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Observational Study
. 2020 Aug 21;15(8):e0237960.
doi: 10.1371/journal.pone.0237960. eCollection 2020.

Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona

Antoni Sisó-Almirall  1   2   3 , Belchin Kostov  1   2 , Minerva Mas-Heredia  1   3 , Sergi Vilanova-Rotllan  1   3 , Ethel Sequeira-Aymar  1   4 , Mireia Sans-Corrales  1   2   5 , Elisenda Sant-Arderiu  1   4 , Laia Cayuelas-Redondo  1   2   4 , Angela Martínez-Pérez  1   4 , Noemí García-Plana  1   5 , August Anguita-Guimet  1   3 , Jaume Benavent-Àreu  1   2
Affiliations
Observational Study

Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona

Antoni Sisó-Almirall et al. PLoS One. .

Abstract

Background: In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community.

Aim: To determine clinical factors of a poor prognosis in patients with COVID-19 infection.

Design and setting: Descriptive, observational, retrospective study in three primary healthcare centres with an assigned population of 100,000.

Method: Examination of the medical records of patients with COVID-19 infections confirmed by polymerase chain reaction. Logistic multivariate regression models adjusted for age and sex were constructed to analyse independent predictive factors associated with death, ICU admission and hospitalization.

Results: We included 322 patients (mean age 56.7 years, 50% female, 115 (35.7%) aged ≥ 65 years): 123 (38.2) were health workers (doctors, nurses, auxiliaries). Predictors of ICU admission or death were greater age (OR = 1.05; 95%CI = 1.03 to 1.07), male sex (OR = 2.94; 95%CI = 1.55 to 5.82), autoimmune disease (OR = 2.82; 95%CI = 1.00 to 7.84), bilateral pulmonary infiltrates (OR = 2.86; 95%CI = 1.41 to 6.13), elevated lactate-dehydrogenase (OR = 2.85; 95%CI = 1.28 to 6.90), elevated D-dimer (OR = 2.85; 95%CI = 1.22 to 6.98) and elevated C-reactive protein (OR = 2.38; 95%CI = 1.22 to 4.68). Myalgia or arthralgia (OR = 0.31; 95%CI = 0.12 to 0.70) was protective factor against ICU admission and death. Predictors of hospitalization were chills (OR = 5.66; 95%CI = 1.68 to 23.49), fever (OR = 3.33; 95%CI = 1.89 to 5.96), dyspnoea (OR = 2.92; 95%CI = 1.62 to 5.42), depression (OR = 6.06; 95%CI = 1.54 to 40.42), lymphopenia (OR = 3.48; 95%CI = 1.67 to 7.40) and elevated C-reactive protein (OR = 3.27; 95%CI = 1.59 to 7.18). Anosmia (OR = 0.42; 95%CI = 0.19 to 0.90) was the only significant protective factor for hospitalization after adjusting for age and sex.

Conclusion: Determining the clinical, biological and radiological characteristics of patients with suspected COVID-19 infection will be key to early treatment and isolation and the tracing of contacts.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Prognostic factors for death and ICU admission.
*The upper limits of the confidence intervals were restricted to 10 in order not to mask the significant effects of other variables with smaller ranges.
Fig 2
Fig 2. Prognostic factors for hospitalization.
*The upper limits of the confidence intervals were restricted to 10 in order not to mask the significant effects of other variables with smaller ranges.
See this image and copyright information in PMC

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