Serveur d'exploration sur la COVID chez les séniors

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Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection.

Identifieur interne : 000315 ( Main/Exploration ); précédent : 000314; suivant : 000316

Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection.

Auteurs : Donogh Maguire [Royaume-Uni] ; Marylynne Woods [Royaume-Uni] ; Conor Richards [Royaume-Uni] ; Ross Dolan [Royaume-Uni] ; Jesse Wilson Veitch [Royaume-Uni] ; Wei M J. Sim [Royaume-Uni] ; Olivia E H. Kemmett [Royaume-Uni] ; David C. Milton [Royaume-Uni] ; Sophie L W. Randall [Royaume-Uni] ; Ly D. Bui [Royaume-Uni] ; Nicola Goldmann [Royaume-Uni] ; Allan Cameron [Royaume-Uni] ; Barry Laird [Royaume-Uni] ; Dinesh Talwar [Royaume-Uni] ; Ian Godber [Royaume-Uni] ; Alan Davidson [Royaume-Uni] ; Donald C. Mcmillan [Royaume-Uni]

Source :

RBID : pubmed:32933530

Descripteurs français

English descriptors

Abstract

BACKGROUND

Severe COVID-19 infection results in a systemic inflammatory response (SIRS). This SIRS response shares similarities to the changes observed during the peri-operative period that are recognised to be associated with the development of multiple organ failure.

METHODS

Electronic patient records for patients who were admitted to an urban teaching hospital during the initial 7-week period of the COVID-19 pandemic in Glasgow, U.K. (17th March 2020-1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. Age, sex, BMI and documented evidence of COVID-19 infection at time of discharge or death certification were considered minimal criteria for inclusion.

RESULTS

Of the 224 patients who fulfilled the criteria for inclusion, 52 (23%) had died at 30-days following admission. COVID-19 related respiratory failure (75%) and multiorgan failure (12%) were the commonest causes of death recorded. Age ≥ 70 years (p < 0.001), past medical history of cognitive impairment (p ≤ 0.001), previous delirium (p < 0.001), clinical frailty score > 3 (p < 0.001), hypertension (p < 0.05), heart failure (p < 0.01), national early warning score (NEWS) > 4 (p < 0.01), positive CXR (p < 0.01), and subsequent positive COVID-19 swab (p ≤ 0.001) were associated with 30-day mortality. CRP > 80 mg/L (p < 0.05), albumin < 35 g/L (p < 0.05), peri-operative Glasgow Prognostic Score (poGPS) (p < 0.05), lymphocytes < 1.5 10

CONCLUSION

Age ≥ 70 years and severe systemic inflammation as measured by the peri-operative Glasgow Prognostic Score are independently associated with 30-day mortality among patients admitted to hospital with COVID-19 infection.


DOI: 10.1186/s12967-020-02524-4
PubMed: 32933530
PubMed Central: PMC7491021


Affiliations:


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<name sortKey="Laird, Barry" sort="Laird, Barry" uniqKey="Laird B" first="Barry" last="Laird">Barry Laird</name>
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<country xml:lang="fr">Royaume-Uni</country>
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<orgName type="university">Université d'Édimbourg</orgName>
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<nlm:affiliation>St Columba's Hospice, 15 Boswall Rd, Edinburgh, EH5 3RW, UK.</nlm:affiliation>
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<name sortKey="Talwar, Dinesh" sort="Talwar, Dinesh" uniqKey="Talwar D" first="Dinesh" last="Talwar">Dinesh Talwar</name>
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<name sortKey="Godber, Ian" sort="Godber, Ian" uniqKey="Godber I" first="Ian" last="Godber">Ian Godber</name>
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<nlm:affiliation>Department of Clinical Biochemistry, Queen Elizabeth University Hospital, Govan, Glasgow, G51 4TF, UK.</nlm:affiliation>
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<name sortKey="Davidson, Alan" sort="Davidson, Alan" uniqKey="Davidson A" first="Alan" last="Davidson">Alan Davidson</name>
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<nlm:affiliation>Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK.</nlm:affiliation>
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<name sortKey="Mcmillan, Donald C" sort="Mcmillan, Donald C" uniqKey="Mcmillan D" first="Donald C" last="Mcmillan">Donald C. Mcmillan</name>
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<title level="j">Journal of translational medicine</title>
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<term>Age Factors (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Betacoronavirus (MeSH)</term>
<term>C-Reactive Protein (metabolism)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Coronavirus Infections (mortality)</term>
<term>Coronavirus Infections (physiopathology)</term>
<term>Female (MeSH)</term>
<term>Hospital Mortality (MeSH)</term>
<term>Hospitalization (MeSH)</term>
<term>Hospitals, Teaching (MeSH)</term>
<term>Hospitals, Urban (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Inflammation (physiopathology)</term>
<term>Lymphocytes (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Multivariate Analysis (MeSH)</term>
<term>Neutrophils (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Pneumonia, Viral (mortality)</term>
<term>Pneumonia, Viral (physiopathology)</term>
<term>Prognosis (MeSH)</term>
<term>Scotland (epidemiology)</term>
<term>Translational Medical Research (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr">
<term>Adulte d'âge moyen (MeSH)</term>
<term>Analyse multifactorielle (MeSH)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Facteurs âges (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Granulocytes neutrophiles (MeSH)</term>
<term>Hospitalisation (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Hôpitaux d'enseignement (MeSH)</term>
<term>Hôpitaux urbains (MeSH)</term>
<term>Infections à coronavirus (mortalité)</term>
<term>Infections à coronavirus (physiopathologie)</term>
<term>Infections à coronavirus (épidémiologie)</term>
<term>Inflammation (physiopathologie)</term>
<term>Lymphocytes (MeSH)</term>
<term>Mortalité hospitalière (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (mortalité)</term>
<term>Pneumopathie virale (physiopathologie)</term>
<term>Pneumopathie virale (épidémiologie)</term>
<term>Pronostic (MeSH)</term>
<term>Protéine C-réactive (métabolisme)</term>
<term>Recherche médicale translationnelle (MeSH)</term>
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<term>C-Reactive Protein</term>
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<term>Scotland</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en">
<term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en">
<term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr">
<term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr">
<term>Protéine C-réactive</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr">
<term>Infections à coronavirus</term>
<term>Inflammation</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en">
<term>Coronavirus Infections</term>
<term>Inflammation</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr">
<term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
<term>Écosse</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Age Factors</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Betacoronavirus</term>
<term>Female</term>
<term>Hospital Mortality</term>
<term>Hospitalization</term>
<term>Hospitals, Teaching</term>
<term>Hospitals, Urban</term>
<term>Humans</term>
<term>Lymphocytes</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Multivariate Analysis</term>
<term>Neutrophils</term>
<term>Pandemics</term>
<term>Prognosis</term>
<term>Translational Medical Research</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Adulte d'âge moyen</term>
<term>Analyse multifactorielle</term>
<term>Betacoronavirus</term>
<term>Facteurs âges</term>
<term>Femelle</term>
<term>Granulocytes neutrophiles</term>
<term>Hospitalisation</term>
<term>Humains</term>
<term>Hôpitaux d'enseignement</term>
<term>Hôpitaux urbains</term>
<term>Lymphocytes</term>
<term>Mortalité hospitalière</term>
<term>Mâle</term>
<term>Pandémies</term>
<term>Pronostic</term>
<term>Recherche médicale translationnelle</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>BACKGROUND</b>
</p>
<p>Severe COVID-19 infection results in a systemic inflammatory response (SIRS). This SIRS response shares similarities to the changes observed during the peri-operative period that are recognised to be associated with the development of multiple organ failure.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>Electronic patient records for patients who were admitted to an urban teaching hospital during the initial 7-week period of the COVID-19 pandemic in Glasgow, U.K. (17th March 2020-1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. Age, sex, BMI and documented evidence of COVID-19 infection at time of discharge or death certification were considered minimal criteria for inclusion.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Of the 224 patients who fulfilled the criteria for inclusion, 52 (23%) had died at 30-days following admission. COVID-19 related respiratory failure (75%) and multiorgan failure (12%) were the commonest causes of death recorded. Age ≥ 70 years (p < 0.001), past medical history of cognitive impairment (p ≤ 0.001), previous delirium (p < 0.001), clinical frailty score > 3 (p < 0.001), hypertension (p < 0.05), heart failure (p < 0.01), national early warning score (NEWS) > 4 (p < 0.01), positive CXR (p < 0.01), and subsequent positive COVID-19 swab (p ≤ 0.001) were associated with 30-day mortality. CRP > 80 mg/L (p < 0.05), albumin < 35 g/L (p < 0.05), peri-operative Glasgow Prognostic Score (poGPS) (p < 0.05), lymphocytes < 1.5 10</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>Age ≥ 70 years and severe systemic inflammation as measured by the peri-operative Glasgow Prognostic Score are independently associated with 30-day mortality among patients admitted to hospital with COVID-19 infection.</p>
</div>
</front>
</TEI>
<pubmed>
<MedlineCitation Status="MEDLINE" Owner="NLM">
<PMID Version="1">32933530</PMID>
<DateCompleted>
<Year>2020</Year>
<Month>10</Month>
<Day>02</Day>
</DateCompleted>
<DateRevised>
<Year>2020</Year>
<Month>10</Month>
<Day>02</Day>
</DateRevised>
<Article PubModel="Electronic">
<Journal>
<ISSN IssnType="Electronic">1479-5876</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>18</Volume>
<Issue>1</Issue>
<PubDate>
<Year>2020</Year>
<Month>09</Month>
<Day>15</Day>
</PubDate>
</JournalIssue>
<Title>Journal of translational medicine</Title>
<ISOAbbreviation>J Transl Med</ISOAbbreviation>
</Journal>
<ArticleTitle>Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection.</ArticleTitle>
<Pagination>
<MedlinePgn>354</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1186/s12967-020-02524-4</ELocationID>
<Abstract>
<AbstractText Label="BACKGROUND">Severe COVID-19 infection results in a systemic inflammatory response (SIRS). This SIRS response shares similarities to the changes observed during the peri-operative period that are recognised to be associated with the development of multiple organ failure.</AbstractText>
<AbstractText Label="METHODS">Electronic patient records for patients who were admitted to an urban teaching hospital during the initial 7-week period of the COVID-19 pandemic in Glasgow, U.K. (17th March 2020-1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. Age, sex, BMI and documented evidence of COVID-19 infection at time of discharge or death certification were considered minimal criteria for inclusion.</AbstractText>
<AbstractText Label="RESULTS">Of the 224 patients who fulfilled the criteria for inclusion, 52 (23%) had died at 30-days following admission. COVID-19 related respiratory failure (75%) and multiorgan failure (12%) were the commonest causes of death recorded. Age ≥ 70 years (p < 0.001), past medical history of cognitive impairment (p ≤ 0.001), previous delirium (p < 0.001), clinical frailty score > 3 (p < 0.001), hypertension (p < 0.05), heart failure (p < 0.01), national early warning score (NEWS) > 4 (p < 0.01), positive CXR (p < 0.01), and subsequent positive COVID-19 swab (p ≤ 0.001) were associated with 30-day mortality. CRP > 80 mg/L (p < 0.05), albumin < 35 g/L (p < 0.05), peri-operative Glasgow Prognostic Score (poGPS) (p < 0.05), lymphocytes < 1.5 10
<sup>9</sup>
/l (p < 0.05), neutrophil lymphocyte ratio (p ≤ 0.001), haematocrit (< 0.40 L/L (male)/ < 0.37 L/L (female)) (p ≤ 0.01), urea > 7.5 mmol/L (p < 0.001), creatinine > 130 mmol/L (p < 0.05) and elevated urea: albumin ratio (< 0.001) were also associated with 30-day mortality. On multivariate analysis, age ≥ 70 years (O.R. 3.9, 95% C.I. 1.4-8.2, p < 0.001), past medical history of heart failure (O.R. 3.3, 95% C.I. 1.2-19.3, p < 0.05), NEWS > 4 (O.R. 2.4, 95% C.I. 1.1-4.4, p < 0.05), positive initial CXR (O.R. 0.4, 95% C.I. 0.2-0.9, p < 0.05) and poGPS (O.R. 2.3, 95% C.I. 1.1-4.4, p < 0.05) remained independently associated with 30-day mortality. Among those patients who tested PCR COVID-19 positive (n = 122), age ≥ 70 years (O.R. 4.7, 95% C.I. 2.0-11.3, p < 0.001), past medical history of heart failure (O.R. 4.4, 95% C.I. 1.2-20.5, p < 0.05) and poGPS (O.R. 2.4, 95% C.I. 1.1-5.1, p < 0.05) remained independently associated with 30-days mortality.</AbstractText>
<AbstractText Label="CONCLUSION">Age ≥ 70 years and severe systemic inflammation as measured by the peri-operative Glasgow Prognostic Score are independently associated with 30-day mortality among patients admitted to hospital with COVID-19 infection.</AbstractText>
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<LastName>Maguire</LastName>
<ForeName>Donogh</ForeName>
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<Affiliation>Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK. Donogh.Maguire@glasgow.ac.uk.</Affiliation>
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<LastName>Woods</LastName>
<ForeName>Marylynne</ForeName>
<Initials>M</Initials>
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<Affiliation>School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK.</Affiliation>
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<LastName>Richards</LastName>
<ForeName>Conor</ForeName>
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<ForeName>Wei M J</ForeName>
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<LastName>Cameron</LastName>
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