Risk categories in COVID-19 based on degrees of inflammation: data on more than 17,000 patients from the spanish SEMI-COVID-19 registry
Author
Rubio-Rivas, Manuel
Corbella Virós, Xavier
Formiga, Francesc
Menéndez Fernández, Estela
Martín Escalante, María Dolores
Baños Fernández, Isolina
Arnalich Fernández, Francisco
Del Corral-Beamonte, Esther
Lalueza, Antonio
Parra Virto, Alejandro
Roy Vallejo, Emilia
Loureiro-Amigo, José
Álvarez Suárez, Ana María
Abadía-Otero, Jesica
Navarro De La Chica, María
Estévez González, Raquel
Hernández Milián, Almudena
Areses Manrique, María
Blázquez Encinar, Julio César
González Noya, Amara
González Ferrer, Ruth
Pérez Aguilera, María
Gil Sánchez, Ricardo
Millán Núñez-Cortés, Jesús
Casas-Rojo, José Manuel
SEMI-COVID-19 Network
Publication date
2021ISSN
2077-0383
Abstract
(1) Background: The inflammation or cytokine storm that accompanies COVID-19 marks the prognosis. This study aimed to identify three risk categories based on inflammatory parameters on admission. (2) Methods: Retrospective cohort study of patients diagnosed with COVID-19, collected and followed-up from 1 March to 31 July 2020, from the nationwide Spanish SEMI-COVID-19 Registry. The three categories of low, intermediate, and high risk were determined by taking into consideration the terciles of the total lymphocyte count and the values of C-reactive protein, lactate dehydrogenase, ferritin, and D-dimer taken at the time of admission. (3) Results: A total of 17,122 patients were included in the study. The high-risk group was older (57.9 vs. 64.2 vs. 70.4 years; p < 0.001) and predominantly male (37.5% vs. 46.9% vs. 60.1%; p < 0.001). They had a higher degree of dependence in daily tasks prior to admission (moderate-severe dependency in 10.8% vs. 14.1% vs. 17%; p < 0.001), arterial hypertension (36.9% vs. 45.2% vs. 52.8%; p < 0.001), dyslipidemia (28.4% vs. 37% vs. 40.6%; p < 0.001), diabetes mellitus (11.9% vs. 17.1% vs. 20.5%; p < 0.001), ischemic heart disease (3.7% vs. 6.5% vs. 8.4%; p < 0.001), heart failure (3.4% vs. 5.2% vs. 7.6%; p < 0.001), liver disease (1.1% vs. 3% vs. 3.9%; p = 0.002), chronic renal failure (2.3% vs. 3.6% vs. 6.7%; p < 0.001), cancer (6.5% vs. 7.2% vs. 11.1%; p < 0.001), and chronic obstructive pulmonary disease (5.7% vs. 5.4% vs. 7.1%; p < 0.001). They presented more frequently with fever, dyspnea, and vomiting. These patients more frequently required high flow nasal cannula (3.1% vs. 4.4% vs. 9.7%; p < 0.001), non-invasive mechanical ventilation (0.9% vs. 3% vs. 6.3%; p < 0.001), invasive mechanical ventilation (0.6% vs. 2.7% vs. 8.7%; p < 0.001), and ICU admission (0.9% vs. 3.6% vs. 10.6%; p < 0.001), and had a higher percentage of in-hospital mortality (2.3% vs. 6.2% vs. 23.9%; p < 0.001). The three risk categories proved to be an independent risk factor in multivariate analyses. (4) Conclusion: The present study identifies three risk categories for the requirement of high flow nasal cannula, mechanical ventilation, ICU admission, and in-hospital mortality based on lymphopenia and inflammatory parameters.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
61 - Medical sciences
616.9 - Communicable diseases. Infectious and contagious diseases, fevers
Keywords
COVID-19 (Malaltia)
Tempesta de citoquines
Pronòstic
Factors de risc
Mortalitat
COVID-19
Tormenta de citoquinas
Pronóstico
Factores de riesgo
Mortalidad
COVID-19
Cytokine storm
Prognosis
Risk factors
Mortality
Pages
13
Publisher
MDPI
Collection
10;
Is part of
Journal of Clinical Medicine
Citation
Rubio-Rivas, Manuel; Corbella Virós, Xavier; Formiga, Francesc [et al.]. Risk categories in COVID-19 based on degrees of inflammation: data on more than 17,000 patients from the spanish SEMI-COVID-19 registry. Journal of Clinical Medicine, 2021, 10(10), 2214. Disponible en: <https://www.mdpi.com/2077-0383/10/10/2214>. Fecha de acceso: 7 jun. 2021. DOI: 10.3390/jcm10102214
This item appears in the following Collection(s)
- Ciències de la Salut [738]
Rights
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0/