Outcomes and predictors of mortality in patients with severe COVID-19 and COPD admitted to ICU: A multicenter study

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dc.contributor.authorFernández Barat, Laia
dc.contributor.authorMotos, Ana
dc.contributor.authorCanseco Ribas, Joan
dc.contributor.authorGabarrús, Albert
dc.contributor.authorLópez Aladid, Ruben
dc.contributor.authorAlvaro Meca, Alejandro
dc.contributor.authorCeccato, Adrián
dc.contributor.authorGarcía, Nadia
dc.contributor.authorFerrer, Miquel
dc.contributor.authorBattaglini, Denise
dc.contributor.authorÁvarez Napagao, Sergio
dc.contributor.authorGarcía Gasulla, Dario
dc.contributor.authorFerrer, Ricard
dc.contributor.authorde Gonzalo Calvo, David
dc.contributor.authorLorente, José Ángel
dc.contributor.authorMenéndez, Rosario
dc.contributor.authorPeñuelas, Oscar
dc.contributor.authorRiera, Jordi
dc.contributor.authorRodríguez, Alejandro
dc.contributor.authorAmaya Villar, Rosario
dc.contributor.authorAñón, José
dc.contributor.authorBalan Mariño, Ana
dc.contributor.authorBarberà, Carme
dc.contributor.authorBarberán, José
dc.contributor.authorBlandino Ortiz, Aaron
dc.contributor.authorBoado, Maria Victoria
dc.contributor.authorBofill, Neus
dc.contributor.authorBustamante Munguira, Elena
dc.contributor.authorCaballero, Jesús
dc.contributor.authorCantón Bulnes, María Luisa
dc.contributor.authorCarbajales Pérez, Cristina
dc.contributor.authorCarbonell, Nieves
dc.contributor.authorCatalán González, Mercedes
dc.contributor.authorDel Carmen de la Torre, Maria
dc.contributor.authorDíaz, Emili
dc.contributor.authorEstella, Ángel
dc.contributor.authorFigueras, Albert
dc.contributor.authorde Frutos, Raul
dc.contributor.authorFranco, Nieves
dc.contributor.authorGalbán, Cristóbal
dc.contributor.authorGallego, Elena
dc.contributor.authorGarcía Garmendia, José Luis
dc.contributor.authorGonzález Gutiérrez, Jessica
dc.contributor.authorGómez, José
dc.contributor.authorGumucio Sanguino, Víctor
dc.contributor.authorHuerta, Arturo
dc.contributor.authorJorge García, Ruth Noemí
dc.contributor.authorLoza Vázquez, Ana
dc.contributor.authorMarin Corral, Judith
dc.contributor.authorMartin Delgado, María Cruz
dc.contributor.authorMartínez de la Gándara, Amalia
dc.contributor.authorMartínez Varela, Ignacio
dc.contributor.authorAlbaiceta, Guillermo
dc.contributor.authorNieto, Maite
dc.contributor.authorPeñasco, Yhivian
dc.contributor.authorPérez Bastida, Leire
dc.contributor.authorPérez García, Felipe
dc.contributor.authorPozo Laderas, Juan Carlos
dc.contributor.authorRicart, Pilar
dc.contributor.authorSagredo, Víctor
dc.contributor.authorSánchez Miralles, Ángel
dc.contributor.authorSancho Chinesta, Susana
dc.contributor.authorSocias, Lorenzo
dc.contributor.authorSolé Violan, Jordi
dc.contributor.authorSuarez Sipmann, Fernando
dc.contributor.authorTamayo Lomas, Luis
dc.contributor.authorTrenado, José
dc.contributor.authorÚbeda, Alejandro
dc.contributor.authorJorge Valdivia, Luis
dc.contributor.authorVidal, Pablo
dc.contributor.authorBermejo Martin, Jesús
dc.contributor.authorBarbé Illa, Ferran
dc.contributor.authorTorres, Antoni
dc.date.accessioned2025-11-12T18:54:10Z
dc.date.available2025-11-12T18:54:10Z
dc.date.issued2025-09
dc.description.abstractBackground High mortality rates among patients with chronic obstructive pulmonary disease (COPD) admitted to intensive care units (ICUs) during the COVID-19 pandemic highlight the need for tailored clinical management strategies. Study Design and Methods Epidemiological, clinical, and laboratory data were collected in REDCap for 6512 patients hospitalized with COVID-19 across 55 Spanish ICUs. Patients were stratified into three groups: those with COPD, those with other chronic respiratory diseases (CRD), and those without respiratory comorbidities (No CRD). The primary outcome was to determine clinical predictors for 90-day mortality, focusing on the COPD group. A propensity score matching (PSM) method was applied to analyze the effects of respiratory support, biomarkers, and immunomarkers. Results Patients with COPD (n = 328) exhibited a 50% mortality rate compared to 33% of those with other chronic respiratory diseases (CRD, n = 547), and those without respiratory comorbidities (No CRD, n = 5124). Among COPD patients, 95% of whom had Acute Respiratory Distress Syndrome (ARDS) due to COVID-19, the use of a high-flow nasal cannula (HFNC) was associated with reduced 90-day mortality (hazard ratio: 0.54 (95% Confidence Interval [0.31–0.95]). At a molecular scale, lower IgG levels but higher viral load and TNF-alpha, Vascular Cell Adhesion Molecule-1 (VCAM-1), and Fas Cell Surface Death Receptor (Fas) were associated with mortality in the COPD group. Conclusions In COPD patients with ARDS due to COVID-19, the use of HFNC was associated with a better prognosis. The dysregulation in biomarkers and immunomarkers in COPD patients and its association with mortality highlight the need for further targeted therapeutic strategies.
dc.description.sponsorshipThe Instituto de Salud Carlos III de Madrid (COV20/00110, ISCIII); Fondo Europeo de Desarrollo Regional (FEDER); ‘‘Una manera de hacer Europa’’; and Centro de Investigacio´ n Biome´ dica En Red—Enfermedades Respiratorias (CIBERES) provided financial support. Donation Program ‘‘estar preparados’’, UNESPA, Madrid, Spain. DdGC has received financial support from the Instituto de Salud Carlos III (Miguel Servet 2020: CP20/00041), co-funded by the European Social Fund (ESF)/‘‘Investing in your future’’. CC received a grant from the Fondo de Investigacio´ n Sanitaria (PI19/00207), Instituto de Salud Carlos III, co-funded by the European Union, ICREA Academy award to AT, SGR 01148 (2021) from Generalitat de Catalunya to LFB. Role of the Funder/ Sponsor: The funding sources had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication
dc.identifier.doihttps://doi.org/10.1016/j.accpm.2025.101558
dc.identifier.issn2352-5568
dc.identifier.urihttps://hdl.handle.net/10459.1/469049
dc.language.isoeng
dc.publisherElsevier
dc.relationPI19/0020info:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 (ISCIII)/PI19%2F00207/ES/FENOTIPOS RELACIONADOS CON LA EVOLUCION CLINICA A CORTO Y LARGO PLAZO EN LA NEUMONIA ADQUIRIDA EN LA COMUNIDAD/
dc.relation.isformatofReproducció del document publicat a https://doi.org/10.1016/j.accpm.2025.101558
dc.relation.ispartofAnaesthesia Critical Care and Pain Medicine, 2025, vol. 44, núm. 5, 101558
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectAcute respiratory distress syndrome
dc.subjectBiomarkers
dc.subjectChronic obstructive pulmonary disease
dc.subjectHigh flow nasal cannulas
dc.subjectRespiratory support
dc.titleOutcomes and predictors of mortality in patients with severe COVID-19 and COPD admitted to ICU: A multicenter study
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
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