Publicado en The Lancet el trabajo Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: A retrospective observational study (COQUIMA cohort), realizado por profesionales sanitarios del Hospital Universitario Quiron Salud de Madrid y Universidad Europea de Madrid.
Pablo Guisado-Vascoa,*, Sofia Valderas-Ortegab, Maria Maravillas Carralon-Gonzaleza, Ana Roda-Santacruzc, Lucia Gonzalez-Cortijod, Gabriel Sotres-Fernandeza, Eva María Martí-Ballesterose, Jose Manuel Luque-Pinillaa, Elena Almagro-Casadod, Felix J. La Coma-Lanuzaf, Ruth Barrena-Puertasa, Esteban Javier Malo-Benagesg, María Jose Monforte-Gomezh, Rocío Diez-Munari, Esther Merino-Lanzaj, Lorena Comeche-Casanovak, Margarita Remirez-de-Esparza-Oterol, María Correyero-Plazam, Manuel Recio-Rodríguezn, Margarita Rodríguez-Lopezo, María Dolores Sanchez-Manzanoa, Cristina Andreu-Vazquezp, Israel John Thuissard-Vasallop, Jose María Echave-Sustaeta María-Tomek, Daniel Carnevali-Ruiza
a Department of Internal Medicine. Hospital universitario quironsalud Madrid, Universidad Europea (Madrid), Pozuelo de Alarcon, Madrid, Spain.
b Nurse. Hospital Infectious Diseases Control Unit, Hospital universitario quironsalud Madrid, Pozuelo de Alarcon, Madrid, Spain.
c Research coordinator. Research and clinical trials unit, Hospital universitario quironsalud Madrid, Pozuelo de Alarcon, Madrid, Spain
d Department of Oncology. Hospital universitario quironsalud Madrid, Universidad Europea (Madrid), Pozuelo de Alarcon, Madrid, Spain.
e Department of Hematology, Hospital universitario quironsalud Madrid, Pozuelo de Alarcon, Madrid, Spain
f Intensive Care Unit, Hospital universitario quironsalud Madrid, Pozuelo de Alarcon, Madrid, Spain.
g Department of Angiology and Vascular Surgery, Hospital universitario quironsalud Madrid, Pozuelo de Alarcon, Madrid, Spain.
h Department of Internal Medicine, Hospital quironsalud San Jose, Madrid, Spain.
i Department of Anesthesiology, Hospital universitario quironsalud Madrid, Pozuelo de Alarcon, Madrid, Spain.
j Department of Cardiology, Hospital universitario quironsalud Madrid, Pozuelo de Alarcon, Madrid, Spain
k Department of Pneumology, Hospital universitario quironsalud Madrid, Universidad Europea (Madrid), Pozuelo de Alarcon, Madrid, Spain.
l Pharmacy Unit, Hospital universitario quironsalud Madrid, Pozuelo de Alarcon, Madrid, Spain
m Department of Rheumatology, Hospital universitario quironsalud Madrid, Pozuelo de Alarcon, Madrid, Spain
n Department of Radiology department, Hospital universitario quironsalud Madrid, Universidad Europea (Madrid), Pozuelo de Alarcon, Madrid, Spain.
o Department of Endocrinology, Hospital universitario quironsalud Madrid, Pozuelo de Alarcon, Madrid, Spain
p Statistical section, Faculty of Biomedical Science and Health, Universidad Europea (Madrid), Villaciosa de Odon, Madrid, Spain.
ABSTRACT
Background: The COVID-19 outbreak challenges the Spanish health system since March 2020. Some available therapies (antimalarials, antivirals, biological agents) were grounded on clinical case observations or basic science data. The aim of this study is to describe the characteristics and impact of different therapies on clinical outcomes in a cohort of severe COVID-19 patients.
Methods: In this retrospective, single-center, observational study, we collected sequential data on adult patients admitted to Hospital Universitario Quironsalud Madrid. Eligible patients should have a microbiolog- ical (positive test on RT-PCR assay from a nasal swab) or an epidemiological diagnosis of severe COVID-19. Demographic, baseline comorbidities, laboratory data, clinical outcomes, and treatments were compared between survivors and non-survivors. We carried out univariate and multivariate logistic regression models to assess potential risk factors for in-hospital mortality.
Findings: From March 10th to April 15th, 2020, 607 patients were included. Median age was 69 years [inter- quartile range, {IQR} 22; 65% male). The most common comorbidities were hypertension (276 [46¢94%]),