PLoS ONE (Jan 2020)

Association between COVID-19 prognosis and disease presentation, comorbidities and chronic treatment of hospitalized patients.

  • Alejandro Rodríguez-Molinero,
  • César Gálvez-Barrón,
  • Antonio Miñarro,
  • Oscar Macho,
  • Gabriela F López,
  • Maria Teresa Robles,
  • María Dolores Dapena,
  • Sergi Martínez,
  • Núria Milà Ràfols,
  • Ernesto E Monaco,
  • Antonio Hidalgo García,
  • COVID-19 Research Group of CSAPG

DOI
https://doi.org/10.1371/journal.pone.0239571
Journal volume & issue
Vol. 15, no. 10
p. e0239571

Abstract

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ImportanceThe rapid pandemic expansion of the disease caused by the new SARS-CoV-2 virus has compromised health systems worldwide. Knowledge of prognostic factors in affected patients can help optimize care.ObjectiveThe objective of this study was to analyze the relationship between the prognosis of COVID-19 and the form of presentation of the disease, the previous pathologies of patients and their chronic treatments.Design, participants and locationsThis was an observational study on a cohort of 418 patients admitted to three regional hospitals in Catalonia (Spain). As primary outcomes, severe disease (need for oxygen therapy via nonrebreather mask or mechanical ventilation) and death were studied. Multivariate binary logistic regression models were performed to study the association between the different factors and the results.ResultsAdvanced age, male sex and obesity were independent markers of poor prognosis. The most frequent presenting symptom was fever, while dyspnea was associated with severe disease and the presence of cough with greater survival. Low oxygen saturation in the emergency room, elevated CRP in the emergency room and initial radiological involvement were all related to worse prognosis. The presence of eosinophilia (% of eosinophils) was an independent marker of less severe disease.ConclusionsThis study identified the most robust markers of poor prognosis for COVID-19. These results can help to correctly stratify patients at the beginning of hospitalization based on the risk of developing severe disease.