TY - JOUR
T1 - Mortality risk assessment in Spain and Italy, insights of the HOPE COVID-19 registry
AU - HOPE COVID-19 investigators
AU - Núñez-Gil, Iván J.
AU - Fernández-Pérez, Cristina
AU - Estrada, Vicente
AU - Becerra-Muñoz, Víctor M.
AU - El-Battrawy, Ibrahim
AU - Uribarri, Aitor
AU - Fernández-Rozas, Inmaculada
AU - Feltes, Gisela
AU - Viana-Llamas, María C.
AU - Trabattoni, Daniela
AU - López-País, Javier
AU - Pepe, Martino
AU - Romero, Rodolfo
AU - Castro-Mejía, Alex F.
AU - Cerrato, Enrico
AU - Astrua, Thamar Capel
AU - D’Ascenzo, Fabrizio
AU - Fabregat-Andres, Oscar
AU - Moreu, José
AU - Guerra, Federico
AU - Signes-Costa, Jaime
AU - Marín, Francisco
AU - Buosenso, Danilo
AU - Bardají, Alfredo
AU - Raposeiras-Roubín, Sergio
AU - Elola, Javier
AU - Molino, Ángel
AU - Gómez-Doblas, Juan J.
AU - Abumayyaleh, Mohammad
AU - Aparisi, Álvaro
AU - Molina, María
AU - Guerri, Asunción
AU - Arroyo-Espliguero, Ramón
AU - Assanelli, Emilio
AU - Mapelli, Massimo
AU - García-Acuña, José M.
AU - Brindicci, Gaetano
AU - Manzone, Edoardo
AU - Ortega-Armas, María E.
AU - Bianco, Matteo
AU - Trung, Chinh Pham
AU - Núñez, María José
AU - Castellanos-Lluch, Carmen
AU - García-Vázquez, Elisa
AU - Cabello-Clotet, Noemí
AU - Jamhour-Chelh, Karim
AU - Tellez, María J.
AU - Fernández-Ortiz, Antonio
AU - Macaya, Carlos
N1 - Publisher Copyright:
© 2020, Società Italiana di Medicina Interna (SIMI).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - 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-ORhydroxychloroquine 0.88; 95% CI 0.81–0.91, p = 0.005; adjusted-ORantiviral 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.
AB - 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-ORhydroxychloroquine 0.88; 95% CI 0.81–0.91, p = 0.005; adjusted-ORantiviral 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.
KW - COVID-19
KW - Mortality
KW - Prognosis
KW - Registry
KW - Score
UR - http://www.scopus.com/inward/record.url?scp=85095688015&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85095688015&partnerID=8YFLogxK
U2 - 10.1007/s11739-020-02543-5
DO - 10.1007/s11739-020-02543-5
M3 - Article
AN - SCOPUS:85095688015
JO - Internal and Emergency Medicine
JF - Internal and Emergency Medicine
SN - 1828-0447
ER -