tetano
Editor, Senior Moderator
Intern Emerg Med
. 2020 Nov 9.
doi: 10.1007/s11739-020-02543-5. Online ahead of print.
Mortality risk assessment in Spain and Italy, insights of the HOPE COVID-19 registry
Iv?n J N??ez-Gil[SUP] 1 [/SUP], Cristina Fern?ndez-P?rez[SUP] 2 3 [/SUP], Vicente Estrada[SUP] 4 [/SUP], V?ctor M Becerra-Mu?oz[SUP] 5 [/SUP], Ibrahim El-Battrawy[SUP] 6 [/SUP], Aitor Uribarri[SUP] 7 [/SUP], Inmaculada Fern?ndez-Rozas[SUP] 8 [/SUP], Gisela Feltes[SUP] 9 [/SUP], Mar?a C Viana-Llamas[SUP] 10 [/SUP], Daniela Trabattoni[SUP] 11 [/SUP], Javier L?pez-Pa?s[SUP] 2 [/SUP], Martino Pepe[SUP] 12 [/SUP], Rodolfo Romero[SUP] 13 [/SUP], Alex F Castro-Mej?a[SUP] 14 [/SUP], Enrico Cerrato[SUP] 15 16 [/SUP], Thamar Capel Astrua[SUP] 17 [/SUP], Fabrizio D'Ascenzo[SUP] 18 [/SUP], Oscar Fabregat-Andres[SUP] 19 [/SUP], Jos? Moreu[SUP] 20 [/SUP], Federico Guerra[SUP] 21 [/SUP], Jaime Signes-Costa[SUP] 22 [/SUP], Francisco Mar?n[SUP] 23 24 [/SUP], Danilo Buosenso[SUP] 25 [/SUP], Alfredo Bardaj?[SUP] 26 [/SUP], Sergio Raposeiras-Roub?n[SUP] 27 [/SUP], Javier Elola[SUP] 3 [/SUP], ?ngel Molino[SUP] 4 [/SUP], Juan J G?mez-Doblas[SUP] 5 [/SUP], Mohammad Abumayyaleh[SUP] 6 [/SUP], ?lvaro Aparisi[SUP] 7 [/SUP], Mar?a Molina[SUP] 8 [/SUP], Asunci?n Guerri[SUP] 9 [/SUP], Ram?n Arroyo-Espliguero[SUP] 10 [/SUP], Emilio Assanelli[SUP] 11 [/SUP], Massimo Mapelli[SUP] 11 28 [/SUP], Jos? M Garc?a-Acu?a[SUP] 2 [/SUP], Gaetano Brindicci[SUP] 12 [/SUP], Edoardo Manzone[SUP] 13 [/SUP], Mar?a E Ortega-Armas[SUP] 14 [/SUP], Matteo Bianco[SUP] 15 [/SUP], Chinh Pham Trung[SUP] 17 [/SUP], Mar?a Jos? N??ez[SUP] 4 [/SUP], Carmen Castellanos-Lluch[SUP] 22 [/SUP], Elisa Garc?a-V?zquez[SUP] 23 24 [/SUP], Noem? Cabello-Clotet[SUP] 4 [/SUP], Karim Jamhour-Chelh[SUP] 27 [/SUP], Mar?a J Tellez[SUP] 4 [/SUP], Antonio Fern?ndez-Ortiz[SUP] 4 [/SUP], Carlos Macaya[SUP] 4 [/SUP], HOPE COVID-19 Investigators
Affiliations
Abstract
Recently the coronavirus disease (COVID-19) outbreak has been declared a pandemic. Despite its aggressive extension and significant morbidity and mortality, risk factors are poorly characterized outside China. We designed a registry, HOPE COVID-19 (NCT04334291), assessing data of 1021 patients discharged (dead or alive) after COVID-19, from 23 hospitals in 4 countries, between 8 February and 1 April. The primary end-point was all-cause mortality aiming to produce a mortality risk score calculator. The median age was 68 years (IQR 52-79), and 59.5% were male. Most frequent comorbidities were hypertension (46.8%) and dyslipidemia (35.8%). A relevant heart or lung disease were depicted in 20%. And renal, neurological, or oncological disease, respectively, were detected in nearly 10%. Most common symptoms were fever, cough, and dyspnea at admission. 311 patients died and 710 were discharged alive. In the death-multivariate analysis, raised as most relevant: age, hypertension, obesity, renal insufficiency, any immunosuppressive disease, 02 saturation < 92% and an elevated C reactive protein (AUC = 0.87; Hosmer-Lemeshow test, p > 0.999; bootstrap-optimist: 0.0018). We provide a simple clinical score to estimate probability of death, dividing patients in four grades (I-IV) of increasing probability. Hydroxychloroquine (79.2%) and antivirals (67.6%) were the specific drugs most commonly used. After a propensity score adjustment, the results suggested a slight improvement in mortality rates (adjusted-OR[SUB]hydroxychloroquine[/SUB] 0.88; 95% CI 0.81-0.91, p = 0.005; adjusted-OR[SUB]antiviral[/SUB] 0.94; 95% CI 0.87-1.01; p = 0.115). COVID-19 produces important mortality, mostly in patients with comorbidities with respiratory symptoms. Hydroxychloroquine could be associated with survival benefit, but this data need to be confirmed with further trials. Trial Registration: NCT04334291/EUPAS34399.
Keywords: COVID-19; Mortality; Prognosis; Registry; Score.
. 2020 Nov 9.
doi: 10.1007/s11739-020-02543-5. Online ahead of print.
Mortality risk assessment in Spain and Italy, insights of the HOPE COVID-19 registry
Iv?n J N??ez-Gil[SUP] 1 [/SUP], Cristina Fern?ndez-P?rez[SUP] 2 3 [/SUP], Vicente Estrada[SUP] 4 [/SUP], V?ctor M Becerra-Mu?oz[SUP] 5 [/SUP], Ibrahim El-Battrawy[SUP] 6 [/SUP], Aitor Uribarri[SUP] 7 [/SUP], Inmaculada Fern?ndez-Rozas[SUP] 8 [/SUP], Gisela Feltes[SUP] 9 [/SUP], Mar?a C Viana-Llamas[SUP] 10 [/SUP], Daniela Trabattoni[SUP] 11 [/SUP], Javier L?pez-Pa?s[SUP] 2 [/SUP], Martino Pepe[SUP] 12 [/SUP], Rodolfo Romero[SUP] 13 [/SUP], Alex F Castro-Mej?a[SUP] 14 [/SUP], Enrico Cerrato[SUP] 15 16 [/SUP], Thamar Capel Astrua[SUP] 17 [/SUP], Fabrizio D'Ascenzo[SUP] 18 [/SUP], Oscar Fabregat-Andres[SUP] 19 [/SUP], Jos? Moreu[SUP] 20 [/SUP], Federico Guerra[SUP] 21 [/SUP], Jaime Signes-Costa[SUP] 22 [/SUP], Francisco Mar?n[SUP] 23 24 [/SUP], Danilo Buosenso[SUP] 25 [/SUP], Alfredo Bardaj?[SUP] 26 [/SUP], Sergio Raposeiras-Roub?n[SUP] 27 [/SUP], Javier Elola[SUP] 3 [/SUP], ?ngel Molino[SUP] 4 [/SUP], Juan J G?mez-Doblas[SUP] 5 [/SUP], Mohammad Abumayyaleh[SUP] 6 [/SUP], ?lvaro Aparisi[SUP] 7 [/SUP], Mar?a Molina[SUP] 8 [/SUP], Asunci?n Guerri[SUP] 9 [/SUP], Ram?n Arroyo-Espliguero[SUP] 10 [/SUP], Emilio Assanelli[SUP] 11 [/SUP], Massimo Mapelli[SUP] 11 28 [/SUP], Jos? M Garc?a-Acu?a[SUP] 2 [/SUP], Gaetano Brindicci[SUP] 12 [/SUP], Edoardo Manzone[SUP] 13 [/SUP], Mar?a E Ortega-Armas[SUP] 14 [/SUP], Matteo Bianco[SUP] 15 [/SUP], Chinh Pham Trung[SUP] 17 [/SUP], Mar?a Jos? N??ez[SUP] 4 [/SUP], Carmen Castellanos-Lluch[SUP] 22 [/SUP], Elisa Garc?a-V?zquez[SUP] 23 24 [/SUP], Noem? Cabello-Clotet[SUP] 4 [/SUP], Karim Jamhour-Chelh[SUP] 27 [/SUP], Mar?a J Tellez[SUP] 4 [/SUP], Antonio Fern?ndez-Ortiz[SUP] 4 [/SUP], Carlos Macaya[SUP] 4 [/SUP], HOPE COVID-19 Investigators
Affiliations
- PMID: 33165755
- DOI: 10.1007/s11739-020-02543-5
Abstract
Recently the coronavirus disease (COVID-19) outbreak has been declared a pandemic. Despite its aggressive extension and significant morbidity and mortality, risk factors are poorly characterized outside China. We designed a registry, HOPE COVID-19 (NCT04334291), assessing data of 1021 patients discharged (dead or alive) after COVID-19, from 23 hospitals in 4 countries, between 8 February and 1 April. The primary end-point was all-cause mortality aiming to produce a mortality risk score calculator. The median age was 68 years (IQR 52-79), and 59.5% were male. Most frequent comorbidities were hypertension (46.8%) and dyslipidemia (35.8%). A relevant heart or lung disease were depicted in 20%. And renal, neurological, or oncological disease, respectively, were detected in nearly 10%. Most common symptoms were fever, cough, and dyspnea at admission. 311 patients died and 710 were discharged alive. In the death-multivariate analysis, raised as most relevant: age, hypertension, obesity, renal insufficiency, any immunosuppressive disease, 02 saturation < 92% and an elevated C reactive protein (AUC = 0.87; Hosmer-Lemeshow test, p > 0.999; bootstrap-optimist: 0.0018). We provide a simple clinical score to estimate probability of death, dividing patients in four grades (I-IV) of increasing probability. Hydroxychloroquine (79.2%) and antivirals (67.6%) were the specific drugs most commonly used. After a propensity score adjustment, the results suggested a slight improvement in mortality rates (adjusted-OR[SUB]hydroxychloroquine[/SUB] 0.88; 95% CI 0.81-0.91, p = 0.005; adjusted-OR[SUB]antiviral[/SUB] 0.94; 95% CI 0.87-1.01; p = 0.115). COVID-19 produces important mortality, mostly in patients with comorbidities with respiratory symptoms. Hydroxychloroquine could be associated with survival benefit, but this data need to be confirmed with further trials. Trial Registration: NCT04334291/EUPAS34399.
Keywords: COVID-19; Mortality; Prognosis; Registry; Score.