6 results on '"Arnalich Fernández, Francisco"'
Search Results
2. Clinical Characteristics and Risk Factors for Mortality in Very Old Patients Hospitalized With COVID-19 in Spain
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Ramos-Rincon, Jose-Manuel, Buonaiuto, Verónica, Ricci, Michele, Martín-Carmona, Jesica, Paredes-Ruíz, Diana, Calderón-Moreno, María, Rubio-Rivas, Manel, Beato-Pérez, José-Luis, Arnalich-Fernández, Francisco, Monge-Monge, Daniel, Vargas-Núñez, Juan-Antonio, Acebes-Repiso, Gonzalo, Mendez-Bailon, Manuel, Perales-Fraile, Isabel, García-García, Gema-María, Guisado-Vasco, Pablo, Abdelhady-Kishta, Alaaeldeen, Pascual-Pérez, Maria-de-Los-Reyes, Rodríguez-Fernández-Viagas, Cristina, Montaño-Martínez, Adrián, López-Ruiz, Antonio, Gonzalez-Juarez, Maria-Jesus, Pérez-García, Cristina, Casas-Rojo, José-Manuel, Gómez-Huelgas, Ricardo, and SEMI-COVID-19 Network
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Male ,Aging ,medicine.medical_specialty ,Age ≥ 80 ,Pneumonia, Viral ,Renal function ,030204 cardiovascular system & hematology ,Prognostic factors ,Logistic regression ,AcademicSubjects/MED00280 ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Humans ,Medicine ,Hospital Mortality ,030212 general & internal medicine ,Mortality ,Risk factor ,Retrospective Studies ,Aged, 80 and over ,SARS-CoV-2 ,business.industry ,COVID-19 ,Age = 80 ,Retrospective cohort study ,=+80%22">Age >= 80 ,Prognosis ,medicine.disease ,Comorbidity ,Hospitalization ,Ageing ,Spain ,Cohort ,AcademicSubjects/SCI00960 ,Female ,Observational study ,Geriatrics and Gerontology ,business ,Research Article - Abstract
Background Advanced age is a well-known risk factor for poor prognosis in COVID-19. However, few studies have specifically focused on very old inpatients with COVID-19. This study aims to describe the clinical characteristics of very old inpatients with COVID-19 and identify risk factors for in-hospital mortality at admission. Methods We conducted a nationwide, multicenter, retrospective, observational study in patients ≥ 80 years hospitalized with COVID-19 in 150 Spanish hospitals (SEMI-COVID-19) Registry (March 1–May 29, 2020). The primary outcome was in-hospital mortality. A uni- and multivariate logistic regression was performed to assess predictors of mortality at admission. Results A total of 2772 consecutive patients (49.4% men, median age 86.3 years) were analyzed. Rates of atherosclerotic cardiovascular disease, diabetes mellitus, dementia, and Barthel Index < 60 were 30.8%, 25.6%, 30.5%, and 21.0%, respectively. The overall case-fatality rate was 46.9% (n: 1301) and increased with age (80–84 years: 41.6%; 85–90 years: 47.3%; 90–94 years: 52.7%; ≥95 years: 54.2%). After analysis, male sex and moderate-to-severe dependence were independently associated with in-hospital mortality; comorbidities were not predictive. At admission, independent risk factors for death were: oxygen saturation < 90%; temperature ≥ 37.8°C; quick sequential organ failure assessment (qSOFA) score ≥ 2; and unilateral–bilateral infiltrates on chest x-rays. Some analytical findings were independent risk factors for death, including estimated glomerular filtration rate < 45 mL/min/1.73 m2; lactate dehydrogenase ≥ 500 U/L; C-reactive protein ≥ 80 mg/L; neutrophils ≥ 7.5 × 103/μL; lymphocytes < 0.8 × 103/μL; and monocytes < 0.5 × 103/μL. Conclusions This first large, multicenter cohort of very old inpatients with COVID-19 shows that age, male sex, and poor preadmission functional status—not comorbidities—are independently associated with in-hospital mortality. Severe COVID-19 at admission is related to poor prognosis.
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- 2020
3. Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19
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Roy Vallejo, Emilia, Sánchez Purificación, Aquilino, Torres Peña, José, Sánchez Moreno, Beatriz, Arnalich Fernández, Francisco, García Blanco, María, López Miranda, José, Romero Cabrera, Juan, Herrero Gil, Carmen, Bascunana, José, Rubio-Rivas, Manuel, Pintos Otero, Sara, Martínez Sempere, Verónica, Ballano Rodríguez-Solís, Jesús, Gil Sánchez, Ricardo, Luque del Pino, Jairo, González Noya, Amara, Navas Alcántara, María, Cortés Rodríguez, Begoña, Alcalá, José, Suárez Lombraña, Ana, Andrés Soler, Jorge, Gómez Huelgas, Ricardo, Casas Rojo, José, Millán Núñez-Cortés, Jesús, and SEMI-COVID-19 Network
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medicine.medical_specialty ,Angiotensin receptor ,Coronavirus disease 2019 (COVID-19) ,Pronòstic mèdic ,medicine.medical_treatment ,MACE ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Pacients hospitalitzats ,Article ,Hospital patients ,law.invention ,ACEI, ARB, COVID-19, MACE, prognosis ,03 medical and health sciences ,0302 clinical medicine ,COVID‐19 ,law ,Internal medicine ,medicine ,Clinical endpoint ,030212 general & internal medicine ,cardiovascular diseases ,Mechanical ventilation ,biology ,business.industry ,Incidence (epidemiology) ,COVID-19 ,Angiotensin-converting enzyme ,General Medicine ,ARB ,Prognosis ,Intensive care unit ,female genital diseases and pregnancy complications ,Hospitals ,biology.protein ,Medicine ,prognosis ,business ,Mace ,ACEI - Abstract
Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female, 2162 patients received ACEI/ARB treatment. ACEI/ARB treatment showed lower all-cause mortality (p <, 0.0001). Hypertensive patients in the ACEI/ARB group had better results in IMV, ICU admission, and the composite outcome of prognosis (p <, 0.0001 for all). No differences were found in the incidence of major adverse cardiovascular events. Patients previously treated with ACEI/ARB continuing treatment during hospitalization had a lower incidence of the composite outcome of prognosis than those whose treatment was withdrawn (RR 0.67, 95%CI 0.63–0.76). ARB was associated with better survival than ACEI (HR 0.77, 95%CI 0.62–0.96). ACEI/ARB treatment during COVID-19 hospitalization was associated with protection on mortality. The benefits were greater in hypertensive, those who continued treatment, and those taking ARB.
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- 2021
4. Gender-Based Differences by Age Range in Patients Hospitalized with COVID-19: A Spanish Observational Cohort Study
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Josa Laorden, Claudia, Crestelo Vieitez, Anxela, García Andreu, María, Rubio-Rivas, Manuel, Sánchez, Marcos, Toledo Samaniego, Neera, Arnalich Fernández, Francisco, Iguaran Bermudez, Rosario, Fonseca Aizpuru, Eva, Vargas Núñez, Juan Antonio, Pesqueira Fontan, Paula Maria, Serrano Ballesteros, Jorge, Freire Castro, Santiago, Pestaña Fernández, Melani, Viana García, Alba, Nuñez Rodriguez, Victoria, Giner Galvañ, Vicente, Carrasco Sánchez, Francisco, Hernández Milián, Almudena, Cobos Siles, Marta, Napal Lecumberri, Jose, Herrero García, Virginia, Pascual Pérez, Maria, Millán Núñez-Cortés, Jesús, Casas Rojo, José, SEMI-COVID-19 Network, UAM. Departamento de Medicina, and Instituto de Investigación Sanitaria Hospital Universitario de La Paz (IdiPAZ)
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medicine.medical_specialty ,Multivariate analysis ,Medicina ,medicine.medical_treatment ,coronavirus ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Lower risk ,Article ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Internal medicine ,medicine ,Factors sexuals en les malalties ,030212 general & internal medicine ,Espanya ,Mechanical ventilation ,business.industry ,SARS-CoV-2 ,Mortality rate ,lcsh:R ,COVID-19 ,General Medicine ,Intensive care unit ,gender differences ,Spain ,Sex factors in disease ,Observational study ,Complication ,business ,Cohort study - Abstract
There is some evidence that male gender could have a negative impact on the prognosis and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of the present study was to compare the characteristics of coronavirus disease 2019 (COVID-19) between hospitalized men and women with confirmed SARS-CoV-2 infection. This multicenter, retrospective, observational study is based on the SEMI-COVID-19 Registry. We analyzed the differences between men and women for a wide variety of demographic, clinical, and treatment variables, and the sex distribution of the reported COVID-19 deaths, as well as intensive care unit (ICU) admission by age subgroups. This work analyzed 12,063 patients (56.8% men). The women in our study were older than the men, on average (67.9 vs. 65.7 years; p < 001). Bilateral condensation was more frequent among men than women (31.8% vs. 29.9%; p = 0.007). The men needed non-invasive and invasive mechanical ventilation more frequently (5.6% vs. 3.6%, p < 0.001, and 7.9% vs. 4.8%, p < 0.001, respectively). The most prevalent complication was acute respiratory distress syndrome, with severe cases in 19.9% of men (p < 0.001). In men, intensive care unit admission was more frequent (10% vs. 6.1%; p < 0.001) and the mortality rate was higher (23.1% vs. 18.9%; p < 0.001). Regarding mortality, the differences by gender were statistically significant in the age groups from 55 years to 89 years of age. A multivariate analysis showed that female sex was significantly and independently associated with a lower risk of mortality in our study. Male sex appears to be related to worse progress in COVID-19 patients and is an independent prognostic factor for mortality. In order to fully understand its prognostic impact, other factors associated with sex must be considered.
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- 2021
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5. Predicting critical illness on initial diagnosis of COVID-19 based on easily obtained clinical variables: development and validation of the PRIORITY model
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Martínez Lacalzada, Miguel, Viteri Noël, Adrián, Manzano Espinosa, Luis, Fabregate, Martin, Rubio Rivas, Manuel, Luis García, Sara, Arnalich Fernández, Francisco, Beato Pérez, José Luis, Vargas Núñez, Juan Antonio, Calvo Manuel, Elpidio, Espiño Álvarez, Alexia Constanza, Freire Castro, Santiago J., Loureiro Amigo, Jose, Pesqueira Fontan, Paula Maria, Pina, Adela, Álvarez Suárez, Ana María, Silva Asiain, Andrea, García López, Beatriz, Luque del Pino, Jairo, Sanz Cánovas, Jaime, Chazarra Pérez, Paloma, García García, Gema María, Núñez Cortés, Jesús Millán, Casas Rojo, José Manuel, Gómez Huelgas, Ricardo, Abrego Vaca, Luis F., Andreu Arnanz, Ana, Arce García, Octavio A., Bajo González, Marta, Borque Sanz, Pablo, Cózar Llistó, Alberto, Hoyo Cuenda, Beatriz del, Gamboa Osorio, Alejandra, García Sánchez, Isabel, López Cisneros, Óscar A., Merino Ortiz, Borja, Riera González, Elisa, Rey García, Jimena, Sánchez Díaz, Cristina, Starita Fajardo, Grisell, Suárez Carantoña, Cecilia, Zhilina Zhilina, Svetlana, SEMI-COVID-19 Network, and UAM. Departamento de Medicina
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Microbiology (medical) ,medicine.medical_specialty ,Evidence-based medicine ,Prognostic models ,Referral ,Medicina ,Critical Illness ,Logistic regression ,Initial assessment ,Risk Assessment ,law.invention ,law ,medicine ,Humans ,Medical history ,Generalizability theory ,Hospital Mortality ,Retrospective Studies ,business.industry ,Medicina basada en l'evidència ,COVID-19 ,Easily obtained clinical variables ,General Medicine ,Models, Theoretical ,medicine.disease ,Intensive care unit ,Confidence interval ,Hospitalization ,Infectious Diseases ,Spain ,Emergency medicine ,Cohort ,Critical illness ,business ,Kidney disease - Abstract
Objectives: We aimed to develop and validate a prediction model, based on clinical history and examination findings on initial diagnosis of coronavirus disease 2019 (COVID-19), to identify patients at risk of critical outcomes. Methods: We used data from the SEMI-COVID-19 Registry, a cohort of consecutive patients hospitalized for COVID-19 from 132 centres in Spain (23rd March to 21st May 2020). For the development cohort, tertiary referral hospitals were selected, while the validation cohort included smaller hospitals. The primary outcome was a composite of in-hospital death, mechanical ventilation, or admission to intensive care unit. Clinical signs and symptoms, demographics, and medical history ascertained at presentation were screened using least absolute shrinkage and selection operator, and logistic regression was used to construct the predictive model. Results: There were 10 433 patients, 7850 in the development cohort (primary outcome 25.1%, 1967/7850) and 2583 in the validation cohort (outcome 27.0%, 698/2583). The PRIORITY model included: age, dependency, cardiovascular disease, chronic kidney disease, dyspnoea, tachypnoea, confusion, systolic blood pressure, and SpO2 ≤93% or oxygen requirement. The model showed high discrimination for critical illness in both the development (C-statistic 0.823; 95% confidence interval (CI) 0.813, 0.834) and validation (C-statistic 0.794; 95%CI 0.775, 0.813) cohorts. A freely available web-based calculator was developed based on this model (https://www.evidencio.com/models/show/2344). Conclusions: The PRIORITY model, based on easily obtained clinical information, had good discrimination and generalizability for identifying COVID-19 patients at risk of critical outcomes., No funding was received for this work.
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- 2021
6. Inappropriate antibiotic use in the COVID-19 era: Factors associated with inappropriate prescribing and secondary complications. Analysis of the registry SEMI-COVID
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Calderón Parra, Jorge, Muiño Míguez, Antonio, Bendala Estrada, Alejandro David, Ramos Martínez, Antonio, Muñez Rubio, Elena, Fernández Carracedo, Eduardo, Tejada Montes, Javier, Rubio-Rivas, Manuel, Arnalich Fernández, Francisco, Beato Pérez, Jose Luis, García Bruñén, Jose Miguel, Corral-Beamonte, Esther del, Pesqueira Fontan, Paula Maria, Carmona, Maria Del Mar, Fernández-Madera Martínez, Rosa, González García, Andrés, Salazar Mosteiro, Cristina, Tuñón de Almeida, Carlota, González Moraleja, Julio, Deodati, Francesco, Martín Escalante, María Dolores, Asensio Tomás, María Luisa, Gómez Huelgas, Ricardo, Casas Rojo, José, Millán Núñez-Cortés, Jesús, and For The Semi-covid-19 Network
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0301 basic medicine ,Male ,Viral Diseases ,Epidemiology ,Physiology ,Antibiotics ,Fevers ,Inappropriate Prescribing ,Comorbidity ,medicine.disease_cause ,Medical Conditions ,0302 clinical medicine ,Risk Factors ,Medicine and Health Sciences ,Coughing ,Odds Ratio ,Medicine ,030212 general & internal medicine ,Registries ,Multidisciplinary ,Antimicrobials ,Drugs ,Acute Kidney Injury ,Middle Aged ,Anti-Bacterial Agents ,Infectious Diseases ,C-Reactive Protein ,Superinfection ,Cohort ,Female ,Research Article ,medicine.medical_specialty ,Fever ,medicine.drug_class ,Science ,Immunology ,030106 microbiology ,Pharmacy practice ,Microbiology ,Autoimmune Diseases ,03 medical and health sciences ,Signs and Symptoms ,Antibiotic resistance ,Microbial Control ,Internal medicine ,Humans ,Medical prescription ,Aged ,Retrospective Studies ,Atenció farmacèutica ,Pharmacology ,business.industry ,SARS-CoV-2 ,Pharmacy--Practice ,Biology and Life Sciences ,COVID-19 ,Covid 19 ,Retrospective cohort study ,Odds ratio ,medicine.disease ,Dyspnea ,Logistic Models ,Cough ,Antibiotic Resistance ,Medical Risk Factors ,Clinical Immunology ,Antimicrobial Resistance ,Clinical Medicine ,Physiological Processes ,business - Abstract
Background Most patients with COVID-19 receive antibiotics despite the fact that bacterial co-infections are rare. This can lead to increased complications, including antibacterial resistance. We aim to analyze risk factors for inappropriate antibiotic prescription in these patients and describe possible complications arising from their use. Methods The SEMI-COVID-19 Registry is a multicenter, retrospective patient cohort. Patients with antibiotic were divided into two groups according to appropriate or inappropriate prescription, depending on whether the patient fulfill any criteria for its use. Comparison was made by means of multilevel logistic regression analysis. Possible complications of antibiotic use were also identified. Results Out of 13,932 patients, 3047 (21.6%) were prescribed no antibiotics, 6116 (43.9%) were appropriately prescribed antibiotics, and 4769 (34.2%) were inappropriately prescribed antibiotics. The following were independent factors of inappropriate prescription: February-March 2020 admission (OR 1.54, 95%CI 1.18–2.00), age (OR 0.98, 95%CI 0.97–0.99), absence of comorbidity (OR 1.43, 95%CI 1.05–1.94), dry cough (OR 2.51, 95%CI 1.94–3.26), fever (OR 1.33, 95%CI 1.13–1.56), dyspnea (OR 1.31, 95%CI 1.04–1.69), flu-like symptoms (OR 2.70, 95%CI 1.75–4.17), and elevated C-reactive protein levels (OR 1.01 for each mg/L increase, 95% CI 1.00–1.01). Adverse drug reactions were more frequent in patients who received ANTIBIOTIC (4.9% vs 2.7%, p < .001). Conclusion The inappropriate use of antibiotics was very frequent in COVID-19 patients and entailed an increased risk of adverse reactions. It is crucial to define criteria for their use in these patients. Knowledge of the factors associated with inappropriate prescribing can be helpful.
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- 2021
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