Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: A retrospective observational study (COQUIMA cohort)
| Autor: | Ana Roda-Santacruz, Eva María Martí-Ballesteros, Esther Merino-Lanza, María José Monforte-Gómez, Manuel Recio-Rodríguez, Gabriel Sotres-Fernández, María Correyero-Plaza, Margarita Rodríguez-López, José María Echave-Sustaeta María-Tomé, Elena Almagro-Casado, María Dolores Sánchez-Manzano, Lorena Comeche-Casanova, Margarita Remirez-de-Esparza-Otero, Félix J. La Coma-Lanuza, José Manuel Luque-Pinilla, Pablo Guisado-Vasco, Lucia González-Cortijo, Esteban Javier Malo-Benages, Rocío Diez-Munar, Sofia Valderas-Ortega, Daniel Carnevali-Ruiz, Cristina Andreu-Vázquez, Ruth Barrena-Puertas, Israel Thuissard-Vasallo, Maria Maravillas Carralón-González |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Acute respiratory insufficiency Infecciones por coronavirus 01 natural sciences Article 03 medical and health sciences chemistry.chemical_compound Hospital Tratamiento médico 0302 clinical medicine Tocilizumab Interquartile range Internal medicine Epidemiology medicine 030212 general & internal medicine 0101 mathematics Severe COVID-19 lcsh:R5-920 business.industry SARS-CoV-2 infection 010102 general mathematics Hydroxychloroquine Retrospective cohort study Odds ratio General Medicine Clinical trial Immunosuppressants Cyclosporine a Hyperinflammation state chemistry Cohort lcsh:Medicine (General) business Virología medicine.drug |
| Zdroj: | EClinicalMedicine EClinicalMedicine, Vol 28, Iss, Pp 100591-(2020) ABACUS. Repositorio de Producción Científica Universidad Europea (UEM) |
| ISSN: | 2589-5370 |
| DOI: | 10.1016/j.eclinm.2020.100591 |
| Popis: | Background The COVID-19 outbreak challenges the Spanish health system since March 2020. Some available therapies (antimalarials, antivirals, biological agents) were grounded on clinical case observations or basic science data. The aim of this study is to describe the characteristics and impact of different therapies on clinical outcomes in a cohort of severe COVID-19 patients. Methods In this retrospective, single-center, observational study, we collected sequential data on adult patients admitted to Hospital Universitario Quironsalud Madrid. Eligible patients should have a microbiological (positive test on RT-PCR assay from a nasal swab) or an epidemiological diagnosis of severe COVID-19. Demographic, baseline comorbidities, laboratory data, clinical outcomes, and treatments were compared between survivors and non-survivors. We carried out univariate and multivariate logistic regression models to assess potential risk factors for in-hospital mortality. Findings From March 10th to April 15th, 2020, 607 patients were included. Median age was 69 years [interquartile range, {IQR} 22; 65% male). The most common comorbidities were hypertension (276 [46·94%]), diabetes (95 [16·16%]), chronic cardiac (133 [22·62%]) and respiratory (114 [19·39%]) diseases. 141 patients (23·2%) died. In the multivariate model the risk of death increased with older age (odds ratio, for every year of age, 1·15, [95% CI 1·11 - 1·2]), tocilizumab therapy (2·4, [1·13 - 5·11]), C-reactive protein at admission (1·07, per 10 mg/L, [1·04 - 1·10]), d-dimer > 2·5 μg/mL (1·99, [1·03 - 3·86]), diabetes mellitus (2·61, [1·19 - 5·73]), and the PaO2/FiO2 at admission (0·99, per every 1 mmHg, [0·98 - 0·99]). Among the prescribed therapies (tocilizumab, glucocorticoids, lopinavir/ritonavir, hydroxychloroquine, cyclosporine), only cyclosporine was associated with a significant decrease in mortality (0·24, [0·12 - 0·46]; p |
| Databáze: | OpenAIRE |
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