Development of a predictive prognostic rule for early assessment of COVID-19 patients in primary care settings

• Published in: Atención primaria 2021-11, Vol.53 (9), p.102118-102118, Article 102118
• Main Authors: Vila-Corcoles, Angel, Satue-Gracia, Eva, Vila-Rovira, Angel, de Diego-Cabanes, Cinta, Forcadell-Peris, Maria Jose, Ochoa-Gondar, Olga
• Format: Article
• Language: English
• Subjects: Comorbidities; Comorbilidades; COVID-19; Mortalidad; Mortality; Original; Prognosis; Pronóstico; Symptoms; Síntomas
• ISSN: 0212-6567; 1578-1275
• DOI: 10.1016/j.aprim.2021.102118

To investigate possible early prognostic factors among middle-aged and older adult and explore prognostic rules stratifying risk of patients. Community-based retrospective cohort. Primary Health Care Tarragona region. 282 community-dwelling symptomatic patients ≥50 years with laboratory-confirmed COVID-19 (hospitalised and/or outpatient) during March-June 2020 in Tarragona (Southern Catalonia, Spain). Relationship between demographics, pre-existing comorbidities and early symptomatology (first 5-days) and risk of suffering critical outcome (ICU-admission/death) across clinical course was evaluated by logistic regression analyses, and simple predictive models were developed. Of the 282 cases (mean age: 65.9 years; 140 men), 154 (54.6%) were hospitalised (30 ICU-admitted) and 45 (16%) deceased. Median time follow-up in clinical course was 31 days (range: 30–150) for survivors and 14 days (range: 1–81) for deceased patients. In crude analyses, increasing age, male sex, some comorbidities (renal, respiratory or cardiac disease, diabetes and hypertension) and symptoms (confusion, dyspnoea) were associated with an increased risk to suffer critical outcome, whereas other symptoms (rinorrhea, myalgias, headache, anosmia/disgeusia) were related with reduced risk. After multivariable-adjustment only age/years (OR: 1.04; 95% CI: 1.01–1.07; p=0.004), confusion (OR: 5.33; 95% CI: 1.54–18.48; p=0.008), dyspnoea (OR: 5.41; 95% CI: 2.74–10.69; p