Fatality and risk features for prognosis in COVID-19 according to the care approach – a retrospective cohort study

• DOI: 10.1371/journal.pone.0248869
• Publication Date: 2021-03-23T17:57:03Z
• Authors: Mariano Andrés; Jose-Manuel Leon-...; Oscar Moreno-Perez; José Sánchez-Payá; Ignacio Gayá; Violeta Esteban; Isabel Ribes; Diego Torrus-Tendero; Pilar González-de...; Pere Llorens; Vicente Boix; Joan Gil; Esperanza Merino
• Keywords: Case fatality rate

Introduction This study analyzed the impact of a categorized approach, based on patients’ prognosis, major outcomes and explanators in patients hospitalized for COVID-19 pneumonia an academic center Spain. Methods Retrospective cohort (March 3 to May 2, 2020). Patients were according followed clinical management, as maximum care or limited therapeutic effort (LTE). Main all-cause mortality need invasive mechanical ventilation (IMV). Baseline factors associated with by multiple logistic regression, estimating odds ratios (OR; 95%CI). Results Thirty-hundred six hospitalized, median age 65.0 years, 57.8% males, 53.3% Charlson index ≥3. The overall fatality rate was 15.0% (n = 46). Maximum provided 238 (77.8%), IMV used 38 (16.0%), 5.5% died. LTE decided 68 (22.2%), none received 48.5%. Independent risk under lymphocytes <790/mm , troponin T >15ng/L hypotension. Advanced age, BNP >240pg/mL independently requirement. Conclusion Overall 15% but markedly varied regarding approach (maximum versus LTE), translating into nine-fold higher different factors.