Manejo clínico de la EPOC en situación de vida real. Análisis a partir de big data

Izquierdo, José Luis; Morena, Diego; González, Yolanda; Paredero, José Manuel; Pérez, Bernardino Gago; Graziani, Desirée; Gutiérrez, Matilde; Rodríguez, José Miguel

doi:10.1016/j.arbres.2019.12.025

Cited by 40 publications

(17 citation statements)

References 24 publications

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“…Second, it has a good EHR system, which has been standardized and is shared across all five provinces. Finally, the SAVANA Manager ® tool is widely available in the region, allowing access to large amounts of clinical information (27).…”

Section: Resultsmentioning

confidence: 99%

The impact of COVID-19 on patients with asthma

Izquierdo

Almonacid

González³

et al. 2020

Eur Respir J

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163

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BackgroundAn association between the severity of COVID-19 and the presence of certain chronic conditions has been suggested. However, unlike influenza and other viruses, the disease burden in patients with asthma has been less evident.ObjectiveTo understand the impact of COVID-19 in patients with asthma.MethodsUsing big data analytics and artificial intelligence through the SAVANA Manager® clinical platform, we analysed clinical data from patients with asthma from January 1st to May 10th, 2020.ResultsOut of 71 182 patients with asthma, 1006 (1.41%) suffered from COVID-19. Compared to asthmatic individuals without COVID-19, patients with asthma and COVID-19 were significantly older (55 versus 42 years), predominantly female (66% versus 59%), smoked more frequently, and had higher prevalence of hypertension, dyslipidemias, diabetes, and obesity. Allergy-related factors such as rhinitis and eczema were less common in asthmatic patients with COVID-19 (p<.001). Higher prevalence of these comorbidities was also observed in patients with COVID-19 who required hospital admission. The use of inhaled corticosteroids (ICS) was lower in patients who required hospitalisation due to COVID-19, as compared to non-hospitalised patients (48.3% versus 61.5%; OR: 0.58: 95% CI 0.44–0.77). Although patients treated with biologics (n=865; 1.21%) showed increased severity and more comorbidities at the ENT level, COVID-19-related hospitalisations in these patients were relatively low (0.23%).ConclusionPatients with asthma and COVID-19 were older and at increased risk due to comorbidity-related factors. ICS and biologics are generally safe and may be associated with a protective effect against severe COVID-19 infection.

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Section: Resultsmentioning

confidence: 99%

The impact of COVID-19 on patients with asthma

Izquierdo

Almonacid

González³

et al. 2020

Eur Respir J

Self Cite

181

163

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“…In fact, in clinical practice it is common that more than 50% of patients are taking the high dose triple in GOLD, which is not in accordance with the (GOLD) guidelines. 35 In conclusion, triple therapy may be an appropriate option in many patients, with low doses of IC. Increased IC doses were not associated with a reduction in the number of exacerbations, while an increased risk of pneumonia was observed.…”

Section: Dovepressmentioning

confidence: 94%

<p>Clinical and Economic Consequences of Inhaled Corticosteroid Doses and Particle Size in Triple Inhalation Therapy for COPD: Real-Life Study</p>

Sicras‐Mainar¹,

Abajo

Izquierdo

2020

COPD

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“…Clinical data from a total of 1,164,283 patients with available EHRs throughout the community of Castilla La-Mancha (Spain) were collected from all available departments, including inpatient, outpatient, emergency room, and primary care. The search terms for COPD and COVID-19 have been previously described (16,17). The study was compliant with legal and regulatory requirements and the research practices described in the ICH Guide to Good Clinical Practice, The Declaration of Helsinki in its latest edition, good pharmacoepidemiology practices, and local regulations.…”

Section: Methodsmentioning

confidence: 99%

Characteristics and Prognosis of COVID-19 in Patients with COPD

Graziani¹,

Soriano²,

Rio-Bermúdez³

et al. 2020

Preprint

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Patients with COPD have a higher prevalence of coronary ischemia and other factors that put them at risk for COVID-19-related complications. We aimed to explore the impact of COVID-19 in a large population-based sample of patients with COPD in Castilla-La Mancha, Spain. We analyzed clinical data in electronic health records from January 1st to May 10th, 2020 by using Natural Language Processing through the SAVANA Manager® clinical platform. Out of 31,633 COPD patients, 793 had a diagnosis of COVID-19. The proportion of patients with COVID-19 in the COPD population (2,51%; CI95% 2,33 – 2,68) was significantly higher than in the general population aged > 40 years (1,16%; 95%CI 1,14 – 1,18); P < .001. Compared with COPD-free individuals, COPD patients with COVID-19 showed significantly poorer disease prognosis, as evaluated by hospitalizations (31,1 % vs 39,8%: OR 1,57; 95%CI 1,14 – 1,18) and mortality (3,4% vs 9,3%: OR 2,93; 95%CI 2,27 – 3,79). Patients with COPD and COVID-19 were significantly older (75 vs. 66 years), predominantly male (83% vs 17%), smoked more frequently, and had more comorbidities than their non-COPD counterparts. Pneumonia was the most common diagnosis among COPD patients hospitalized due to COVID-19 (59%); 19% of patients showed pulmonary infiltrates suggestive of pneumonia and heart failure. Mortality in COPD patients with COVID-19 was associated with older age and prevalence of heart failure (P<0.05). COPD patients with COVID-19 showed higher rates of hospitalization and mortality, mainly associated with pneumonia. This clinical profile is different from exacerbations caused by other respiratory viruses in the winter season.

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Manejo clínico de la EPOC en situación de vida real. Análisis a partir de big data

Cited by 40 publications

References 24 publications

The impact of COVID-19 on patients with asthma

The impact of COVID-19 on patients with asthma

<p>Clinical and Economic Consequences of Inhaled Corticosteroid Doses and Particle Size in Triple Inhalation Therapy for COPD: Real-Life Study</p>

Characteristics and Prognosis of COVID-19 in Patients with COPD

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