The factors that predispose an individual to a higher risk of death from COVID-19 are poorly understood. The goal of the study was to identify factors associated with risk of death among patients with COVID-19. This is a retrospective cohort study of people with laboratory-confirmed SARS-CoV-2 infection from February to May 22, 2020. Data retrieved for this study included patient sociodemographic data, baseline comorbidities, baseline treatments, other background data on care provided in hospital or primary care settings, and vital status. Main outcome was deaths until June 29, 2020. In the multivariable model based on nursing home residents, predictors of mortality were being male, older than 80 years, admitted to a hospital for COVID-19, and having cardiovascular disease, kidney disease or dementia while taking anticoagulants or lipid-lowering drugs at baseline was protective. The AUC was 0.754 for the risk score based on this model and 0.717 in the validation subsample. Predictors of death among people from the general population were being male and/or older than 60 years, having been hospitalized in the month before admission for COVID-19, being admitted to a hospital for COVID-19, having cardiovascular disease, dementia, respiratory disease, liver disease, diabetes with organ damage, or cancer while being on anticoagulants was protective. The AUC was 0.941 for this model's risk score and 0.938 in the validation subsample. Our risk scores could help physicians identify high-risk groups and establish preventive measures and better follow-up for patients at high risk of dying. ClinicalTrials.gov Identifier: NCT04463706Keywords COVID-19 • Cohort study • Prognostic factors • Mortality • Clinical prediction rules Details of the COVID-19-Osakidetza Working group is given in the acknowledgement section.
Background The aims of this study were to analyse the mental health and health‐related quality of life (HRQoL) of a broad sample of healthcare workers (HCWs) in Spain and to identify potential factors that have a significant effect on their mental health and HRQoL. Method This prospective cohort study comprised 2089 HCWs who completed the Generalized Anxiety Disorder 7‐item (GAD‐7) Scale, the Patient Health Questionnaire‐9 (PHQ‐9), the Impact Event Scale‐Revised (IES‐R), the Insomnia Severity Index (ISI), and the health‐related quality of life Questionnaire (EQ‐5D). Sociodemographic and clinical data in relation to Covid‐19 were also recorded. Descriptive statistics, univariable analysis and multivariable linear regression models were applied to identify factors associated with mental health and HRQoL. Results 80.87% of participants were female and 19.13% male; 82.38% were aged under 55 years; 39.13% were physicians and 50.17% were nurses or auxiliaries; 80.42% of the health workers have directly treated patients with Covid‐19 and 12.28% have themselves tested positive for Covid‐19. 38.58% of HCWs had clinical depression; over half (51.75%) had clinical anxiety; 60.4% had clinical stress; and 21.57% had clinical insomnia. Older professionals (>55 years) reported lower rates of anxiety, depression, insomnia, and stress. Having worked directly with Covid‐19 patients appears to be an explanatory variable of suffering greater anxiety, depression, stress and insomnia, and of having a worse HRQoL amongst our HCWs. The group of HCWs suffering the worst mental state were nursing home workers. Conclusions Our study confirms that symptomatology of anxiety, depression, stress, insomnia, and HRQoL were affected amongst HCW during the Covid‐19 pandemic.
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