

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