COVID-19 pneumonia in Galicia (Spain): impact of prognostic factors and therapies on mortality and need for mechanical ventilation

Abstract

Introduction: This study was aimed to identify risk factors associated with unfavorable outcomes (composite outcome variable: mortality and need for mechanical ventilation) in patients hospitalized in Galicia with COVID-19 pneumonia.

Methods: Retrospective, multicenter, observational study carried out in the 8 Galician tertiary hospitals. All patients admitted with confirmed COVID-19 pneumonia from 1st of March to April 24th, 2020 were included. A multivariable logistic regression analysis was performed in order to identify the relationship between risk factors, therapeutic interventions and the composite outcome variable.

Results: A total of 1292 patients (56.1% male) were included. Two hundred and twenty-one (17.2%) died and 349 (27%) reached the main outcome variable. Age [odds ratio (OR) = 1.02 (95% confidence interval (CI): 1.01 – 1.03)], CRP quartiles 3 and 4 [OR = 2.06 (95% CI: 1.31 – 2.25)] and [OR = 2.76 (95% CI: 1.75 – 4.35)], respectively, Charlson index [OR = 1.17 (95%CI: 1.07 – 1.27)], SaO2 upon admission [OR = 0.94 (95% CI: 0.92 – 0.95)], the ratio admissions/hospital beds [OR = 1.05 (95% CI: 1.01 – 1.09)], hydroxychloroquine prescription [OR = 0.19 (95%CI: 0.11 – 0.33)], systemic corticosteroids prescription [OR = 2.01 (95%CI: 1.48 – 2.75)], and tocilizumab prescription [OR = 3.28 (95%CI: 2.08 – 5.17)], significantly impacted the outcome.

Conclusion: These findings may help to identify patients at hospital admission with a higher risk of death and may urge healthcare authorities to implement policies aimed at reducing deaths by increasing the availability of hospital beds.