Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain
Berenguer et al.,
Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain,
Clinical Microbiology and Infection, doi:10.1016/j.cmi.2020.07.024
Retrospective 4035 hospitalized patients in Spain showing reduced mortality with HCQ (data is in the supplementary appendix).
risk of death, 18.2% lower, RR 0.82, p < 0.001, treatment 681 of 2,618 (26.0%), control 438 of 1,377 (31.8%), NNT 17.
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Berenguer et al., 3 Aug 2020, retrospective, Spain, peer-reviewed, 8 authors, average treatment delay 7.0 days.
Abstract: Clinical Microbiology and Infection 26 (2020) 1525e1536
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Clinical Microbiology and Infection
journal homepage: www.clinicalmicrobiologyandinfection.com
Original article
Characteristics and predictors of death among 4035 consecutively
hospitalized patients with COVID-19 in Spain
~ o 7, 8, 9, Inmaculada Jarrín 4,
Juan Berenguer 1, 2, *, y, Pablo Ryan 2, 3, Jesús Rodríguez-Ban
nimo Pacho
n 8, 9, 10, María Yllescas 5, Jose
Ramo
n Arriba 6, 14, y, for
11, 12, 13, Jero
Jordi Carratala
the COVID-19@Spain Study Groupyy
~o
n, Spain
Hospital General Universitario Gregorio Maran
n Sanitaria Gregorio Maran
~o
n (IiSGM), Spain
Instituto de Investigacio
Hospital Universitario Infanta Leonor, Spain
4)
Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Spain
5)
n SEIMC/GeSIDA, Spain
Fundacio
6)
Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
7)
Hospital Universitario Virgen Macarena, Spain
8)
Instituto de Biomedicina de Sevilla (IBiS), Spain
9)
Department of Medicine, Universidad de Sevilla, Spain
10)
Hospital Universitario Virgen del Rocío, Seville, Spain
11)
Hospital Universitario de Bellvitge, Spain
12)
n Biom
Instituto de Investigacio
edica de Bellvitge (IDIBELL), Spain
13)
Universitat de Barcelona, Barcelona, Spain
14)
n Hospital Universitario La Paz, La Paz, Spain
Instituto de Investigacio
1)
2)
3)
a r t i c l e i n f o
a b s t r a c t
Article history:
Received 9 June 2020
Received in revised form
6 July 2020
Accepted 16 July 2020
Available online 4 August 2020
Objectives: To analyse the characteristics and predictors of death in hospitalized patients with coronavirus disease 2019 (COVID-19) in Spain.
Methods: A retrospective observational study was performed of the first consecutive patients hospitalized with COVID-19 confirmed by real-time PCR assay in 127 Spanish centres until 17 March 2020. The
follow-up censoring date was 17 April 2020. We collected demographic, clinical, laboratory, treatment
and complications data. The primary endpoint was all-cause mortality. Univariable and multivariable Cox
regression analyses were performed to identify factors associated with death.
Results: Of the 4035 patients, male subjects accounted for 2433 (61.0%) of 3987, the median age was
70 years and 2539 (73.8%) of 3439 had one or more comorbidity. The most common symptoms were a
history of fever, cough, malaise and dyspnoea. During hospitalization, 1255 (31.5%) of 3979 patients
developed acute respiratory distress syndrome, 736 (18.5%) of 3988 were admitted to intensive care units
and 619 (15.5%) of 3992 underwent mechanical ventilation. Virus- or host-targeted medications included
lopinavir/ritonavir (2820/4005, 70.4%), hydroxychloroquine (2618/3995, 65.5%), interferon beta (1153/
3950, 29.2%), corticosteroids (1109/3965, 28.0%) and tocilizumab (373/3951, 9.4%). Overall, 1131 (28%) of
4035 patients died. Mortality increased with age (85.6% occurring in older than 65 years). Seventeen
factors were independently associated with an increased hazard of death, the strongest among them
including advanced age, liver cirrhosis, low age-adjusted oxygen saturation, higher concentrations of Creactive protein and lower estimated glomerular filtration rate.
Conclusions: Our findings provide comprehensive information about characteristics and complications of
severe COVID-19, and may help clinicians identify patients at a higher risk of death. Juan Berenguer, Clin
Microbiol Infect..
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