Prognostic factors in spanish COVID-19 patients: A case series from barcelona

Background

In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community.

Aim

To determine clinical factors of a poor prognosis in patients with COVID-19 infection.

Design and Setting

Descriptive, observational, retrospective study in three primary healthcare centres with an assigned population of 100,000.

Method

Examination of the medical records of patients with COVID-19 infections confirmed by polymerase chain reaction.

Results

We included 322 patients (mean age 56.7 years, 50% female, 115 (35.7%) aged ≥ 65 years). The best predictors of ICU admission or death were greater age, male sex (OR=2.99; 95%CI=1.55 to 6.01), fever (OR=2.18; 95%CI=1.06 to 4.80), dyspnoea

(OR=2.22; 95%CI=1.14 to 4.24), low oxygen saturation (OR=2.94; 95%CI=1.34 to 6.42), auscultatory alterations (OR=2.21; 95%CI=1.00 to 5.29), heart disease (OR=4.37; 95%CI=1.68 to 11.13), autoimmune disease (OR=4.03; 95%CI=1.41 to 11.10), diabetes (OR=4.00; 95%CI=1.89 to 8.36), hypertension (OR=3.92; 95%CI=2.07 to 7.53), bilateral pulmonary infiltrates (OR=3.56; 95%CI=1.70 to 7.96), elevated lactate-dehydrogenase (OR=3.02; 95%CI=1.30 to 7.68), elevated C-reactive protein (OR=2.94; 95%CI=1.47 to 5.97), elevated D-dimer (OR=2.66; 95%CI=1.15 to 6.51) and low platelet count (OR=2.41; 95%CI=1.12 to 5.14). Myalgia or artralgia (OR=0.28; 95%CI=0.10 to 0.66), dysgeusia (OR=0.28; 95%CI=0.05 to 0.92) and anosmia (OR=0.23; 95%CI=0.04 to 0.75) were protective factors.

Conclusion

Determining the clinical, biological and radiological characteristics of patients with suspected COVID-19 infection will be key to early treatment and isolation and the tracing of contacts.