Abstract
Few large series describe the clinical characteristics, outcomes and costs of COVID-19 in Western countries. This cohort reports the first 1255 adult cases receiving anti-COVID-19 treatment at a Spanish hospital (1-24 March 2020). Treatment costs were calculated. A logistic regression model was used to explore risk factors on admission associated with ARDS. A bivariate Cox proportional hazard ratio (HR) model was employed to determine the HR between individual factors and death. We included 1255 patients (median age 65 years; 57.8% male), of which 92.3% required hospitalisation. The prevalence of hypertension, cardiovascular disease and diabetes mellitus (DM) was 45.1%, 31.4% and 19.9%, respectively. Lymphocytopenia (54.8%), elevated alanine aminotransferase (33.0%) and elevated lactate dehydrogenase (58.5%) were frequent. Overall, 36.7% of patients developed ARDS, 10.0% were admitted to an ICU and 21.3% died. The most frequent antiviral combinations were lopinavir/ritonavir plus hydroxychloroquine (44.2%), followed by triple therapy with interferon beta-1b (32.7%). Corticosteroids and tocilizumab were used in 25.3% and 12.9% of patients, respectively. Total cost of anti-COVID-19 agents was €511 825 (€408/patient). By multivariate analysis, risk factors associated with ARDS included older age, obesity, DM, severe hypoxaemia, lymphocytopenia, increased creatine kinase and increased C-reactive protein. In multivariate Cox model, older age (HR 1.07, 95% CI 1.06-1.09), cardiovascular disease (HR 1.34, 95% CI 1.01-1.79), DM (HR 1.45, 95% CI 1.09-1.92), severe hypoxaemia (HR 2.01, 95% CI 1.49-2.72), lymphocytopenia (HR 1.62, 95% CI 1.20-2.20) and increased C-reactive protein (HR 1.04, 95% CI 1.02-1.06) were risk factors for mortality.
Keywords: COVID-19; Costs; Mortality; Risk factors; SARS-CoV-2; Spain.
【저자키워드】 COVID-19, SARS-CoV-2, Risk factors, Mortality, Spain, Costs, 【초록키워드】 Treatment, ARDS, Corticosteroids, therapy, Risk factors, Lopinavir/ritonavir, Hydroxychloroquine, Antiviral, Tocilizumab, Clinical characteristics, obesity, creatine, hospital, Lopinavir, Ritonavir, Diabetes Mellitus, C-reactive protein, cardiovascular disease, diabetes, outcome, risk factor, hypertension, lactate dehydrogenase, ICU, Prevalence, Cohort, lymphocytopenia, male, Patient, Older age, Spain, death, hypoxaemia, creatine kinase, hospitalisation, Admission, patients, Multivariate analysis, Lactate, Combination, Analysis, Interferon beta-1b, followed by, on admission, alanine aminotransferase, interferon beta, Factor, 95% CI, hazard ratio, median age, logistic regression model, Alanine, elevated lactate dehydrogenase, Spanish, multivariate Cox model, was used, died, required, elevated, receiving, calculated, were used, determine, Total, 【제목키워드】 cohort study, hospitalised patient,