tetano
Editor, Senior Moderator
Emergencias
. 2020 Ago;32(4):233-241.
Analysis of clinical characteristics and outcomes in patients with COVID-19 based on a series of 1000 patients treated in Spanish emergency departments
[Article in Spanish, En]
Adriana Gil-Rodrigo[SUP] 1 [/SUP], ?scar Mir?[SUP] 2 [/SUP], Pascual Pi?era[SUP] 3 [/SUP], Guillermo Burillo-Putze[SUP] 4 [/SUP], S?nia Jim?nez[SUP] 2 [/SUP], Alfonso Mart?n[SUP] 5 [/SUP], Francisco Javier Mart?n-S?nchez[SUP] 6 [/SUP], Javier Jacob[SUP] 7 [/SUP], Josep Mar?a Guardiola[SUP] 8 [/SUP], Eric Jorge Garc?a-Lamberechts[SUP] 6 [/SUP], Bego?a Espinosa[SUP] 1 [/SUP], Enrique Mart?n Mojarro[SUP] 9 [/SUP], Matilde Gonz?lez Tejera[SUP] 10 [/SUP], Leticia Serrano[SUP] 11 [/SUP], Carmen Ag?era[SUP] 12 [/SUP], Ester Soy[SUP] 13 [/SUP], Llu?s Llauger[SUP] 14 [/SUP], Mar?a ?ngeles Juan[SUP] 15 [/SUP], Anna Palau[SUP] 16 [/SUP], Carmen Del Arco[SUP] 17 [/SUP], Bel?n Rodr?guez Miranda[SUP] 18 [/SUP], Mar?a Teresa Maza Vera[SUP] 19 [/SUP], Alejandro Mart?n Quir?s[SUP] 20 [/SUP], Laura Tejada de Los Santos[SUP] 21 [/SUP], Noem? Ruiz de Lobera[SUP] 22 [/SUP], Marta Iglesias Vela[SUP] 23 [/SUP], Raquel Torres Garate[SUP] 5 [/SUP], Aitor Alqu?zar-Arb?[SUP] 8 [/SUP], Juan Gonz?lez Del Castillo[SUP] 6 [/SUP], Pere Llorens[SUP] 1 [/SUP], en representaci?n de la red de investigaci?n SIESTA
Affiliations
Abstract
in En , Spanish
Objectives: To describe the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) treated in hospital emergency departments (EDs) in Spain, and to assess associations between characteristics and outcomes.
Material and methods: Prospective, multicenter, nested-cohort study. Sixty-one EDs included a random sample of all patients diagnosed with COVID-19 between March 1 and April 30, 2020. Demographic and baseline health information, including concomitant conditions; clinical characteristics related to the ED visit and complementary test results; and treatments were recorded throughout the episode in the ED. We calculated crude and adjusted odds ratios for risk of in-hospital death and a composite outcome consisting of the following events: intensive care unit admission, orotracheal intubation or mechanical ventilation, or in-hospital death. The logistic regression models were constructed with 3 groups of independent variables: the demographic and baseline health characteristics, clinical characteristics and complementary test results related to the ED episode, and treatments.
Results: The mean (SD) age of patients was 62 (18) years. Most had high- or low-grade fever, dry cough, dyspnea, and diarrhea. The most common concomitant conditions were cardiovascular diseases, followed by respiratory diseases and cancer. Baseline patient characteristics that showed a direct and independent association with worse outcome (death and the composite outcome) were age and obesity. Clinical variables directly associated with worse outcomes were impaired consciousness and pulmonary crackles; headache was inversely associated with worse outcomes. Complementary test findings that were directly associated with outcomes were bilateral lung infiltrates, lymphopenia, a high platelet count, a D-dimer concentration over 500 mg/dL, and a lactate-dehydrogenase concentration over 250 IU/L in blood.
Conclusion: This profile of the clinical characteristics and comorbidity of patients with COVID-19 treated in EDs helps us predict outcomes and identify cases at risk of exacerbation. The information can facilitate preventive measures and improve outcomes.
Keywords: COVID-19; Caracter?sticas cl?nicas; Clinical characteristics; Comorbidity; Comorbilidades; Coronavirus disease 2019 (COVID-19); Emergency health services; SARS-CoV-2; Servicios de urgencias; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
. 2020 Ago;32(4):233-241.
Analysis of clinical characteristics and outcomes in patients with COVID-19 based on a series of 1000 patients treated in Spanish emergency departments
[Article in Spanish, En]
Adriana Gil-Rodrigo[SUP] 1 [/SUP], ?scar Mir?[SUP] 2 [/SUP], Pascual Pi?era[SUP] 3 [/SUP], Guillermo Burillo-Putze[SUP] 4 [/SUP], S?nia Jim?nez[SUP] 2 [/SUP], Alfonso Mart?n[SUP] 5 [/SUP], Francisco Javier Mart?n-S?nchez[SUP] 6 [/SUP], Javier Jacob[SUP] 7 [/SUP], Josep Mar?a Guardiola[SUP] 8 [/SUP], Eric Jorge Garc?a-Lamberechts[SUP] 6 [/SUP], Bego?a Espinosa[SUP] 1 [/SUP], Enrique Mart?n Mojarro[SUP] 9 [/SUP], Matilde Gonz?lez Tejera[SUP] 10 [/SUP], Leticia Serrano[SUP] 11 [/SUP], Carmen Ag?era[SUP] 12 [/SUP], Ester Soy[SUP] 13 [/SUP], Llu?s Llauger[SUP] 14 [/SUP], Mar?a ?ngeles Juan[SUP] 15 [/SUP], Anna Palau[SUP] 16 [/SUP], Carmen Del Arco[SUP] 17 [/SUP], Bel?n Rodr?guez Miranda[SUP] 18 [/SUP], Mar?a Teresa Maza Vera[SUP] 19 [/SUP], Alejandro Mart?n Quir?s[SUP] 20 [/SUP], Laura Tejada de Los Santos[SUP] 21 [/SUP], Noem? Ruiz de Lobera[SUP] 22 [/SUP], Marta Iglesias Vela[SUP] 23 [/SUP], Raquel Torres Garate[SUP] 5 [/SUP], Aitor Alqu?zar-Arb?[SUP] 8 [/SUP], Juan Gonz?lez Del Castillo[SUP] 6 [/SUP], Pere Llorens[SUP] 1 [/SUP], en representaci?n de la red de investigaci?n SIESTA
Affiliations
- PMID: 32692000
Abstract
in En , Spanish
Objectives: To describe the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) treated in hospital emergency departments (EDs) in Spain, and to assess associations between characteristics and outcomes.
Material and methods: Prospective, multicenter, nested-cohort study. Sixty-one EDs included a random sample of all patients diagnosed with COVID-19 between March 1 and April 30, 2020. Demographic and baseline health information, including concomitant conditions; clinical characteristics related to the ED visit and complementary test results; and treatments were recorded throughout the episode in the ED. We calculated crude and adjusted odds ratios for risk of in-hospital death and a composite outcome consisting of the following events: intensive care unit admission, orotracheal intubation or mechanical ventilation, or in-hospital death. The logistic regression models were constructed with 3 groups of independent variables: the demographic and baseline health characteristics, clinical characteristics and complementary test results related to the ED episode, and treatments.
Results: The mean (SD) age of patients was 62 (18) years. Most had high- or low-grade fever, dry cough, dyspnea, and diarrhea. The most common concomitant conditions were cardiovascular diseases, followed by respiratory diseases and cancer. Baseline patient characteristics that showed a direct and independent association with worse outcome (death and the composite outcome) were age and obesity. Clinical variables directly associated with worse outcomes were impaired consciousness and pulmonary crackles; headache was inversely associated with worse outcomes. Complementary test findings that were directly associated with outcomes were bilateral lung infiltrates, lymphopenia, a high platelet count, a D-dimer concentration over 500 mg/dL, and a lactate-dehydrogenase concentration over 250 IU/L in blood.
Conclusion: This profile of the clinical characteristics and comorbidity of patients with COVID-19 treated in EDs helps us predict outcomes and identify cases at risk of exacerbation. The information can facilitate preventive measures and improve outcomes.
Keywords: COVID-19; Caracter?sticas cl?nicas; Clinical characteristics; Comorbidity; Comorbilidades; Coronavirus disease 2019 (COVID-19); Emergency health services; SARS-CoV-2; Servicios de urgencias; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).