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The SADDEN DEATH Study: Results from a Pilot Study in Non-ICU COVID-19 Spanish Patients

Introduction: The worldwide pandemic, coronavirus disease 2019 (COVID-19) is a novel infection with serious clinical manifestations, including death. Our aim is to describe the first non-ICU Spanish deceased series with COVID-19, comparing specifically between unexpected and expected deaths. Methods...

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Autores principales: Pérez-García, Carlos Nicolás, Enríquez-Vázquez, Daniel, Méndez-Bailón, Manuel, Olmos, Carmen, Gómez-Polo, Juan Carlos, Iguarán, Rosario, Ramos-López, Noemí, García-Klepzig, José Luis, Ferrández-Escarabajal, Marcos, Jerónimo, Adrián, Martínez-Gómez, Eduardo, Font-Urgelles, Judit, Fragiel-Saavedra, Marcos, Paz-Arias, Pilar, Romero-Delgado, Teresa, Gómez-Álvarez, Zaira, Playán-Escribano, Julia, Jaén, Esther, Vargas, Gianna, González, Elizabeth, Orviz, Eva, Burruezo, Irene, Calvo, Alberto, Nieto, Ángel, Molino, Ángel, Lorenzo-Villalba, Noël, Andrès, Emmanuel, Macaya, Carlos, Vilacosta, Isidre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922313/
https://www.ncbi.nlm.nih.gov/pubmed/33670462
http://dx.doi.org/10.3390/jcm10040825
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author Pérez-García, Carlos Nicolás
Enríquez-Vázquez, Daniel
Méndez-Bailón, Manuel
Olmos, Carmen
Gómez-Polo, Juan Carlos
Iguarán, Rosario
Ramos-López, Noemí
García-Klepzig, José Luis
Ferrández-Escarabajal, Marcos
Jerónimo, Adrián
Martínez-Gómez, Eduardo
Font-Urgelles, Judit
Fragiel-Saavedra, Marcos
Paz-Arias, Pilar
Romero-Delgado, Teresa
Gómez-Álvarez, Zaira
Playán-Escribano, Julia
Jaén, Esther
Vargas, Gianna
González, Elizabeth
Orviz, Eva
Burruezo, Irene
Calvo, Alberto
Nieto, Ángel
Molino, Ángel
Lorenzo-Villalba, Noël
Andrès, Emmanuel
Macaya, Carlos
Vilacosta, Isidre
author_facet Pérez-García, Carlos Nicolás
Enríquez-Vázquez, Daniel
Méndez-Bailón, Manuel
Olmos, Carmen
Gómez-Polo, Juan Carlos
Iguarán, Rosario
Ramos-López, Noemí
García-Klepzig, José Luis
Ferrández-Escarabajal, Marcos
Jerónimo, Adrián
Martínez-Gómez, Eduardo
Font-Urgelles, Judit
Fragiel-Saavedra, Marcos
Paz-Arias, Pilar
Romero-Delgado, Teresa
Gómez-Álvarez, Zaira
Playán-Escribano, Julia
Jaén, Esther
Vargas, Gianna
González, Elizabeth
Orviz, Eva
Burruezo, Irene
Calvo, Alberto
Nieto, Ángel
Molino, Ángel
Lorenzo-Villalba, Noël
Andrès, Emmanuel
Macaya, Carlos
Vilacosta, Isidre
author_sort Pérez-García, Carlos Nicolás
collection PubMed
description Introduction: The worldwide pandemic, coronavirus disease 2019 (COVID-19) is a novel infection with serious clinical manifestations, including death. Our aim is to describe the first non-ICU Spanish deceased series with COVID-19, comparing specifically between unexpected and expected deaths. Methods: In this single-centre study, all deceased inpatients with laboratory-confirmed COVID-19 who had died from March 4 to April 16, 2020 were consecutively included. Demographic, clinical, treatment, and laboratory data, were analyzed and compared between groups. Factors associated with unexpected death were identified by multivariable logistic regression methods. Results: In total, 324 deceased patients were included. Median age was 82 years (IQR 76–87); 55.9% males. The most common cardiovascular risk factors were hypertension (78.4%), hyperlipidemia (57.7%), and diabetes (34.3%). Other common comorbidities were chronic kidney disease (40.1%), chronic pulmonary disease (30.3%), active cancer (13%), and immunosuppression (13%). The Confusion, BUN, Respiratory Rate, Systolic BP and age ≥65 (CURB-65) score at admission was >2 in 40.7% of patients. During hospitalization, 77.8% of patients received antivirals, 43.3% systemic corticosteroids, and 22.2% full anticoagulation. The rate of bacterial co-infection was 5.5%, and 105 (32.4%) patients had an increased level of troponin I. The median time from initiation of therapy to death was 5 days (IQR 3.0–8.0). In 45 patients (13.9%), the death was exclusively attributed to COVID-19, and in 254 patients (78.4%), both COVID-19 and the clinical status before admission contributed to death. Progressive respiratory failure was the most frequent cause of death (92.0%). Twenty-five patients (7.7%) had an unexpected death. Factors independently associated with unexpected death were male sex, chronic kidney disease, insulin-treated diabetes, and functional independence. Conclusions: This case series provides in-depth characterization of hospitalized non-ICU COVID-19 patients who died in Madrid. Male sex, insulin-treated diabetes, chronic kidney disease, and independency for activities of daily living are predictors of unexpected death.
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spelling pubmed-79223132021-03-03 The SADDEN DEATH Study: Results from a Pilot Study in Non-ICU COVID-19 Spanish Patients Pérez-García, Carlos Nicolás Enríquez-Vázquez, Daniel Méndez-Bailón, Manuel Olmos, Carmen Gómez-Polo, Juan Carlos Iguarán, Rosario Ramos-López, Noemí García-Klepzig, José Luis Ferrández-Escarabajal, Marcos Jerónimo, Adrián Martínez-Gómez, Eduardo Font-Urgelles, Judit Fragiel-Saavedra, Marcos Paz-Arias, Pilar Romero-Delgado, Teresa Gómez-Álvarez, Zaira Playán-Escribano, Julia Jaén, Esther Vargas, Gianna González, Elizabeth Orviz, Eva Burruezo, Irene Calvo, Alberto Nieto, Ángel Molino, Ángel Lorenzo-Villalba, Noël Andrès, Emmanuel Macaya, Carlos Vilacosta, Isidre J Clin Med Article Introduction: The worldwide pandemic, coronavirus disease 2019 (COVID-19) is a novel infection with serious clinical manifestations, including death. Our aim is to describe the first non-ICU Spanish deceased series with COVID-19, comparing specifically between unexpected and expected deaths. Methods: In this single-centre study, all deceased inpatients with laboratory-confirmed COVID-19 who had died from March 4 to April 16, 2020 were consecutively included. Demographic, clinical, treatment, and laboratory data, were analyzed and compared between groups. Factors associated with unexpected death were identified by multivariable logistic regression methods. Results: In total, 324 deceased patients were included. Median age was 82 years (IQR 76–87); 55.9% males. The most common cardiovascular risk factors were hypertension (78.4%), hyperlipidemia (57.7%), and diabetes (34.3%). Other common comorbidities were chronic kidney disease (40.1%), chronic pulmonary disease (30.3%), active cancer (13%), and immunosuppression (13%). The Confusion, BUN, Respiratory Rate, Systolic BP and age ≥65 (CURB-65) score at admission was >2 in 40.7% of patients. During hospitalization, 77.8% of patients received antivirals, 43.3% systemic corticosteroids, and 22.2% full anticoagulation. The rate of bacterial co-infection was 5.5%, and 105 (32.4%) patients had an increased level of troponin I. The median time from initiation of therapy to death was 5 days (IQR 3.0–8.0). In 45 patients (13.9%), the death was exclusively attributed to COVID-19, and in 254 patients (78.4%), both COVID-19 and the clinical status before admission contributed to death. Progressive respiratory failure was the most frequent cause of death (92.0%). Twenty-five patients (7.7%) had an unexpected death. Factors independently associated with unexpected death were male sex, chronic kidney disease, insulin-treated diabetes, and functional independence. Conclusions: This case series provides in-depth characterization of hospitalized non-ICU COVID-19 patients who died in Madrid. Male sex, insulin-treated diabetes, chronic kidney disease, and independency for activities of daily living are predictors of unexpected death. MDPI 2021-02-18 /pmc/articles/PMC7922313/ /pubmed/33670462 http://dx.doi.org/10.3390/jcm10040825 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pérez-García, Carlos Nicolás
Enríquez-Vázquez, Daniel
Méndez-Bailón, Manuel
Olmos, Carmen
Gómez-Polo, Juan Carlos
Iguarán, Rosario
Ramos-López, Noemí
García-Klepzig, José Luis
Ferrández-Escarabajal, Marcos
Jerónimo, Adrián
Martínez-Gómez, Eduardo
Font-Urgelles, Judit
Fragiel-Saavedra, Marcos
Paz-Arias, Pilar
Romero-Delgado, Teresa
Gómez-Álvarez, Zaira
Playán-Escribano, Julia
Jaén, Esther
Vargas, Gianna
González, Elizabeth
Orviz, Eva
Burruezo, Irene
Calvo, Alberto
Nieto, Ángel
Molino, Ángel
Lorenzo-Villalba, Noël
Andrès, Emmanuel
Macaya, Carlos
Vilacosta, Isidre
The SADDEN DEATH Study: Results from a Pilot Study in Non-ICU COVID-19 Spanish Patients
title The SADDEN DEATH Study: Results from a Pilot Study in Non-ICU COVID-19 Spanish Patients
title_full The SADDEN DEATH Study: Results from a Pilot Study in Non-ICU COVID-19 Spanish Patients
title_fullStr The SADDEN DEATH Study: Results from a Pilot Study in Non-ICU COVID-19 Spanish Patients
title_full_unstemmed The SADDEN DEATH Study: Results from a Pilot Study in Non-ICU COVID-19 Spanish Patients
title_short The SADDEN DEATH Study: Results from a Pilot Study in Non-ICU COVID-19 Spanish Patients
title_sort sadden death study: results from a pilot study in non-icu covid-19 spanish patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922313/
https://www.ncbi.nlm.nih.gov/pubmed/33670462
http://dx.doi.org/10.3390/jcm10040825
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