COVID-19 Outcomes in 4712 consecutively confirmed SARS-CoV2 cases in the city of Madrid

Sarah Heili-Frades,Pablo Minguez, Ignacio Mahillo Fernández,Tomás Prieto-Rumeau, Antonio Herrero González,Lorena de la Fuente, María Jesús Rodríguez Nieto,Germán Peces-Barba Romero, Mario Peces-Barba,María del Pilar Carballosa de Miguel, Itziar Fernández Ormaechea,Alba Naya prieto, Farah Ezzine de Blas,Luis Jiménez Hiscock, Cesar Perez Calvo, Arnoldo Santos, Luis Enrique Muñoz Alameda,Fredeswinda Romero Bueno, Miguel Górgolas Hernández-Mora, Alfonso Cabello Úbeda,Beatriz Álvarez Álvarez, Elizabet Petkova, Nerea Carrasco, Dolores Martín Ríos, Nicolás González Mangado,Olga Sánchez Pernaute, and the COVID FJD-TEAM

medrxiv(2020)

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摘要
There is limited information describing features and outcomes of patients requiring hospitalization for COVID19 disease and still no treatments have clearly demonstrated efficacy. Demographics and clinical variables on admission, as well as laboratory markers and therapeutic interventions were extracted from electronic Clinical Records (eCR) in 4712 SARS-CoV2 infected patients attending 4 public Hospitals in Madrid. Patients were stratified according to age and stage of severity. Using multivariate logistic regression analysis, cut-off points that best discriminated mortality were obtained for each of the studied variables. Principal components analysis and a neural network (NN) algorithm were applied. A high mortality incidence associated to age >70, comorbidities (hypertension, neurological disorders and diabetes), altered vitals such as fever, heart rhythm disturbances or elevated systolic blood pressure, and alterations in several laboratory tests. Remarkably, analysis of therapeutic options either taken individually or in combination drew a universal relationship between the use of Cyclosporine A and better outcomes as also a benefit of tocilizumab and/or corticosteroids in critically ill patients. We present a large Spanish population-based study addressing factors influencing survival in current SARS CoV2 pandemic, with particular emphasis on the effectivity of treatments. In addition, we have generated an NN capable of identifying severity predictors of SARS CoV2. A rapid extraction and management of data protocol from eCR and artificial intelligence in-house implementations allowed us to perform almost real time monitoring of the outbreak evolution. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The study has no specific funding. AS has a Marie Sklodowska-Curie grant (#796721). LF is supported by ISCIII (CA18/00017). PM has a Miguel Servet contract funded by the ISCIII (CP16/00116). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The survey is a retrospective study with de-identified medical record data. No patient management protocols have been altered due to the study. The study was approved by our Institutional Ethics Committee. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The datasets analyzed during the current study are available from the corresponding author on request.
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