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COVID-19 Outcomes in 4712 consecutively confirmed SARS-CoV2 cases in the city of Madrid.
medRxiv - Respiratory Medicine Pub Date : 2020-05-29 , DOI: 10.1101/2020.05.22.20109850
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 ,

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.

中文翻译:

4712例COVID-19结果在马德里市连续确认SARS-CoV2病例。

很少有信息描述需要因COVID19疾病住院的患者的特征和结局,但仍没有任何治疗方法能清楚地证明其疗效。从马德里的4家公立医院就诊的4712名SARS-CoV2感染患者的电子临床记录(eCR)中提取了入院时的人口统计学和临床​​变量以及实验室标记和治疗干预措施。根据年龄和严重程度对患者进行分层。使用多元逻辑回归分析,可以为每个研究变量获得最佳区分死亡率的临界点。应用了主成分分析和神经网络算法。与年龄> 70岁,合并症(高血压,神经系统疾病和糖尿病)相关的高死亡率,诸如发热,心律失常或收缩压升高等生命体质发生改变,以及一些实验室测试的改变。值得注意的是,对单独或组合使用的治疗方案的分析得出了环孢菌素A使用与更好的预后之间的普遍关系,以及在危重患者中使用tocilizumab和/或皮质类固醇也有好处。我们提出了一项基于西班牙人口的大型研究,解决了影响当前SARS CoV2大流行中生存的因素,特别强调了治疗的有效性。此外,我们已经生成了能够识别SARS CoV2严重程度预测指标的NN。从eCR和人工智能内部实施中快速提取和管理数据协议,使我们能够对爆发演变进行几乎实时的监控。心律失常或收缩压升高,以及一些实验室检查的改变。值得注意的是,对单独或组合使用的治疗方案的分析得出了环孢菌素A使用与更好的预后之间的普遍关系,以及在危重患者中使用tocilizumab和/或皮质类固醇也有好处。我们提出了一项基于西班牙人口的大型研究,解决了影响当前SARS CoV2大流行中生存的因素,特别强调了治疗的有效性。此外,我们已经生成了能够识别SARS CoV2严重程度预测指标的NN。从eCR和人工智能内部实施中快速提取和管理数据协议,使我们能够对爆发演变进行几乎实时的监控。心律失常或收缩压升高,以及一些实验室检查的改变。值得注意的是,对单独或组合使用的治疗方案的分析得出了环孢菌素A使用与更好的预后之间的普遍关系,以及在危重患者中使用tocilizumab和/或皮质类固醇也有好处。我们提出了一项基于西班牙人口的大型研究,解决了影响当前SARS CoV2大流行中生存的因素,特别强调了治疗的有效性。此外,我们已经生成了能够识别SARS CoV2严重程度预测指标的NN。从eCR和人工智能内部实施中快速提取和管理数据协议,使我们能够对爆发演变进行几乎实时的监控。
更新日期:2020-05-29
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