Dataset Information

Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study.

ABSTRACT:

Background

The clinical heterogeneity of COVID-19 suggests the existence of different phenotypes with prognostic implications. We aimed to analyze comorbidity patterns in critically ill COVID-19 patients and assess their impact on in-hospital outcomes, response to treatment and sequelae.

Methods

Multicenter prospective/retrospective observational study in intensive care units of 55 Spanish hospitals. 5866 PCR-confirmed COVID-19 patients had comorbidities recorded at hospital admission; clinical and biological parameters, in-hospital procedures and complications throughout the stay; and, clinical complications, persistent symptoms and sequelae at 3 and 6 months.

Findings

Latent class analysis identified 3 phenotypes using training and test subcohorts: low-morbidity (n=3385; 58%), younger and with few comorbidities; high-morbidity (n=2074; 35%), with high comorbid burden; and renal-morbidity (n=407; 7%), with chronic kidney disease (CKD), high comorbidity burden and the worst oxygenation profile. Renal-morbidity and high-morbidity had more in-hospital complications and higher mortality risk than low-morbidity (adjusted HR (95% CI): 1.57 (1.34-1.84) and 1.16 (1.05-1.28), respectively). Corticosteroids, but not tocilizumab, were associated with lower mortality risk (HR (95% CI) 0.76 (0.63-0.93)), especially in renal-morbidity and high-morbidity. Renal-morbidity and high-morbidity showed the worst lung function throughout the follow-up, with renal-morbidity having the highest risk of infectious complications (6%), emergency visits (29%) or hospital readmissions (14%) at 6 months (p<0.01).

Interpretation

Comorbidity-based phenotypes were identified and associated with different expression of in-hospital complications, mortality, treatment response, and sequelae, with CKD playing a major role. This could help clinicians in day-to-day decision making including the management of post-discharge COVID-19 sequelae.

Funding

ISCIII, UNESPA, CIBERES, FEDER, ESF.

SUBMITTER: Benitez ID

PROVIDER: S-EPMC9148543 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study.

Benítez Iván D ID de Batlle Jordi J Torres Gerard G González Jessica J de Gonzalo-Calvo David D Targa Adriano D S ADS Gort-Paniello Clara C Moncusí-Moix Anna A Ceccato Adrián A Fernández-Barat Laia L Ferrer Ricard R Garcia-Gasulla Dario D Menéndez Rosario R Motos Anna A Peñuelas Oscar O Riera Jordi J Bermejo-Martin Jesús F JF Peñasco Yhivian Y Ricart Pilar P Martin Delgado María Cruz MC Aguilera Luciano L Rodríguez Alejandro A Boado Varela Maria Victoria MV Suarez-Sipmann Fernando F Pozo-Laderas Juan Carlos JC Solé-Violan Jordi J Nieto Maite M Novo Mariana Andrea MA Barberán José J Amaya Villar Rosario R Garnacho-Montero José J García-Garmendia Jose Luis JL Gómez José M JM Lorente José Ángel JÁ Blandino Ortiz Aaron A Tamayo Lomas Luis L López-Ramos Esther E Úbeda Alejandro A Catalán-González Mercedes M Sánchez-Miralles Angel A Martínez Varela Ignacio I Jorge García Ruth Noemí RN Franco Nieves N Gumucio-Sanguino Víctor D VD Huerta Garcia Arturo A Bustamante-Munguira Elena E Valdivia Luis Jorge LJ Caballero Jesús J Gallego Elena E Martínez de la Gándara Amalia A Castellanos-Ortega Álvaro Á Trenado Josep J Marin-Corral Judith J Albaiceta Guillermo M GM de la Torre Maria Del Carmen MDC Loza-Vázquez Ana A Vidal Pablo P Lopez Messa Juan J Añón Jose M JM Carbajales Pérez Cristina C Sagredo Victor V Bofill Neus N Carbonell Nieves N Socias Lorenzo L Barberà Carme C Estella Angel A Valledor Mendez Manuel M Diaz Emili E López Lago Ana A Torres Antoni A Barbé Ferran F

The Lancet regional health. Europe 20220529

<h4>Background</h4>The clinical heterogeneity of COVID-19 suggests the existence of different phenotypes with prognostic implications. We aimed to analyze comorbidity patterns in critically ill COVID-19 patients and assess their impact on in-hospital outcomes, response to treatment and sequelae.<h4>Methods</h4>Multicenter prospective/retrospective observational study in intensive care units of 55 Spanish hospitals. 5866 PCR-confirmed COVID-19 patients had comorbidities recorded at hospital admis ...[more]

PMID: 35655660

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Dataset Information

Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study.

Background

Methods

Findings

Interpretation

Funding

Publications

Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study.

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