COVID-19 pneumonia in Galicia (Spain): Impact of prognostic factors and therapies on mortality and need for mechanical ventilation

• Published in: PloS one 2021-06, Vol.16 (6), p.e0253465
• Main Authors: Pérez-de-Llano, Luis, Romay-Lema, Eva María, Baloira-Villar, Adolfo, Anchorena, Christian, Torres-Durán, María Luisa, Sousa, Adrián, Corbacho-Abelaira, Dolores, Paz-Ferrin, José, Diego-Roza, Carmen, Vilariño-Maneiro, Laura, Marcos, Pedro J, Montero-Martínez, Carmen, de la Iglesia-Martínez, Fernando, Riveiro-Blanco, Vanessa, Rodríguez-Núñez, Nuria, Abal-Arca, José, Bustillo-Casado, María, Golpe, Rafael
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - therapeutic use; Age; Aged; Aged, 80 and over; Antibiotics; Antiviral Agents - therapeutic use; Biology and Life Sciences; Care and treatment; Comorbidity; Confidence intervals; Coronaviruses; Corticoids; Corticosteroids; COVID-19; COVID-19 - epidemiology; COVID-19 - mortality; COVID-19 - therapy; Diabetes; Evaluation; Fatalities; Female; Health risks; Hospital patients; Hospitals; Hospitals - statistics & numerical data; Humans; Hydroxychloroquine; Hydroxychloroquine - therapeutic use; Hypertension; Infections; Infectious diseases; Internal medicine; Laboratories; Male; Mechanical ventilation; Medical prognosis; Medical records; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Patients; Pneumonia; Pulmonology; Quartiles; Regression analysis; Regression models; Respiration, Artificial; Retrospective Studies; Risk analysis; Risk Factors; Sensitivity analysis; Severe acute respiratory syndrome coronavirus 2; Software; Spain; Spain - epidemiology; Statistical analysis; Therapeutic applications; Treatment Outcome; Variables; Ventilation; Ventilators
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0253465

This study was aimed to identify risk factors associated with unfavorable outcomes (composite outcome variable: mortality and need for mechanical ventilation) in patients hospitalized in Galicia with COVID-19 pneumonia. Retrospective, multicenter, observational study carried out in the 8 Galician tertiary hospitals. All Patients admitted with confirmed COVID-19 pneumonia from 1st of March to April 24th, 2020 were included. A multivariable logistic regression analysis was performed in order to identify the relationship between risk factors, therapeutic interventions and the composite outcome variable. A total of 1292 patients (56.1% male) were included. Two hundred and twenty-five (17.4%) died and 327 (25.3%) reached the main outcome variable. Age [odds ratio (OR) = 1.03 (95% confidence interval (CI): 1.01-1.04)], CRP quartiles 3 and 4 [OR = 2.24 (95% CI: 1.39-3.63)] and [OR = 3.04 (95% CI: 1.88-4.92)], respectively, Charlson index [OR = 1.16 (95%CI: 1.06-1.26)], SaO2 upon admission [OR = 0.93 (95% CI: 0.91-0.95)], hydroxychloroquine prescription [OR = 0.22 (95%CI: 0.12-0.37)], systemic corticosteroids prescription [OR = 1.99 (95%CI: 1.45-2.75)], and tocilizumab prescription [OR = 3.39 (95%CI: 2.15-5.36)], significantly impacted the outcome. Sensitivity analysis using different alternative logistic regression models identified consistently the ratio admissions/hospital beds as a predictor of the outcome [OR = 1.06 (95% CI: 1.02-1.11)]. These findings may help to identify patients at hospital admission with a higher risk of death and may urge healthcare authorities to implement policies aimed at reducing deaths by increasing the availability of hospital beds.