Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona

In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community. To determine clinical factors of a poor prognosis in patients with COVID-19 infection. Descriptive, observational, retrosp...

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Bibliographic Details
Published in:PloS one 2020-08, Vol.15 (8), p.e0237960-e0237960
Main Authors: Sisó-Almirall, Antoni, Kostov, Belchin, Mas-Heredia, Minerva, Vilanova-Rotllan, Sergi, Sequeira-Aymar, Ethel, Sans-Corrales, Mireia, Sant-Arderiu, Elisenda, Cayuelas-Redondo, Laia, Martínez-Pérez, Angela, García-Plana, Noemí, Anguita-Guimet, August, Benavent-Àreu, Jaume
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Age Factors
Aged
Aged, 80 and over
Anosmia
Arthralgia
Autoimmune diseases
Betacoronavirus - genetics
Biology and Life Sciences
C-reactive protein
Chills
Chronology
Coronavirus Infections - diagnosis
Coronavirus Infections - epidemiology
Coronavirus Infections - mortality
Coronavirus Infections - virology
Coronaviruses
COVID-19
Death
Diagnostic systems
Dimers
Disease transmission
Dyspnea
Female
Fever
Hospitalization
Hospitals
Humans
Infections
Intensive Care Units
Lactic acid
Lymphopenia
Male
Medical personnel
Medical prognosis
Medical records
Medicine and Health Sciences
Middle Aged
Mortality
Myalgia
Olfaction disorders
Oxygen saturation
Pandemics
Patients
Physicians
Pneumonia
Pneumonia, Viral - diagnosis
Pneumonia, Viral - epidemiology
Pneumonia, Viral - mortality
Pneumonia, Viral - virology
Polymerase Chain Reaction
Population
Primary care
Prognosis
Protective Factors
Proteins
Regression analysis
Regression models
Research and Analysis Methods
Respiration
Retrospective Studies
Risk Factors
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Sex
Sex Factors
Spain - epidemiology
Statistical analysis
Studies
Supervision
Viral diseases
Young Adult
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Summary:In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community. To determine clinical factors of a poor prognosis in patients with COVID-19 infection. Descriptive, observational, retrospective study in three primary healthcare centres with an assigned population of 100,000. Examination of the medical records of patients with COVID-19 infections confirmed by polymerase chain reaction. Logistic multivariate regression models adjusted for age and sex were constructed to analyse independent predictive factors associated with death, ICU admission and hospitalization. We included 322 patients (mean age 56.7 years, 50% female, 115 (35.7%) aged ≥ 65 years): 123 (38.2) were health workers (doctors, nurses, auxiliaries). Predictors of ICU admission or death were greater age (OR = 1.05; 95%CI = 1.03 to 1.07), male sex (OR = 2.94; 95%CI = 1.55 to 5.82), autoimmune disease (OR = 2.82; 95%CI = 1.00 to 7.84), bilateral pulmonary infiltrates (OR = 2.86; 95%CI = 1.41 to 6.13), elevated lactate-dehydrogenase (OR = 2.85; 95%CI = 1.28 to 6.90), elevated D-dimer (OR = 2.85; 95%CI = 1.22 to 6.98) and elevated C-reactive protein (OR = 2.38; 95%CI = 1.22 to 4.68). Myalgia or arthralgia (OR = 0.31; 95%CI = 0.12 to 0.70) was protective factor against ICU admission and death. Predictors of hospitalization were chills (OR = 5.66; 95%CI = 1.68 to 23.49), fever (OR = 3.33; 95%CI = 1.89 to 5.96), dyspnoea (OR = 2.92; 95%CI = 1.62 to 5.42), depression (OR = 6.06; 95%CI = 1.54 to 40.42), lymphopenia (OR = 3.48; 95%CI = 1.67 to 7.40) and elevated C-reactive protein (OR = 3.27; 95%CI = 1.59 to 7.18). Anosmia (OR = 0.42; 95%CI = 0.19 to 0.90) was the only significant protective factor for hospitalization after adjusting for age and sex. Determining the clinical, biological and radiological characteristics of patients with suspected COVID-19 infection will be key to early treatment and isolation and the tracing of contacts.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0237960