COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort study
IntroductionCOVID-19 has initially been studied in terms of an acute-phase disease, although recently more attention has been given to the long-term consequences. In this study, we examined COVID-19 as an independent risk factor for long-term mortality in patients with acute illness treated by EMS (...
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.1076627/full |
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| author | José L. Martín-Conty José L. Martín-Conty Begoña Polonio-López Begoña Polonio-López Ancor Sanz-García Ancor Sanz-García Carlos del Pozo Vegas Carlos del Pozo Vegas Carlos del Pozo Vegas Laura Mordillo-Mateos Juan José Bernal-Jiménez Rosa Conty-Serrano Miguel A. Castro Villamor Miguel A. Castro Villamor Raúl López-Izquierdo Raúl López-Izquierdo Raúl López-Izquierdo Francisco Martín-Rodríguez Francisco Martín-Rodríguez Francisco Martín-Rodríguez |
| author_facet | José L. Martín-Conty José L. Martín-Conty Begoña Polonio-López Begoña Polonio-López Ancor Sanz-García Ancor Sanz-García Carlos del Pozo Vegas Carlos del Pozo Vegas Carlos del Pozo Vegas Laura Mordillo-Mateos Juan José Bernal-Jiménez Rosa Conty-Serrano Miguel A. Castro Villamor Miguel A. Castro Villamor Raúl López-Izquierdo Raúl López-Izquierdo Raúl López-Izquierdo Francisco Martín-Rodríguez Francisco Martín-Rodríguez Francisco Martín-Rodríguez |
| author_sort | José L. Martín-Conty |
| collection | DOAJ |
| description | IntroductionCOVID-19 has initially been studied in terms of an acute-phase disease, although recently more attention has been given to the long-term consequences. In this study, we examined COVID-19 as an independent risk factor for long-term mortality in patients with acute illness treated by EMS (emergency medical services) who have previously had the disease against those who have not had the disease.MethodsA prospective, multicenter, ambulance-based, ongoing study was performed with adult patients with acute disease managed by EMS and transferred with high priority to the emergency department (ED) as study subjects. The study involved six advanced life support units, 38 basic life support units, and five emergency departments from Spain. Sociodemographic inputs, baseline vital signs, pre-hospital blood tests, and comorbidities, including COVID-19, were collected. The main outcome was long-term mortality, which was classified into 1-year all-cause mortality and 1-year in- and out-of-hospital mortality. To compare both the patients with COVID-19 vs. patients without COVID-19 and to compare survival vs non-survival, two main statistical analyses were performed, namely, a longitudinal analysis (Cox regression) and a logistic regression analysis.ResultsBetween 12 March 2020 and 30 September 2021, a total of 3,107 patients were included in the study, with 2,594 patients without COVID-19 and 513 patients previously suffering from COVID-19. The mortality rate was higher in patients with COVID-19 than in patients without COVID-19 (31.8 vs. 17.9%). A logistic regression showed that patients previously diagnosed with COVID-19 presented higher rates of nursing home residency, a higher number of breaths per minute, and suffering from connective disease, dementia, and congestive heart failure. The longitudinal analysis showed that COVID-19 was a risk factor for mortality [hazard ratio 1.33 (1.10–1.61); p < 0.001].ConclusionThe COVID-19 group presented an almost double mortality rate compared with the non-COVID-19 group. The final model adjusted for confusion factors suggested that COVID-19 was a risk factor for long-term mortality. |
| first_indexed | 2024-04-10T23:48:59Z |
| format | Article |
| id | doaj.art-46a60f7bcdca4adcacb0258935534df5 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-10T23:48:59Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-46a60f7bcdca4adcacb0258935534df52023-01-10T21:16:25ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-01-011010.3389/fpubh.2022.10766271076627COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort studyJosé L. Martín-Conty0José L. Martín-Conty1Begoña Polonio-López2Begoña Polonio-López3Ancor Sanz-García4Ancor Sanz-García5Carlos del Pozo Vegas6Carlos del Pozo Vegas7Carlos del Pozo Vegas8Laura Mordillo-Mateos9Juan José Bernal-Jiménez10Rosa Conty-Serrano11Miguel A. Castro Villamor12Miguel A. Castro Villamor13Raúl López-Izquierdo14Raúl López-Izquierdo15Raúl López-Izquierdo16Francisco Martín-Rodríguez17Francisco Martín-Rodríguez18Francisco Martín-Rodríguez19Faculty of Health Sciences, Universidad de Castilla-la Mancha, Talavera de la Reina, SpainTechnological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, SpainFaculty of Health Sciences, Universidad de Castilla-la Mancha, Talavera de la Reina, SpainTechnological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, SpainFaculty of Health Sciences, Universidad de Castilla-la Mancha, Talavera de la Reina, SpainPrehospital Early Warning Scoring-System Investigation Group, Valladolid, SpainPrehospital Early Warning Scoring-System Investigation Group, Valladolid, SpainFaculty of Medicine, Universidad de Valladolid, Valladolid, SpainEmergency Department, Hospital Clínico Universitario, Valladolid, SpainFaculty of Health Sciences, Universidad de Castilla-la Mancha, Talavera de la Reina, SpainFaculty of Health Sciences, Universidad de Castilla-la Mancha, Talavera de la Reina, SpainFaculty of Nursing, University of Castilla-La Mancha, Toledo, SpainPrehospital Early Warning Scoring-System Investigation Group, Valladolid, SpainFaculty of Medicine, Universidad de Valladolid, Valladolid, SpainPrehospital Early Warning Scoring-System Investigation Group, Valladolid, SpainFaculty of Medicine, Universidad de Valladolid, Valladolid, SpainEmergency Department, Hospital Universitario Rio Hortega, Valladolid, SpainPrehospital Early Warning Scoring-System Investigation Group, Valladolid, SpainFaculty of Medicine, Universidad de Valladolid, Valladolid, SpainAdvanced Life Support, Emergency Medical Services (SACYL), Valladolid, SpainIntroductionCOVID-19 has initially been studied in terms of an acute-phase disease, although recently more attention has been given to the long-term consequences. In this study, we examined COVID-19 as an independent risk factor for long-term mortality in patients with acute illness treated by EMS (emergency medical services) who have previously had the disease against those who have not had the disease.MethodsA prospective, multicenter, ambulance-based, ongoing study was performed with adult patients with acute disease managed by EMS and transferred with high priority to the emergency department (ED) as study subjects. The study involved six advanced life support units, 38 basic life support units, and five emergency departments from Spain. Sociodemographic inputs, baseline vital signs, pre-hospital blood tests, and comorbidities, including COVID-19, were collected. The main outcome was long-term mortality, which was classified into 1-year all-cause mortality and 1-year in- and out-of-hospital mortality. To compare both the patients with COVID-19 vs. patients without COVID-19 and to compare survival vs non-survival, two main statistical analyses were performed, namely, a longitudinal analysis (Cox regression) and a logistic regression analysis.ResultsBetween 12 March 2020 and 30 September 2021, a total of 3,107 patients were included in the study, with 2,594 patients without COVID-19 and 513 patients previously suffering from COVID-19. The mortality rate was higher in patients with COVID-19 than in patients without COVID-19 (31.8 vs. 17.9%). A logistic regression showed that patients previously diagnosed with COVID-19 presented higher rates of nursing home residency, a higher number of breaths per minute, and suffering from connective disease, dementia, and congestive heart failure. The longitudinal analysis showed that COVID-19 was a risk factor for mortality [hazard ratio 1.33 (1.10–1.61); p < 0.001].ConclusionThe COVID-19 group presented an almost double mortality rate compared with the non-COVID-19 group. The final model adjusted for confusion factors suggested that COVID-19 was a risk factor for long-term mortality.https://www.frontiersin.org/articles/10.3389/fpubh.2022.1076627/fullclinical decision rulesCOVID-19emergency medical serviceslong-term mortalitypre-hospital care |
| spellingShingle | José L. Martín-Conty José L. Martín-Conty Begoña Polonio-López Begoña Polonio-López Ancor Sanz-García Ancor Sanz-García Carlos del Pozo Vegas Carlos del Pozo Vegas Carlos del Pozo Vegas Laura Mordillo-Mateos Juan José Bernal-Jiménez Rosa Conty-Serrano Miguel A. Castro Villamor Miguel A. Castro Villamor Raúl López-Izquierdo Raúl López-Izquierdo Raúl López-Izquierdo Francisco Martín-Rodríguez Francisco Martín-Rodríguez Francisco Martín-Rodríguez COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort study Frontiers in Public Health clinical decision rules COVID-19 emergency medical services long-term mortality pre-hospital care |
| title | COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort study |
| title_full | COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort study |
| title_fullStr | COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort study |
| title_full_unstemmed | COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort study |
| title_short | COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort study |
| title_sort | covid 19 as a risk factor for long term mortality in patients managed by the emergency medical system a prospective multicenter ambulance based cohort study |
| topic | clinical decision rules COVID-19 emergency medical services long-term mortality pre-hospital care |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.1076627/full |
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