Adriana Gil-Rodrigo1, Òscar Miró2, Pascual Piñera3, Guillermo Burillo-Putze4, Sònia Jiménez2, Alfonso Martín5, Francisco Javier Martín-Sánchez6, Javier Jacob7, Josep María Guardiola8, Eric Jorge García-Lamberechts6, Begoña Espinosa1, Enrique Martín Mojarro9, Matilde González Tejera10, Leticia Serrano11, Carmen Agüera12, Ester Soy13, Lluís Llauger14, María Ángeles Juan15, Anna Palau16, Carmen Del Arco17, Belén Rodríguez Miranda18, María Teresa Maza Vera19, Alejandro Martín Quirós20, Laura Tejada de Los Santos21, Noemí Ruiz de Lobera22, Marta Iglesias Vela23, Raquel Torres Garate5, Aitor Alquézar-Arbé8, Juan González Del Castillo6, Pere Llorens1. 1. Servicio de Urgencias, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Elche, Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), España. 2. Servicio de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, España. 3. Servicio de Urgencias, Hospital General Universitario Reina Sofía, Murcia, España. 4. Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, España. 5. Servicio de Urgencias, Hospital Universitario Severo Ochoa, Leganés, Madrid, España. 6. Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, España. 7. Servicio de Urgencias, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. 8. Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España. 9. Servicio de Urgencias, Hospital Santa Tecla, Tarragona, España. 10. Servicio de Urgencias, Hospital General de Elche, Alicante, España. 11. Servicio de Urgencias, Hospital Politécnico La Fe, Valencia, España. 12. Servicio de Urgencias, Hospital Costa del Sol, Marbella, Málaga, España. 13. Servicio de Urgencias, Hospital Universitari Doctor Josep Trueta, Girona, España. 14. Servicio de Urgencias, Hospital Universitari de Vic, Barcelona, España. 15. Servicio de Urgencias, Hospital Doctor Peset, Valencia, España. 16. Servicio de Urgencias, Hospital Universitari Joan XXIII, Tarragona, España. 17. Servicio de Urgencias, Hospital La Princesa, Madrid, España. 18. Servicio de Urgencias, Hospital Rey Juan Carlos, Madrid, España. 19. Servicio de Urgencias, Complejo Hospitalario Universitario de Vigo. Hospital Álvaro Cunqueiro de Vigo, Pontevedra, España. 20. Servcio de Urgencias, Hospital Universitario La Paz, Madrid, España. 21. Servicio de Urgencias, Complejo Asistencial de Soria, España. 22. Servicio de Urgencias, Hospital San Pedro, Logroño, España. 23. Servicio de Urgencias, Hospital de León, España.
Abstract
OBJECTIVES: To describe the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) treated in hospital emergency departments (EDs) in Spain, and to assess associations between characteristics and outcomes. MATERIAL AND METHODS: Prospective, multicenter, nested-cohort study. Sixty-one EDs included a random sample of all patients diagnosed with COVID-19 between March 1 and April 30, 2020. Demographic and baseline health information, including concomitant conditions; clinical characteristics related to the ED visit and complementary test results; and treatments were recorded throughout the episode in the ED. We calculated crude and adjusted odds ratios for risk of in-hospital death and a composite outcome consisting of the following events: intensive care unit admission, orotracheal intubation or mechanical ventilation, or in-hospital death. The logistic regression models were constructed with 3 groups of independent variables: the demographic and baseline health characteristics, clinical characteristics and complementary test results related to the ED episode, and treatments. RESULTS: The mean (SD) age of patients was 62 (18) years. Most had high- or low-grade fever, dry cough, dyspnea, and diarrhea. The most common concomitant conditions were cardiovascular diseases, followed by respiratory diseases and cancer. Baseline patient characteristics that showed a direct and independent association with worse outcome (death and the composite outcome) were age and obesity. Clinical variables directly associated with worse outcomes were impaired consciousness and pulmonary crackles; headache was inversely associated with worse outcomes. Complementary test findings that were directly associated with outcomes were bilateral lung infiltrates, lymphopenia, a high platelet count, a D-dimer concentration over 500 mg/dL, and a lactate-dehydrogenase concentration over 250 IU/L in blood. CONCLUSION: This profile of the clinical characteristics and comorbidity of patients with COVID-19 treated in EDs helps us predict outcomes and identify cases at risk of exacerbation. The information can facilitate preventive measures and improve outcomes.
OBJECTIVES: To describe the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) treated in hospital emergency departments (EDs) in Spain, and to assess associations between characteristics and outcomes. MATERIAL AND METHODS: Prospective, multicenter, nested-cohort study. Sixty-one EDs included a random sample of all patients diagnosed with COVID-19 between March 1 and April 30, 2020. Demographic and baseline health information, including concomitant conditions; clinical characteristics related to the ED visit and complementary test results; and treatments were recorded throughout the episode in the ED. We calculated crude and adjusted odds ratios for risk of in-hospital death and a composite outcome consisting of the following events: intensive care unit admission, orotracheal intubation or mechanical ventilation, or in-hospital death. The logistic regression models were constructed with 3 groups of independent variables: the demographic and baseline health characteristics, clinical characteristics and complementary test results related to the ED episode, and treatments. RESULTS: The mean (SD) age of patients was 62 (18) years. Most had high- or low-grade fever, dry cough, dyspnea, and diarrhea. The most common concomitant conditions were cardiovascular diseases, followed by respiratory diseases and cancer. Baseline patient characteristics that showed a direct and independent association with worse outcome (death and the composite outcome) were age and obesity. Clinical variables directly associated with worse outcomes were impaired consciousness and pulmonary crackles; headache was inversely associated with worse outcomes. Complementary test findings that were directly associated with outcomes were bilateral lung infiltrates, lymphopenia, a high platelet count, a D-dimer concentration over 500 mg/dL, and a lactate-dehydrogenase concentration over 250 IU/L in blood. CONCLUSION: This profile of the clinical characteristics and comorbidity of patients with COVID-19 treated in EDs helps us predict outcomes and identify cases at risk of exacerbation. The information can facilitate preventive measures and improve outcomes.
Entities:
Keywords:
COVID-19; Características clínicas; Clinical characteristics; Comorbidity; Comorbilidades; Coronavirus disease 2019 (COVID-19); Emergency health services; SARS-CoV-2; Servicios de urgencias; Severe acute respiratoryzzm321990syndrome coronavirus 2 (SARS-CoV-2)
Authors: Òscar Miró; Pere Llorens; Sònia Jiménez; Pascual Piñera; Guillermo Burillo-Putze; Alfonso Martín; Francisco Javier Martín-Sánchez; Eric Jorge García-Lamberetchs; Javier Jacob; Aitor Alquézar-Arbé; Josep Maria Mòdol; María Pilar López-Díez; Josep Maria Guardiola; Carlos Cardozo; Francisco Javier Lucas Imbernón; Alfons Aguirre Tejedo; Ángel García García; Martín Ruiz Grinspan; Ferran Llopis Roca; Juan González Del Castillo Journal: Chest Date: 2020-11-20 Impact factor: 9.410
Authors: F J Candel; P Barreiro; J San Román; J C Abanades; R Barba; J Barberán; C Bibiano; J Canora; R Cantón; C Calvo; M Carretero; F Cava; R Delgado; J García-Rodríguez; J González Del Castillo; C González de Villaumbrosia; M Hernández; J E Losa; F J Martínez-Peromingo; J M Molero; P Muñoz; E Onecha; M Onoda; J Rodríguez; M Sánchez-Celaya; J A Serra; A Zapatero Journal: Rev Esp Quimioter Date: 2020-10-19 Impact factor: 1.553
Authors: Ò Miró; A Alquézar-Arbé; P Llorens; F J Martín-Sánchez; S Jiménez; A Martín; G Burillo-Putze; J Jacob; E J García-Lamberechts; P Piñera; J González Del Castillo Journal: Med Intensiva (Engl Ed) Date: 2020-09-29
Authors: Òscar Miró; Pere Llorens; Sònia Jiménez; Pascual Piñera; Guillermo Burillo-Putze; Alfonso Martín; Francisco Javier Martín-Sánchez; Juan González Del Castillo Journal: Epidemiol Infect Date: 2020-08-26 Impact factor: 2.451