COVID-19 pneumonia in Galicia (Spain): Impact of prognostic factors and therapies on mortality and need for mechanical ventilation

PLoS One. 2021 Jun 23;16(6):e0253465. doi: 10.1371/journal.pone.0253465. eCollection 2021.

Abstract

Introduction: This study was aimed to identify risk factors associated with unfavorable outcomes (composite outcome variable: mortality and need for mechanical ventilation) in patients hospitalized in Galicia with COVID-19 pneumonia.

Methods: Retrospective, multicenter, observational study carried out in the 8 Galician tertiary hospitals. All Patients admitted with confirmed COVID-19 pneumonia from 1st of March to April 24th, 2020 were included. A multivariable logistic regression analysis was performed in order to identify the relationship between risk factors, therapeutic interventions and the composite outcome variable.

Results: A total of 1292 patients (56.1% male) were included. Two hundred and twenty-five (17.4%) died and 327 (25.3%) reached the main outcome variable. Age [odds ratio (OR) = 1.03 (95% confidence interval (CI): 1.01-1.04)], CRP quartiles 3 and 4 [OR = 2.24 (95% CI: 1.39-3.63)] and [OR = 3.04 (95% CI: 1.88-4.92)], respectively, Charlson index [OR = 1.16 (95%CI: 1.06-1.26)], SaO2 upon admission [OR = 0.93 (95% CI: 0.91-0.95)], hydroxychloroquine prescription [OR = 0.22 (95%CI: 0.12-0.37)], systemic corticosteroids prescription [OR = 1.99 (95%CI: 1.45-2.75)], and tocilizumab prescription [OR = 3.39 (95%CI: 2.15-5.36)], significantly impacted the outcome. Sensitivity analysis using different alternative logistic regression models identified consistently the ratio admissions/hospital beds as a predictor of the outcome [OR = 1.06 (95% CI: 1.02-1.11)].

Conclusion: These findings may help to identify patients at hospital admission with a higher risk of death and may urge healthcare authorities to implement policies aimed at reducing deaths by increasing the availability of hospital beds.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use*
  • COVID-19 / epidemiology
  • COVID-19 / mortality*
  • COVID-19 / therapy*
  • Comorbidity
  • Female
  • Hospitals / statistics & numerical data
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Male
  • Middle Aged
  • Respiration, Artificial
  • Retrospective Studies
  • Risk Factors
  • Spain / epidemiology
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Antiviral Agents
  • Hydroxychloroquine

Grants and funding

This project was supported by an unconditional grant from AstraZeneca, with no role in the analysis, decision to publish or preparation of the manuscript. The design, analysis, and writing of this report are entirely the work and responsibility of the authors, and Dr. Pérez de Llano had full access to all data and final responsibility for the decision to submit this work for publication.