Mortality risk assessment in Spain and Italy, insights of the HOPE COVID-19 registry
Núñez-Gil et al.
, Mortality risk assessment in Spain and Italy, insights of the HOPE COVID-19 registry
, Intern. Emerg. Med., doi:10.1007/s11739-020-02543-5
Retrospective database study of 1,021 patients in Ecuador, Germany, Italy, and Spain, showing HCQ propensity score adjusted mortality odds ratio aOR 0.88, p=0.005.
risk of death, 7.9% lower, RR 0.92, p = 0.005, treatment 200 of 686 (29.2%), control 100 of 268 (37.3%), adjusted per study, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Núñez-Gil et al., 9 Nov 2020, retrospective, database analysis, multiple countries, peer-reviewed, median age 68.0, 49 authors.
Abstract: Internal and Emergency Medicine
IM - ORIGINAL
Mortality risk assessment in Spain and Italy, insights of the HOPE
Iván J. Núñez‑Gil1 · Cristina Fernández‑Pérez9,24 · Vicente Estrada1 · Víctor M. Becerra‑Muñoz2 ·
Ibrahim El‑Battrawy3 · Aitor Uribarri4 · Inmaculada Fernández‑Rozas5 · Gisela Feltes6 · María C. Viana‑Llamas7 ·
Daniela Trabattoni8 · Javier López‑País9 · Martino Pepe10 · Rodolfo Romero11 · Alex F. Castro‑Mejía12 ·
Enrico Cerrato13,27 · Thamar Capel Astrua14 · Fabrizio D’Ascenzo15 · Oscar Fabregat‑Andres16 · José Moreu17 ·
Federico Guerra18 · Jaime Signes‑Costa19 · Francisco Marín20,26 · Danilo Buosenso21 · Alfredo Bardají22 ·
Sergio Raposeiras‑Roubín23 · Javier Elola24 · Ángel Molino1 · Juan J. Gómez‑Doblas2 · Mohammad Abumayyaleh3 ·
Álvaro Aparisi4 · María Molina5 · Asunción Guerri6 · Ramón Arroyo‑Espliguero7 · Emilio Assanelli8 ·
Massimo Mapelli8,25 · José M. García‑Acuña9 · Gaetano Brindicci10 · Edoardo Manzone11 · María E. Ortega‑Armas12 ·
Matteo Bianco13 · Chinh Pham Trung14 · María José Núñez1 · Carmen Castellanos‑Lluch19 · Elisa García‑Vázquez20,26 ·
Noemí Cabello‑Clotet1 · Karim Jamhour‑Chelh23 · María J. Tellez1 · Antonio Fernández‑Ortiz1 · Carlos Macaya1 on
behalf of HOPE COVID-19 Investigators
Received: 11 May 2020 / Accepted: 15 October 2020
© Società Italiana di Medicina Interna (SIMI) 2020
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.
Iván J. Núñez-Gil, Cristina Fernández-Pérez and Vicente Estrada
contributed equally to this work.
The members of Hope COVID-19 investigators, scientific
committee and Collaborators are listed in..
is less effective
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation. FLCCC
provide treatment protocols.