RT Journal Article
T1 Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study.
A1 Benitez, Ivan D
A1 de Batlle, Jordi
A1 Torres, Gerard
A1 Gonzalez, Jessica
A1 de Gonzalo-Calvo, David
A1 Targa, Adriano D S
A1 Gort-Paniello, Clara
A1 Moncusi-Moix, Anna
A1 Ceccato, Adrian
A1 Fernandez-Barat, Laia
A1 Ferrer, Ricard
A1 Garcia-Gasulla, Dario
A1 Menendez, Rosario
A1 Motos, Anna
A1 Peñuelas, Oscar
A1 Riera, Jordi
A1 Bermejo-Martin, Jesús F
A1 Peñasco, Yhivian
A1 Ricart, Pilar
A1 Martin Delgado, María Cruz
A1 Aguilera, Luciano
A1 Rodriguez, Alejandro
A1 Boado Varela, Maria Victoria
A1 Suarez-Sipmann, Fernando
A1 Pozo-Laderas, Juan Carlos
A1 Sole-Violan, Jordi
A1 Nieto, Maite
A1 Novo, Mariana Andrea
A1 Barberan, Jose
A1 Amaya Villar, Rosario
A1 Garnacho-Montero, Jose
A1 Garcia-Garmendia, Jose Luis
A1 Gomez, Jose M
A1 Lorente, Jose Angel
A1 Blandino Ortiz, Aaron
A1 Tamayo Lomas, Luis
A1 Lopez-Ramos, Esther
A1 Ubeda, Alejandro
A1 Catalan-Gonzalez, Mercedes
A1 Sanchez-Miralles, Angel
A1 Martinez Varela, Ignacio
A1 Jorge Garcia, Ruth Noemi
A1 Franco, Nieves
A1 Gumucio-Sanguino, Victor D
A1 Huerta Garcia, Arturo
A1 Bustamante-Munguira, Elena
A1 Valdivia, Luis Jorge
A1 Caballero, Jesus
A1 Gallego, Elena
A1 Martinez de la Gandara, Amalia
A1 Castellanos-Ortega, Alvaro
A1 Trenado, Josep
A1 Marin-Corral, Judith
A1 Albaiceta, Guillermo M
A1 de la Torre, Maria Del Carmen
A1 Loza-Vazquez, Ana
A1 Vidal, Pablo
A1 Lopez Messa, Juan
A1 Añon, Jose M
A1 Carbajales Perez, Cristina
A1 Sagredo, Victor
A1 Bofill, Neus
A1 Carbonell, Nieves
A1 Socias, Lorenzo
A1 Barbera, Carme
A1 Estella, Angel
A1 Valledor Mendez, Manuel
A1 Diaz, Emili
A1 Lopez Lago, Ana
A1 Torres, Antoni
A1 Barbe, Ferran
K1 COVID-19
K1 Critical care
K1 Prognosis
K1 Área de Gestión Sanitaria Campo de Gibraltar Oeste
K1 Área de Gestión Sanitaria de Jerez, Costa Noroeste y Sierra de Cádiz
K1 Área de Gestión Sanitaria Sur de Sevilla
AB 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. 
PB The Lancet Publishing Group
YR 2022
FD 2022-05-29
LK http://hdl.handle.net/10668/22351
UL http://hdl.handle.net/10668/22351
LA en
NO Benítez ID, de Batlle J, Torres G, González J, de Gonzalo-Calvo D, Targa ADS, et al. Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study. Lancet Reg Health Eur. 2022 May 29;18:100422
DS RISalud
RD Apr 17, 2025