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COVID-19 pneumonia in Galicia (Spain): Impact of prognostic factors and therapies on mortality and need for mechanical ventilation #MMPMID34161387
Perez-de-Llano L; Romay-Lema EM; Baloira-Villar A; Anchorena C; Torres-Duran ML; Sousa A; Corbacho-Abelaira D; Paz-Ferrin J; Diego-Roza C; Vilarino-Maneiro L; Marcos PJ; Montero-Martinez C; de la Iglesia-Martinez F; Riveiro-Blanco V; Rodriguez-Nunez N; Abal-Arca J; Bustillo-Casado M; Golpe R
PLoS One 2021[]; 16 (6): e0253465 PMID34161387show ga
INTRODUCTION: This study was aimed to identify risk factors associated with unfavorable outcomes (composite outcome variable: mortality and need for mechanical ventilation) in patients hospitalized in Galicia with COVID-19 pneumonia. METHODS: Retrospective, multicenter, observational study carried out in the 8 Galician tertiary hospitals. All Patients admitted with confirmed COVID-19 pneumonia from 1st of March to April 24th, 2020 were included. A multivariable logistic regression analysis was performed in order to identify the relationship between risk factors, therapeutic interventions and the composite outcome variable. RESULTS: A total of 1292 patients (56.1% male) were included. Two hundred and twenty-five (17.4%) died and 327 (25.3%) reached the main outcome variable. Age [odds ratio (OR) = 1.03 (95% confidence interval (CI): 1.01-1.04)], CRP quartiles 3 and 4 [OR = 2.24 (95% CI: 1.39-3.63)] and [OR = 3.04 (95% CI: 1.88-4.92)], respectively, Charlson index [OR = 1.16 (95%CI: 1.06-1.26)], SaO2 upon admission [OR = 0.93 (95% CI: 0.91-0.95)], hydroxychloroquine prescription [OR = 0.22 (95%CI: 0.12-0.37)], systemic corticosteroids prescription [OR = 1.99 (95%CI: 1.45-2.75)], and tocilizumab prescription [OR = 3.39 (95%CI: 2.15-5.36)], significantly impacted the outcome. Sensitivity analysis using different alternative logistic regression models identified consistently the ratio admissions/hospital beds as a predictor of the outcome [OR = 1.06 (95% CI: 1.02-1.11)]. CONCLUSION: These findings may help to identify patients at hospital admission with a higher risk of death and may urge healthcare authorities to implement policies aimed at reducing deaths by increasing the availability of hospital beds.
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PLoS+One 2021 ; 16 (6): e0253465
