Factors associated with the risk of hospitalization and death related to SARS-CoV-2 infection

e202306046

Authors

  • María del Carmen de Diego-Castell Médico Residente de Medicina Familiar y Comunitaria. Centro de Salud Santa Olalla, Gerencia de Atención Integrada de Talavera de la Reina. Talavera de la Reina (Toledo). España. / Programa de Doctorado en Ciencias de la Salud, Universidad Castilla-La Mancha (UCLM). Talavera de la Reina (Toledo). España.
  • Eduardo García-López Médico Residente de Medicina Familiar y Comunitaria. Centro de Salud Presentación Sabio. Móstoles (Madrid). España.
  • Jaime González-González Profesor Asociado de la Universidad de Castilla-La Mancha (UCLM). Talavera de la Reina (Toledo). España. / Médico de Medicina Familiar y Comunitaria. Centro de Salud Santa Olalla, Gerencia de Atención Integrada de Talavera de la Reina. Talavera de la Reina (Toledo). España.
  • Joaquín Antonio Álvarez-Gregori Médico de Medicina Familiar y Comunitaria. Servicio de Urgencias del Hospital Nuestra Señora del Prado, Gerencia de Atención Integrada de Talavera de la Reina. Talavera de la Reina (Toledo). España.
  • Alicia Mohedano-Moriano Profesor Asociado de la Universidad de Castilla-La Mancha (UCLM). Talavera de la Reina (Toledo). España.
  • Juan José Criado-Álvarez Profesor Asociado de la Universidad de Castilla-La Mancha (UCLM). Talavera de la Reina (Toledo). España. / Médico de Medicina Familiar y Comunitaria y de Medicina Preventiva y Salud Pública. Director-Gerente del Instituto de Ciencias de la Salud de Castilla-La Mancha. Consejería de Sanidad. Talavera de la Reina (Toledo). España.

Keywords:

COVID-19, Hospitalization, Death, Comorbidity

Abstract

BACKGROUND // COVID-19 has tried out global health causing high mortality. There are some risk factors that associate greater severity and mortality from COVID-19; but their individual impact is unknown yet. There are also no fixed criteria for hospital admission. For this reason, this study aimed to analyze the factors associated with the severity of COVID-19 and create predictive models for the risk of hospitalization and death due to COVID-19.
METHODS // A descriptive retrospective cohort study was made in Talavera de la Reina (Toledo, Spain). Data were collected through computerized records of Primary Care, Emergencies and Hospitalization. The sample consisted of 275 patients over eighteen years old diagnosed with COVID-19 in a centralized laboratory from March 1st to May 31st, 2020. Analysis was carried on using SPSS, creating two predictive models for the risk of hospitalization and death using linear regression.
RESULTS // The probability of hospitalization increased independently with polypharmacy (OR 1.086; CI95% 1.009-1.169), the Charlson index (OR 1.613; CI95% 1.158-2.247), the history of acute myocardial infarction (AMI) (OR 4.358; 95% CI 1.114-17.051) and the presence of COVID symptoms (OR 7.001; 95% CI 2.805-17.475). The probability of death was independently associated with age, increasing 8.1% (OD 1.081; 95% CI 1.054- 1.110) for each year of the patient.
CONCLUSIONS // Comorbidity, polypharmacy, history of AMI and the presence of COVID-19 symptoms predict the risk of hospitalization. The age of individuals predicts the risk of death. Detecting patients at high risk of hospitalization and death allows us to define the target population and define measures to implement.

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References

Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536-544. doi: https://dx.doi.org/10.1038/s41564-020-0695-z

Oran DP, Topol EJ. Prevalence of Asymptomatic SARS-CoV-2 Infection: A Narrative Review. Ann Intern Med. 2020;173(5):362. Epub 2020 Jun 3.

COVID-19 situation update worldwide, as of week 20, updated 26 May 2022 [Internet]. European Centre for Disease Prevention and Control. [Consultado el 31 de mayo de 2022]. Disponible en: https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases

OMS. «Enfermedad por coronavirus, COVID-19». Centro de Coordinación de Alertas y Emergencias Sanitaria. [Internet: who.int]. Última actualización: 4 de abril de 2020. [Consultado el 26 de abril de 2020.] Disponible en: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/20200404_ITCoronavirus.pdf

Centers for Disease Control and Prevention. Underlying medical conditions associated with high risk for severe COVID-19: Information for healthcare providers. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html (consultado el 1 de marzo de 2022).

Maestre-Muñiz MM, Arias Á, Arias-González L, Angulo-Lara B, Lucendo AJ. Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain. J Clin Med. 2021 Jan 16;10(2):318. doi: https://dx.doi.org/10.3390/jcm10020318. PMID: 33467207; PMCID: PMC7830028.

Liang W, Liang H, Ou L, Chen B, Chen A, Li C, Li Y, Guan W, Sang L, Lu J, Xu Y, Chen G, Guo H, Guo J, Chen Z, Zhao Y, Li S, Zhang N, Zhong N, He J, China Medical Treatment Expert Group for COVID-19. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern Med. 2020;180(8):1081.

Cuschieri S. The STROBE guidelines. Saudi J Anaesth. 2019 Apr;13(Suppl 1):S31-S34.

Richardson S, Hirsch JS, Narasimhan M et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area [preprint publicado online, 22 abr 2020] [corrección publicada aparece en doi: https://dx.doi.org/10.1001/jama.2020.7681]. JAMA. 2020;323(20):2052-2059. doi: https://dx.doi.org/10.1001/jama.2020.6775

Berkman LF, Leo-Summers L, Horwitz RI. Emotional support and survival after myocardial infarction. A prospective, population-based study of the elderly. Ann Intern Med 1992; 117: 1003-1009.

Rosenthal N, Cao Z, Gundrum J, Sianis J, Safo S. Risk Factors Associated With In-Hospital Mortality in a US National Sample of Patients With COVID-19. JAMA Netw Open. 2020;3(12):e2029058. Epub 2020 Dec 1.

Rahman S, Singh K, Dhingra S, Charan J, Sharma P, Islam S, Jahan D, Iskandar K, Samad N, Haque M. The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population-Public Health Implications. Ther Clin Risk Manag. 2020 Oct 20;16:1007-1022. doi: https://dx.doi.org/10.2147/TCRM.S272908. PMID: 33116550; PMCID: PMC7586020.

Secretaría de Estado de Sanidad Española. Centro de Coordinación de Alertas y Emergencias Sanitarias [Internet]. Gob.es. [Consultado 10 jun 2022]. Disponible en: https://www.sanidad.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/20220113_EPIDEMIOLOGIA.pdf

Procedimiento de actuación para los servicios de prevención de riesgos laborales frente a la exposición al SARS-CoV-2 [Internet]. Gob.es. [Consultado 17 jun 2022]. Disponible en: https://www.sanidad.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/PrevencionRRLL_COVID-19.pdf

Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, Curtis HJ, Mehrkar A, Evans D, Inglesby P, Cockburn J, McDonald HI, MacKenna B, Tomlinson L, Douglas IJ, Rentsch CT, Mathur R, Wong AYS, Grieve R, Harrison D, Forbes H, Schultze A, Croker R, Parry J, Hester F, Harper S, Perera R, Evans SJW, Smeeth L, Goldacre B. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584(7821):430. Epub 8 jul 2020.

Pujadas E, Chaudhry F, McBride R, Richter F, Zhao S, Wajnberg A et al. SARS-CoV-2 viral load predicts COVID-19 mortality. Lancet Respir Med [Internet]. 1 de septiembre de 2020 [consultado 4 de enero de 2021];8(9):e70. Disponible en: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30354-4/abstract

Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. AMA. 2020;323(13):1239.

COVID-19 Forecasting Team. Variation in the COVID-19 infection-fatality ratio by age, time, and geography during the pre-vaccine era: a systematic analysis. Lancet. 2022;399(10334):1469. Epub 24 feb 2022.

Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020;323(18):1775.

Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, Curtis HJ, Mehrkar A, Evans D, Inglesby P, Cockburn J, McDonald HI, MacKenna B, Tomlinson L, Douglas IJ, Rentsch CT, Mathur R, Wong AYS, Grieve R, Harrison D, Forbes H, Schultze A, Croker R, Parry J, Hester F, Harper S, Perera R, Evans SJW, Smeeth L, Goldacre B. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584(7821):430. Epub 8 jul 2020.

Mesas AE, Cavero-Redondo I, Álvarez-Bueno C, Sarriá Cabrera MA, Maffei de Andrade S, Sequí-Dominguez I, Martínez-Vizcaíno V. Predictors of in-hospital COVID-19 mortality: A comprehensive systematic review and meta-analysis exploring differences by age, sex and health conditions. PLoS One. 2020 Nov 3;15(11):e0241742. doi: https://dx.doi.org/10.1371/journal.pone.0241742. PMID: 33141836; PMCID: PMC7608886.

Bellido V, Pérez A. COVID-19 and Diabetes. J Clin Med. 2021 Nov 16;10(22):5341. doi: https://dx.doi.org/10.3390/jcm10225341. PMID: 34830623; PMCID: PMC8618368.

Pfenninger EG, Christ P, Neumüller M, Dinse-Lambracht A. Beurteilung des Infektionsrisikos durch SARS-CoV-2 für medizinisches Personal-Erkenntnisse aus der Praxis [Assessment of the risk of infection from SARS-CoV-2 for healthcare workers-findings from practice]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2021 Mar;64(3):304-313. Alemán. doi: https://dx.doi.org/10.1007/s00103-021-03277-1. Epub 26 ene 2021. PMID: 33496803; PMCID: PMC7837074.

Fisman DN, Bogoch I, Lapointe-Shaw L, McCready J, Tuite AR. Risk Factors Associated With Mortality Among Residents With Coronavirus Disease 2019 (COVID-19) in Long-term Care Facilities in Ontario, Canada. JAMA Netw Open. 2020;3(7):e2015957. Epub 1 jul 2020.

Ingram E, Ledden S, Beardon S, Gomes M, Hogarth S, McDonald H, Osborn DP, Sheringham J. Household and area-level social determinants of multimorbidity: a systematic review. J Epidemiol Community Health. 2021 Mar;75(3):232-241. doi: https://dx.doi.org/10.1136/jech-2020-214691. Epub 6 nov 2020. PMID: 33158940; PMCID: PMC7892392.

Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Eurosurveillance [Internet]. 12 de marzo de 2020 [consultado 16 de marzo de 2020];25(10):2000180. Disponible en: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180

Estudio ENE-COVID19: segunda ronda estudio nacional de sero-epidemiología de la infección por SARS-CoV-2 en España. Informe preliminar. [Internet]. Jun 2020. Disponible en: https://www.mscbs.gob.es/ciudadanos/ene-covid/docs/ESTUDIO_ENE- COVID19_SEGUNDA_RONDA_INFORME_PRELIMINAR.pdf

Centers for Disease Control and Prevention. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html.

Impacto de la COVID-19 en lo NO-COVID: Estrategias e intervenciones para “re-priorizar” la atención NO-COVID en el Sistema Nacional de Salud. FACME. Jun 2021.

Martín Fernández A. Papel de los sistemas de información y la salud electrónica en la pandemia de COVID-19. Una llamada a la acción [Role of the information systems and e-health in the COVID-19 pandemic. A call to action]. Rev Esp Salud Publica. 21 ene 2021;95:e202101006. Español. PMID: 33473100.

Published

2023-06-06

How to Cite

1.
de Diego-Castell M del C, García-López E, González-González J, Álvarez-Gregori JA, Mohedano-Moriano A, Criado-Álvarez JJ. Factors associated with the risk of hospitalization and death related to SARS-CoV-2 infection: e202306046. Rev Esp Salud Pública [Internet]. 2023 Jun. 6 [cited 2024 Nov. 5];97:14 páginas. Available from: https://ojs.sanidad.gob.es/index.php/resp/article/view/126