Benitez, Ivan Dde Batlle, JordiTorres, GerardGonzalez, Jessicade Gonzalo-Calvo, DavidTarga, Adriano D SGort-Paniello, ClaraMoncusi-Moix, AnnaCeccato, AdrianFernandez-Barat, LaiaFerrer, RicardGarcia-Gasulla, DarioMenendez, RosarioMotos, AnnaPeñuelas, OscarRiera, JordiBermejo-Martin, Jesús FPeñasco, YhivianRicart, PilarMartin Delgado, María CruzAguilera, LucianoRodriguez, AlejandroBoado Varela, Maria VictoriaSuarez-Sipmann, FernandoPozo-Laderas, Juan CarlosSole-Violan, JordiNieto, MaiteNovo, Mariana AndreaBarberan, JoseAmaya Villar, RosarioGarnacho-Montero, JoseGarcia-Garmendia, Jose LuisGomez, Jose MLorente, Jose AngelBlandino Ortiz, AaronTamayo Lomas, LuisLopez-Ramos, EstherUbeda, AlejandroCatalan-Gonzalez, MercedesSanchez-Miralles, AngelMartinez Varela, IgnacioJorge Garcia, Ruth NoemiFranco, NievesGumucio-Sanguino, Victor DHuerta Garcia, ArturoBustamante-Munguira, ElenaValdivia, Luis JorgeCaballero, JesusGallego, ElenaMartinez de la Gandara, AmaliaCastellanos-Ortega, AlvaroTrenado, JosepMarin-Corral, JudithAlbaiceta, Guillermo Mde la Torre, Maria Del CarmenLoza-Vazquez, AnaVidal, PabloLopez Messa, JuanAñon, Jose MCarbajales Perez, CristinaSagredo, VictorBofill, NeusCarbonell, NievesSocias, LorenzoBarbera, CarmeEstella, AngelValledor Mendez, ManuelDiaz, EmiliLopez Lago, AnaTorres, AntoniBarbe, Ferran2023-05-032023-05-032022-05-29Benítez 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;18:100422http://hdl.handle.net/10668/22351The 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.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/COVID-19Critical carePrognosisÁrea de Gestión Sanitaria Campo de Gibraltar OesteÁrea de Gestión Sanitaria de Jerez, Costa Noroeste y Sierra de CádizÁrea de Gestión Sanitaria Sur de SevillaPatient dischargePrognosisPatient readmissionCritical illnessLatent class analysisAftercareComorbidityresearch article35655660open accessAlta del pacienteAnálisis de clases latentesComorbilidadCuidados posterioresEnfermedad vríticaPronósticoReadmisión del paciente10.1016/j.lanepe.2022.1004222666-7762PMC9148543https://doi.org/10.1016/j.lanepe.2022.100422https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9148543/pdf