|
1
|
Pérez-García CN, Enríquez-Vázquez D, Méndez-Bailón M, Olmos C, Gómez-Polo JC, Iguarán R, Ramos-López N, García-Klepzig JL, Ferrández-Escarabajal M, Jerónimo A, Martínez-Gómez E, Font-Urgelles J, Fragiel-Saavedra M, Paz-Arias P, Romero-Delgado T, Gómez-Álvarez Z, Playán-Escribano J, Jaén E, Vargas G, González E, Orviz E, Burruezo I, Calvo A, Nieto Á, Molino Á, Lorenzo-Villalba N, Andrès E, Macaya C, Vilacosta I. The SADDEN DEATH Study: Results from a Pilot Study in Non-ICU COVID-19 Spanish Patients. J Clin Med 2021; 10:jcm10040825. [PMID: 33670462 PMCID: PMC7922313 DOI: 10.3390/jcm10040825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/14/2021] [Accepted: 02/17/2021] [Indexed: 12/18/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Carlos Nicolás Pérez-García
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
- Correspondence: ; Tel.: +34-913302712; Fax: +34-913303290
| | - Daniel Enríquez-Vázquez
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | - Manuel Méndez-Bailón
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - Carmen Olmos
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | - Juan Carlos Gómez-Polo
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | - Rosario Iguarán
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | - Noemí Ramos-López
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - José Luis García-Klepzig
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - Marcos Ferrández-Escarabajal
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | - Adrián Jerónimo
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | - Eduardo Martínez-Gómez
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | | | - Marcos Fragiel-Saavedra
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - Pilar Paz-Arias
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - Teresa Romero-Delgado
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | - Zaira Gómez-Álvarez
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | - Julia Playán-Escribano
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | - Esther Jaén
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - Gianna Vargas
- Servicio de Neumología, Hospital Clínico San Carlos, 28040 Madrid, Spain; (G.V.); (E.G.)
| | - Elizabeth González
- Servicio de Neumología, Hospital Clínico San Carlos, 28040 Madrid, Spain; (G.V.); (E.G.)
| | - Eva Orviz
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - Irene Burruezo
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - Alberto Calvo
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - Ángel Nieto
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - Ángel Molino
- Servicio de Medicina Interna, Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.M.-B.); (N.R.-L.); (J.L.G.-K.); (M.F.-S.); (P.P.-A.); (E.J.); (E.O.); (I.B.); (A.C.); (Á.N.); (Á.M.)
| | - Noël Lorenzo-Villalba
- Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France; (N.L.-V.); (E.A.)
| | - Emmanuel Andrès
- Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France; (N.L.-V.); (E.A.)
| | - Carlos Macaya
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| | - Isidre Vilacosta
- Instituto Cardiovascular, Hospital Clínico San Carlos, 28040 Madrid, Spain; (D.E.-V.); (C.O.); (J.C.G.-P.); (R.I.); (M.F.-E.); (A.J.); (E.M.-G.); (T.R.-D.); (Z.G.-Á.); (J.P.-E.); (C.M.); (I.V.)
| |
Collapse
|