Introduction This study analyzed the impact of a categorized approach, based on patients’ prognosis, on major outcomes and explanators in patients hospitalized for COVID-19 pneumonia in an academic center in Spain. Methods Retrospective cohort study (March 3 to May 2, 2020). Patients were categorized according to the followed clinical management, as maximum care or limited therapeutic effort (LTE). Main outcomes were all-cause mortality and need for invasive mechanical ventilation (IMV). Baseline factors associated with outcomes were analyzed by multiple logistic regression, estimating odds ratios (OR; 95%CI). Results Thirty-hundred and six patients were hospitalized, median age 65.0 years, 57.8% males, 53.3% Charlson index ≥3. The overall all-cause fatality rate was 15.0% (n = 46). Maximum care was provided in 238 (77.8%), IMV was used in 38 patients (16.0%), and 5.5% died. LTE was decided in 68 patients (22.2%), none received IMV and fatality was 48.5%. Independent risk factors of mortality under maximum care were lymphocytes <790/mm 3 , troponin T >15ng/L and hypotension. Advanced age, lymphocytes <790/mm 3 and BNP >240pg/mL independently associated with IMV requirement. Conclusion Overall fatality in the cohort was 15% but markedly varied regarding the decided approach (maximum care versus LTE), translating into nine-fold higher mortality and different risk factors.
【초록키워드】 COVID-19, Risk factors, Hospitalized, Mortality, Prognosis, Pneumonia, outcome, risk factor, cohort study, lymphocyte, Cohort, therapeutic, Patient, Spain, Logistic regression, Clinical management, age, Care, fatality, BNP, Invasive mechanical ventilation, Odds ratio, Charlson index, Factor, 95%CI, median age, all-cause mortality, Fatality rate, effort, maximum, approach, IMV, males, Result, analyzed, was used, died, provided, patients hospitalized, 【제목키워드】 COVID-19, Prognosis, risk, Care, retrospective cohort study, approach, feature,