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Severe COVID-19 prognostic factors have been studied worldwide throughout the pandemic, but there is considerable variability. Therefore, the investigators will summarize the identified prognostic factors in the international literature and will conduct a retrospective cohort study to identify the prognostic factors of severe COVID-19 in hospitalized patients of the Hospital de la Santa Creu i Sant Pau in Barcelona (Spain) between March 2020 and February 2021, compare them with those mentioned in the international literature and establish those most adequate to our population.
Background: Spain is one of the European countries most affected by the SARS-CoV-2 pandemic, with a fatality rate of 2.2%. Faced with the significant number of patients requiring intensive care, the number of beds increased considerably in the span of 11 months to respond to the situation. There is still no drug treatment or specific prognostic factors for COVID-19 that allow its proper management.
Objective: To study the prognostic factors of severity due to COVID-19 in hospitalized patients at Hospital de la Santa Creu i Sant Pau, and their comparison with the prognostic factors identified in the literature review.
Methods: In a first phase, the published studies will be reviewed to identify the existing prognostic factors through various platforms (MEDLINE, EMBASE, Cochrane). A retrospective cohort study will subsequently be carried out to determine the patients' characteristics and to identify the prognostic factors of severity. Patients over 18 years of age, diagnosed with COVID-19 and hospitalized between March 01, 2020 and February 28, 2021 will be included. A descriptive analysis of the cohort will firstly be performed, followed by an analysis of the possible prognostic factors through bivariate tests and multivariate analyzes. The occurrence of admission to intensive care, mortality, and hospital stay > 30 days will be calculated with logistic regression (p <0.05, a = 0.05, 95% confidence interval). Finally, the prognostic factors identified in the literature review will be compared with those determined in the cohort.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prognostic factors of severe COVID-19 | Other | prognostic factors: patients´ epidemiological characteristics (such as age, sex), comorbidities, length of hospitalization, critical care admission, treatments received, laboratory results, vital signs. |
| Measure | Description | Time Frame |
|---|---|---|
| All cause mortality | All cause mortality of COVID-19 inpatients | one year |
| Critical care admission | Critical care admission of COVID-19 inpatients | one year |
| Length of stay | length of hospital stay equal or longer than 30 days | one year |
| 30-day all cause mortality | 30-day all cause mortality of COVID-19 inpatients | one year |
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Inclusion Criteria:
Exclusion Criteria:
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Adult COVID-19 patients hospitalized at the San Pau Hospital of Barcelona between March 2020 and February 2021.
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| Name | Affiliation | Role |
|---|---|---|
| Teresa Puig, MD, PhD, MSC | Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital de la Santa Creu i Sant Pau | Barcelona | 08041 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33521734 | Background | Cevik M, Tate M, Lloyd O, Maraolo AE, Schafers J, Ho A. SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis. Lancet Microbe. 2021 Jan;2(1):e13-e22. doi: 10.1016/S2666-5247(20)30172-5. Epub 2020 Nov 19. | |
| 32467353 | Background |
| Label | URL |
|---|---|
| World Health Organization | View source |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
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| Wang Y, Tian H, Zhang L, Zhang M, Guo D, Wu W, Zhang X, Kan GL, Jia L, Huo D, Liu B, Wang X, Sun Y, Wang Q, Yang P, MacIntyre CR. Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China. BMJ Glob Health. 2020 May;5(5):e002794. doi: 10.1136/bmjgh-2020-002794. |
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| 32497510 | Background | Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schunemann HJ; COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020 Jun 27;395(10242):1973-1987. doi: 10.1016/S0140-6736(20)31142-9. Epub 2020 Jun 1. |
| 32648959 | Background | Piechotta V, Chai KL, Valk SJ, Doree C, Monsef I, Wood EM, Lamikanra A, Kimber C, McQuilten Z, So-Osman C, Estcourt LJ, Skoetz N. Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2020 Jul 10;7(7):CD013600. doi: 10.1002/14651858.CD013600.pub2. |
| 32451563 | Background | Jain V, Yuan JM. Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis. Int J Public Health. 2020 Jun;65(5):533-546. doi: 10.1007/s00038-020-01390-7. Epub 2020 May 25. |
| 32721533 | Background | Zhou Y, Yang Q, Chi J, Dong B, Lv W, Shen L, Wang Y. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: A systematic review and meta-analysis. Int J Infect Dis. 2020 Oct;99:47-56. doi: 10.1016/j.ijid.2020.07.029. Epub 2020 Jul 25. |
| 33521564 | Background | Hatmi ZN. A Systematic Review of Systematic Reviews on the COVID-19 Pandemic. SN Compr Clin Med. 2021;3(2):419-436. doi: 10.1007/s42399-021-00749-y. Epub 2021 Jan 26. |
| 32749705 | Background | Reddy RK, Charles WN, Sklavounos A, Dutt A, Seed PT, Khajuria A. The effect of smoking on COVID-19 severity: A systematic review and meta-analysis. J Med Virol. 2021 Feb;93(2):1045-1056. doi: 10.1002/jmv.26389. Epub 2020 Aug 13. |
| 32646669 | Background | Moreno G, Carbonell R, Bodi M, Rodriguez A. Systematic review of the prognostic utility of D-dimer, disseminated intravascular coagulation, and anticoagulant therapy in COVID-19 critically ill patients. Med Intensiva (Engl Ed). 2021 Jan-Feb;45(1):42-55. doi: 10.1016/j.medin.2020.06.006. Epub 2020 Jun 17. |
| 33310127 | Background | Lazarus G, Audrey J, Wangsaputra VK, Tamara A, Tahapary DL. High admission blood glucose independently predicts poor prognosis in COVID-19 patients: A systematic review and dose-response meta-analysis. Diabetes Res Clin Pract. 2021 Jan;171:108561. doi: 10.1016/j.diabres.2020.108561. Epub 2020 Dec 9. |
| 33452143 | Background | Martha JW, Wibowo A, Pranata R. Prognostic value of elevated lactate dehydrogenase in patients with COVID-19: a systematic review and meta-analysis. Postgrad Med J. 2022 Jun;98(1160):422-427. doi: 10.1136/postgradmedj-2020-139542. Epub 2021 Jan 15. |
| 33493853 | Background | Martha JW, Wibowo A, Pranata R. Hypocalcemia is associated with severe COVID-19: A systematic review and meta-analysis. Diabetes Metab Syndr. 2021 Jan-Feb;15(1):337-342. doi: 10.1016/j.dsx.2021.01.003. Epub 2021 Jan 18. |
| 33550816 | Background | Chocron R, Galand V, Cellier J, Gendron N, Pommier T, Bory O, Khider L, Trimaille A, Goudot G, Weizman O, Alsac JM, Geneste L, Schmeltz A, Panagides V, Philippe A, Marsou W, Ben Abdallah I, Deney A, El Batti S, Attou S, Juvin P, Delmotte T, Messas E, Pezel T, Planquette B, Duceau B, Gaussem P, Sutter W, Sanchez O, Waldman V, Diehl JL, Mirault T, Bonnet G, Cohen A, Smadja DM; Critical COVID-19 France Investigators. Anticoagulation Before Hospitalization Is a Potential Protective Factor for COVID-19: Insight From a French Multicenter Cohort Study. J Am Heart Assoc. 2021 Apr 20;10(8):e018624. doi: 10.1161/JAHA.120.018624. Epub 2021 Feb 8. |
| 32931146 | Background | Nugroho J, Wardhana A, Maghfirah I, Mulia EPB, Rachmi DA, A'yun MQ, Septianda I. Relationship of D-dimer with severity and mortality in SARS-CoV-2 patients : A meta-analysis. Int J Lab Hematol. 2021 Feb;43(1):110-115. doi: 10.1111/ijlh.13336. Epub 2020 Sep 15. |
| 32338827 | Background | Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, Clark C, Iba T. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020 May;18(5):1023-1026. doi: 10.1111/jth.14810. Epub 2020 Apr 27. No abstract available. |
| 32885373 | Background | Elavarasi A, Prasad M, Seth T, Sahoo RK, Madan K, Nischal N, Soneja M, Sharma A, Maulik SK, Shalimar, Garg P. Chloroquine and Hydroxychloroquine for the Treatment of COVID-19: a Systematic Review and Meta-analysis. J Gen Intern Med. 2020 Nov;35(11):3308-3314. doi: 10.1007/s11606-020-06146-w. Epub 2020 Sep 3. |
| 32706953 | Background | Cavalcanti AB, Zampieri FG, Rosa RG, Azevedo LCP, Veiga VC, Avezum A, Damiani LP, Marcadenti A, Kawano-Dourado L, Lisboa T, Junqueira DLM, de Barros E Silva PGM, Tramujas L, Abreu-Silva EO, Laranjeira LN, Soares AT, Echenique LS, Pereira AJ, Freitas FGR, Gebara OCE, Dantas VCS, Furtado RHM, Milan EP, Golin NA, Cardoso FF, Maia IS, Hoffmann Filho CR, Kormann APM, Amazonas RB, Bocchi de Oliveira MF, Serpa-Neto A, Falavigna M, Lopes RD, Machado FR, Berwanger O; Coalition Covid-19 Brazil I Investigators. Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19. N Engl J Med. 2020 Nov 19;383(21):2041-2052. doi: 10.1056/NEJMoa2019014. Epub 2020 Jul 23. |
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| Digital Economy article | View source |
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| D014777 |
| Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |