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Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: A retrospective observational study (COQUIMA cohort)

التفاصيل البيبلوغرافية
العنوان: Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: A retrospective observational study (COQUIMA cohort)
المؤلفون: Pablo Guisado-Vasco, Sofia Valderas-Ortega, Maria Maravillas Carralón-González, Ana Roda-Santacruz, Lucia González-Cortijo, Gabriel Sotres-Fernández, Eva María Martí-Ballesteros, José Manuel Luque-Pinilla, Elena Almagro-Casado, Félix J. La Coma-Lanuza, Ruth Barrena-Puertas, Esteban Javier Malo-Benages, María José Monforte-Gómez, Rocío Diez-Munar, Esther Merino-Lanza, Lorena Comeche-Casanova, Margarita Remirez-de-Esparza-Otero, María Correyero-Plaza, Manuel Recio-Rodríguez, Margarita Rodríguez-López, María Dolores Sánchez-Manzano, Cristina Andreu-Vázquez, Israel John Thuissard-Vasallo, José María Echave-Sustaeta María-Tomé, Daniel Carnevali-Ruiz
المصدر: EClinicalMedicine, Vol 28, Iss , Pp 100591- (2020)
بيانات النشر: Elsevier, 2020.
سنة النشر: 2020
المجموعة: LCC:Medicine (General)
مصطلحات موضوعية: Severe COVID-19, SARS-CoV-2 infection, Cyclosporine a, Acute respiratory insufficiency, Immunosuppressants, Hyperinflammation state, Medicine (General), R5-920
الوصف: Background: The COVID-19 outbreak challenges the Spanish health system since March 2020. Some available therapies (antimalarials, antivirals, biological agents) were grounded on clinical case observations or basic science data. The aim of this study is to describe the characteristics and impact of different therapies on clinical outcomes in a cohort of severe COVID-19 patients. Methods: In this retrospective, single-center, observational study, we collected sequential data on adult patients admitted to Hospital Universitario Quironsalud Madrid. Eligible patients should have a microbiological (positive test on RT-PCR assay from a nasal swab) or an epidemiological diagnosis of severe COVID-19. Demographic, baseline comorbidities, laboratory data, clinical outcomes, and treatments were compared between survivors and non-survivors. We carried out univariate and multivariate logistic regression models to assess potential risk factors for in-hospital mortality. Findings: From March 10th to April 15th, 2020, 607 patients were included. Median age was 69 years [interquartile range, {IQR} 22; 65% male). The most common comorbidities were hypertension (276 [46·94%]), diabetes (95 [16·16%]), chronic cardiac (133 [22·62%]) and respiratory (114 [19·39%]) diseases. 141 patients (23·2%) died. In the multivariate model the risk of death increased with older age (odds ratio, for every year of age, 1·15, [95% CI 1·11 - 1·2]), tocilizumab therapy (2·4, [1·13 - 5·11]), C-reactive protein at admission (1·07, per 10 mg/L, [1·04 - 1·10]), d-dimer > 2·5 μg/mL (1·99, [1·03 - 3·86]), diabetes mellitus (2·61, [1·19 - 5·73]), and the PaO2/FiO2 at admission (0·99, per every 1 mmHg, [0·98 - 0·99]). Among the prescribed therapies (tocilizumab, glucocorticoids, lopinavir/ritonavir, hydroxychloroquine, cyclosporine), only cyclosporine was associated with a significant decrease in mortality (0·24, [0·12 - 0·46]; p
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2589-5370
العلاقة: http://www.sciencedirect.com/science/article/pii/S2589537020303357Test; https://doaj.org/toc/2589-5370Test
DOI: 10.1016/j.eclinm.2020.100591
الوصول الحر: https://doaj.org/article/2eb34d6bd0724deb8ee2c5da88510c1fTest
رقم الانضمام: edsdoj.2eb34d6bd0724deb8ee2c5da88510c1f
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:25895370
DOI:10.1016/j.eclinm.2020.100591