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

Heili-Frades, S.; Minguez, P.; Mahillo-Fernandez, I.; Prieto-Rumeau, T.; Herrero Gonzalez, A.; de la Fuente, L.; Rodriguez Nieto, M. J.; Peces-Barba Romero, G.; Peces-Barba, M.; Carballosa de Miguel, M. d. P.; Fernandez Ormaechea, I.; Naya Prieto, A.; Ezzine de Blas, F.; Jimenez Hiscock, L.; Perez Calvo, C.; Santos, A.; Munoz Alameda, L. E.; Romero Bueno, F.; Hernandez-Mora, M. G.; Cabello Ubeda, A.; Alvarez Alvarez, B.; Petkova, E.; Carrasco, N.; Martin Rios, D.; Gonzalez Mangado, N.; Sanchez Pernaute, O.

2020-05-29 respiratory medicine
10.1101/2020.05.22.20109850 medRxiv
Show abstract

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.

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