Risk factors for clinical deterioration in patients admitted for COVID-19: A case-control study.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Corporate Authors:
      COVID-19-Osakidetza working group
    • Source:
      Publisher: Elsevier España Country of Publication: Spain NLM ID: 101632437 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2254-8874 (Electronic) Linking ISSN: 22548874 NLM ISO Abbreviation: Rev Clin Esp (Barc) Subsets: MEDLINE
    • Publication Information:
      Original Publication: [Barcelona] : Elsevier España
    • Subject Terms:
      COVID-19* ; Clinical Deterioration*; Case-Control Studies ; Female ; Humans ; Risk Factors ; SARS-CoV-2
    • Abstract:
      Introduction: There is controversy regarding the best predictors of clinical deterioration in COVID-19.
      Objective: This work aims to identify predictors of risk factors for deterioration in patients hospitalized due to COVID-19.
      Methods Design: Nested case-control study within a cohort.
      Setting: 13 acute care centers of the Osakidetza-Basque Health Service.
      Participants: patients hospitalized for COVID-19 with clinical deterioration-defined as onset of severe ARDS, ICU admission, or death-were considered cases. Two controls were matched to each case based on age. Sociodemographic data; comorbidities; baseline treatment; symptoms; date of onset; previous consultations; and clinical, analytical, and radiological variables were collected. An explanatory model of clinical deterioration was created by means of conditional logistic regression.
      Results: A total of 99 cases and 198 controls were included. According to the logistic regression analysis, the independent variables associated with clinical deterioration were: emergency department O 2 saturation ≤90% (OR 16.6; 95%CI 4-68), pathological chest X-ray (OR 5.6; 95%CI 1.7-18.4), CRP > 100 mg/dL (OR 3.62; 95%CI 1.62-8), thrombocytopenia with <150,000 platelets (OR 4; 95%CI 1.84-8.6); and a medical history of acute myocardial infarction (OR 15.7; 95%CI, 3.29-75.09), COPD (OR 3.05; 95%CI 1.43-6.5), or HT (OR 2.21; 95%CI 1.11-4.4). The model's AUC was 0.86. On the univariate analysis, female sex and presence of dry cough and sore throat were associated with better clinical progress, but were not found to be significant on the multivariate analysis.
      Conclusion: The variables identified could be useful in clinical practice for the detection of patients at high risk of poor outcomes.
      (Copyright © 2021 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.)
    • References:
      Lancet Respir Med. 2021 Apr;9(4):349-359. (PMID: 33444539)
      Diabetes Metab Syndr. 2020 Sep - Oct;14(5):725-727. (PMID: 32473903)
      Nat Rev Endocrinol. 2020 Jul;16(7):341-342. (PMID: 32327737)
      JAMA Cardiol. 2020 Jul 1;5(7):811-818. (PMID: 32219356)
      Int J Public Health. 2020 Jun;65(5):533-546. (PMID: 32451563)
      J Thromb Haemost. 2020 Jun;18(6):1469-1472. (PMID: 32302435)
      J Clin Virol. 2020 Jun;127:104370. (PMID: 32344321)
      Eur Respir J. 2015 Sep;46(3):850-3. (PMID: 25900375)
      JAMA Cardiol. 2020 Jul 1;5(7):802-810. (PMID: 32211816)
      Ann Med. 2021 Dec;53(1):103-116. (PMID: 33063540)
      JAMA Intern Med. 2020 Jul 1;180(7):934-943. (PMID: 32167524)
      Diabetes Metab. 2020 Sep;46(4):265-271. (PMID: 32447101)
      Eur Radiol. 2020 Oct;30(10):5702-5708. (PMID: 32385648)
      Lancet. 2020 Aug 22;396(10250):529-530. (PMID: 32771082)
      Cell Metab. 2020 Jun 2;31(6):1068-1077.e3. (PMID: 32369736)
      JAMA Intern Med. 2020 Aug 1;180(8):1081-1089. (PMID: 32396163)
      Biomed Pharmacother. 2020 Jul;127:110230. (PMID: 32428835)
      Rev Clin Esp. 2020 Nov;220(8):480-494. (PMID: 33994573)
      J Allergy Clin Immunol. 2020 Jul;146(1):110-118. (PMID: 32294485)
      Int J Chron Obstruct Pulmon Dis. 2021 Jan 05;15:3433-3445. (PMID: 33447021)
      J Thromb Haemost. 2020 Apr;18(4):844-847. (PMID: 32073213)
      J Clin Med. 2020 Sep 28;9(10):. (PMID: 32998337)
      J Heart Lung Transplant. 2020 May;39(5):405-407. (PMID: 32362390)
      Lancet. 2020 Feb 15;395(10223):507-513. (PMID: 32007143)
    • Contributed Indexing:
      Keywords: COVID-19; Clinical deterioration; Deterioro clínico; Factores pronósticos; Prognostic factors
    • Publication Date:
      Date Created: 20210924 Date Completed: 20220113 Latest Revision: 20231107
    • Publication Date:
      20231215
    • Accession Number:
      PMC8426292
    • Accession Number:
      10.1016/j.rceng.2021.04.009
    • Accession Number:
      34556435