Semergen · 2025
[Predictive variables of clinical evolution of sars-CoV-2 infection during the first half of the pandemic in two health areas of Extremadura].
СтатьяНаблюдательное исследованиеАннотация на английскомНазвание и аннотация: Перевод пока не подготовлен
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Tejero-Mas Manuel, Palmerín-Donoso Alba, Morales-Gabardino José Antonio, Gamero-Samino María José, Fernández-Fernández Leandro, Buitrago-Ramírez Francisco
Аннотация
OBJECTIVE: To identify predictive variables of unfavorable clinical evolution (hospital admission and/or death) in patients with COVID-19 during the first half of the pandemic (01-03-2020 to 31-08-2020) in two health areas of Extremadura.
PATIENTS AND METHODS: Observational, analytical and ambispective study with a two-year follow-up. Patients with incomplete clinical documentation or without confirmed diagnosis where excluded. A total of 216 patients were excluded, resulting in a final sample of 1422 patients. Clinical and sociodemographic characteristics, comorbidities, and the course of the infection were included. A multivariate analysis was performed to identify predictors of hospital emergency department (HED) visits, hospital admissions, and mortality.
RESULTS: Mean age 45.6 years; 53.2% women. 14.2% of patients had an unfavorable clinical evolution and 2.0% died. Age was a predictor of HED visits, hospital admission and death. The highest odds ratio (OR) for mortality in both general population and hospitalized patients was associated with the presence of autoimmune diseases or organ transplants: OR: 9.02; 95% confidence interval (95% CI): 1.72-47.21 and OR: 8.06; 95% CI: 1.17-55.53, respectively. Predictors of HED visits included autoimmune disease or transplant, chronic obstructive pulmonary disease, and cardiovascular diseases. The referral report made by the family physician (FP) was the variable with the greatest predictive capacity for hospital admission or unfavorable outcome in the general population (OR: 44.15; 95% CI: 27.14-71.83 and OR: 43.29; 95% CI: 26.28-71.29, respectively).
CONCLUSIONS: The referral report to the HED by the FP was the strongest predictor of hospital admission and unfavorable outcome.
PATIENTS AND METHODS: Observational, analytical and ambispective study with a two-year follow-up. Patients with incomplete clinical documentation or without confirmed diagnosis where excluded. A total of 216 patients were excluded, resulting in a final sample of 1422 patients. Clinical and sociodemographic characteristics, comorbidities, and the course of the infection were included. A multivariate analysis was performed to identify predictors of hospital emergency department (HED) visits, hospital admissions, and mortality.
RESULTS: Mean age 45.6 years; 53.2% women. 14.2% of patients had an unfavorable clinical evolution and 2.0% died. Age was a predictor of HED visits, hospital admission and death. The highest odds ratio (OR) for mortality in both general population and hospitalized patients was associated with the presence of autoimmune diseases or organ transplants: OR: 9.02; 95% confidence interval (95% CI): 1.72-47.21 and OR: 8.06; 95% CI: 1.17-55.53, respectively. Predictors of HED visits included autoimmune disease or transplant, chronic obstructive pulmonary disease, and cardiovascular diseases. The referral report made by the family physician (FP) was the variable with the greatest predictive capacity for hospital admission or unfavorable outcome in the general population (OR: 44.15; 95% CI: 27.14-71.83 and OR: 43.29; 95% CI: 26.28-71.29, respectively).
CONCLUSIONS: The referral report to the HED by the FP was the strongest predictor of hospital admission and unfavorable outcome.