%0 Journal Article
%A Benitez, Ivan D
%A de Batlle, Jordi
%A Torres, Gerard
%A Gonzalez, Jessica
%A de Gonzalo-Calvo, David
%A Targa, Adriano D S
%A Gort-Paniello, Clara
%A Moncusi-Moix, Anna
%A Ceccato, Adrian
%A Fernandez-Barat, Laia
%A Ferrer, Ricard
%A Garcia-Gasulla, Dario
%A Menendez, Rosario
%A Motos, Anna
%A Peñuelas, Oscar
%A Riera, Jordi
%A Bermejo-Martin, Jesús F
%A Peñasco, Yhivian
%A Ricart, Pilar
%A Martin Delgado, María Cruz
%A Aguilera, Luciano
%A Rodriguez, Alejandro
%A Boado Varela, Maria Victoria
%A Suarez-Sipmann, Fernando
%A Pozo-Laderas, Juan Carlos
%A Sole-Violan, Jordi
%A Nieto, Maite
%A Novo, Mariana Andrea
%A Barberan, Jose
%A Amaya Villar, Rosario
%A Garnacho-Montero, Jose
%A Garcia-Garmendia, Jose Luis
%A Gomez, Jose M
%A Lorente, Jose Angel
%A Blandino Ortiz, Aaron
%A Tamayo Lomas, Luis
%A Lopez-Ramos, Esther
%A Ubeda, Alejandro
%A Catalan-Gonzalez, Mercedes
%A Sanchez-Miralles, Angel
%A Martinez Varela, Ignacio
%A Jorge Garcia, Ruth Noemi
%A Franco, Nieves
%A Gumucio-Sanguino, Victor D
%A Huerta Garcia, Arturo
%A Bustamante-Munguira, Elena
%A Valdivia, Luis Jorge
%A Caballero, Jesus
%A Gallego, Elena
%A Martinez de la Gandara, Amalia
%A Castellanos-Ortega, Alvaro
%A Trenado, Josep
%A Marin-Corral, Judith
%A Albaiceta, Guillermo M
%A de la Torre, Maria Del Carmen
%A Loza-Vazquez, Ana
%A Vidal, Pablo
%A Lopez Messa, Juan
%A Añon, Jose M
%A Carbajales Perez, Cristina
%A Sagredo, Victor
%A Bofill, Neus
%A Carbonell, Nieves
%A Socias, Lorenzo
%A Barbera, Carme
%A Estella, Angel
%A Valledor Mendez, Manuel
%A Diaz, Emili
%A Lopez Lago, Ana
%A Torres, Antoni
%A Barbe, Ferran
%T Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study.
%D 2022
%U http://hdl.handle.net/10668/22351
%X 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. 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. 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 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. 
%K COVID-19
%K Critical care
%K Prognosis
%K Área de Gestión Sanitaria Campo de Gibraltar Oeste
%K Área de Gestión Sanitaria de Jerez, Costa Noroeste y Sierra de Cádiz
%K Área de Gestión Sanitaria Sur de Sevilla
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