Disease progression of 213 patients hospitalized with Covid-19 in the Czech Republic in March-October 2020: An exploratory analysis

. 2021 ; 16 (10) : e0245103. [epub] 20211006

Jazyk angličtina Země Spojené státy americké Médium electronic-ecollection

Typ dokumentu časopisecké články, multicentrická studie

Perzistentní odkaz   https://www.medvik.cz/link/pmid34613965

We collected a multi-centric retrospective dataset of patients (N = 213) who were admitted to ten hospitals in Czech Republic and tested positive for SARS-CoV-2 during the early phases of the pandemic in March-October 2020. The dataset contains baseline patient characteristics, breathing support required, pharmacological treatment received and multiple markers on daily resolution. Patients in the dataset were treated with hydroxychloroquine (N = 108), azithromycin (N = 72), favipiravir (N = 9), convalescent plasma (N = 7), dexamethasone (N = 4) and remdesivir (N = 3), often in combination. To explore association between treatments and patient outcomes we performed multiverse analysis, observing how the conclusions change between defensible choices of statistical model, predictors included in the model and other analytical degrees of freedom. Weak evidence to constrain the potential efficacy of azithromycin and favipiravir can be extracted from the data. Additionally, we performed external validation of several proposed prognostic models for Covid-19 severity showing that they mostly perform unsatisfactorily on our dataset.

Zobrazit více v PubMed

COVID-19 v ČR: Otevřené datové sady a sady ke stažení [Internet]. Ministry of Health of the Czech Republic; Available: https://onemocneni-aktualne.mzcr.cz

Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020;323: 1824–1836. doi: 10.1001/jama.2020.6019 PubMed DOI

Tobaiqy M, Qashqary M, Al-Dahery S, Mujallad A, Hershan AA, Kamal MA, et al.. Therapeutic management of patients with COVID-19: a systematic review. Infection Prevention in Practice. 2020;2: 100061. doi: 10.1016/j.infpip.2020.100061 PubMed DOI PMC

Horby P, Lim WS, Emberson J, Mafham M, Bell J, Linsell L, et al.. Effect of Dexamethasone in Hospitalized Patients with COVID-19—Preliminary Report [Internet]. Infectious Diseases (except HIV/AIDS); 2020. Jun. Available: http://medrxiv.org/lookup/doi/10.1101/2020.06.22.20137273 DOI

Siemieniuk RA, Bartoszko JJ, Ge L, Zeraatkar D, Izcovich A, Kum E, et al.. Drug treatments for covid-19: living systematic review and network meta-analysis. BMJ. 2020;370. doi: 10.1136/bmj.m2980 PubMed DOI PMC

Catteau L, Dauby N, Montourcy M, Bottieau E, Hautekiet J, Goetghebeur E, et al.. Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants. International Journal of Antimicrobial Agents. 2020; 106144. doi: 10.1016/j.ijantimicag.2020.106144 PubMed DOI PMC

Del Valle DM, Kim-Schulze S, Huang H-H, Beckmann ND, Nirenberg S, Wang B, et al.. An inflammatory cytokine signature predicts COVID-19 severity and survival. Nature Medicine. 2020; 1–8. doi: 10.1038/s41591-020-1051-9 PubMed DOI PMC

Castelnuovo AD, Costanzo S, Antinori A, Berselli N, Blandi L, Bruno R, et al.. Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study. European Journal of Internal Medicine. 2020; doi: 10.1016/j.ejim.2020.08.019 PubMed DOI PMC

Janiaud P, Axfors C, Schmitt AM, Gloy V, Ebrahimi F, Hepprich M, et al.. Association of Convalescent Plasma Treatment With Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis. JAMA. 2021;325: 1185. doi: 10.1001/jama.2021.2747 PubMed DOI PMC

Maeda T, Obata R, Rizk DO D, Kuno T. The association of interleukin-6 value, interleukin inhibitors, and outcomes of patients with COVID-19 in New York City. J Med Virol. 2020; jmv.26365. doi: 10/gg6m3s PubMed

Brat GA, Weber GM, Gehlenborg N, Avillach P, Palmer NP, Chiovato L, et al.. International electronic health record-derived COVID-19 clinical course profiles: the 4CE consortium. npj Digital Medicine. Nature Publishing Group; 2020;3: 1–9. doi: 10.1038/s41746-020-00308-0 PubMed DOI PMC

Hood K, Dahly D, Wilkinson J. Statistical review of Efficacy and safety of lopinavir/ritonavir or arbidol in adult patients with mild/moderate COVID-19: an exploratory randomized controlled trial. 2020; doi: 10.5281/zenodo.3779933 PubMed DOI

Hood K, Goulao B, Dahly D, Yap C. Statistical review of Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial [Internet]. Zenodo; 2020. May. Available: https://zenodo.org/record/3819778#.X1yBlotS-Uk PubMed PMC

Wynants L, Calster BV, Collins GS, Riley RD, Heinze G, Schuit E, et al.. Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal. BMJ. 2020;369. doi: 10.1136/bmj.m1328 PubMed DOI PMC

Steegen S, Tuerlinckx F, Gelman A, Vanpaemel W. Increasing Transparency Through a Multiverse Analysis. Perspect Psychol Sci. 2016;11: 702–712. doi: 10.1177/1745691616658637 PubMed DOI

R Core Team. R: A Language and Environment for Statistical Computing [Internet]. 2020. Available: https://www.R-project.org/

Wickham H, Averick M, Bryan J, Chang W, McGowan L, François R, et al.. Welcome to the Tidyverse. JOSS. 2019;4: 1686. doi: 10.21105/joss.01686 DOI

Therneau TM, Grambsch PM. Modeling survival data: extending the Cox model. New York: Springer; 2000.

Bürkner P-C. Advanced Bayesian Multilevel Modeling with the R Package brms. The R Journal. 2018;10: 395. doi: 10.32614/RJ-2018-017 DOI

Williams JP, Storlie CB, Therneau TM, J CR Jr, Hannig J. A Bayesian Approach to Multistate Hidden Markov Models: Application to Dementia Progression. Journal of the American Statistical Association. 2020;115: 16–31. doi: 10.1080/01621459.2019.1594831 DOI

Robin X, Turck N, Hainard A, Tiberti N, Lisacek F, Sanchez J-C, et al.. pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics. 2011;12: 77. doi: 10.1186/1471-2105-12-77 PubMed DOI PMC

Parackova Z, Zentsova I, Bloomfield M, Vrabcova P, Smetanova J, Klocperk A, et al.. Disharmonic Inflammatory Signatures in COVID-19: Augmented Neutrophils’ but Impaired Monocytes’ and Dendritic Cells’ Responsiveness. Cells. Multidisciplinary Digital Publishing Institute; 2020;9: 2206. doi: 10.3390/cells9102206 PubMed DOI PMC

Lu J, Hu S, Fan R, Liu Z, Yin X, Wang Q, et al.. ACP risk grade: a simple mortality index for patients with confirmed or suspected severe acute respiratory syndrome coronavirus 2 disease (COVID-19) during the early stage of outbreak in Wuhan, China. medRxiv. 2020; doi: 10.1101/2020.02.20.20025510 DOI

Chen X, Liu Z. Early prediction of mortality risk among severe COVID-19 patients using machine learning. medRxiv. 2020; doi: 10.1101/2020.04.13.20064329 DOI

Shi Y, Yu X, Zhao H, Wang H, Zhao R, Sheng J. Host susceptibility to severe COVID-19 and establishment of a host risk score: findings of 487 cases outside Wuhan. Critical Care. 2020;24: 108. doi: 10.1186/s13054-020-2833-7 PubMed DOI PMC

Caramelo F, Ferreira N, Oliveiros B. Estimation of risk factors for COVID-19 mortality—preliminary results. medRxiv. 2020; doi: 10.1101/2020.02.24.20027268 DOI

Bello-Chavolla OY, Bahena-López JP, Antonio-Villa NE, Vargas-Vázquez A, González-Díaz A, Márquez-Salinas A, et al.. Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico. J Clin Endocrinol Metab. 2020;105: 2752–2761. doi: 10.1210/clinem/dgaa346 PubMed DOI PMC

Horby P, Mafham M, Linsell L, Bell JL, Staplin N, Emberson JR, et al.. Effect of Hydroxychloroquine in Hospitalized Patients with COVID-19: Preliminary results from a multi-centre, randomized, controlled trial. medRxiv. 2020; doi: 10.1101/2020.07.15.20151852 DOI

Liu STH, Lin H-M, Baine I, Wajnberg A, Gumprecht JP, Rahman F, et al.. Convalescent plasma treatment of severe COVID-19: a propensity score–matched control study. Nat Med. 2020;26: 1708–1713. doi: 10.1038/s41591-020-1088-9 PubMed DOI

Agarwal A, Mukherjee A, Kumar G, Chatterjee P, Bhatnagar T, Malhotra P, et al.. Convalescent plasma in the management of moderate COVID-19 in India: An open-label parallel-arm phase II multicentre randomized controlled trial (PLACID Trial). medRxiv. 2020; doi: 10.1101/2020.09.03.20187252 PubMed DOI PMC

Štefan M, Chrdle A, Husa P, Beneš J, Dlouhý P. Covid-19: diagnostika a léčba [Internet]. Společnost infekčního lékařství ČLS JEP; 2021. Available: https://www.infekce.cz/Covid2019/DPcovid-19_SIL_0421.pdf

COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19)Treatment Guidelines [Internet]. National Institutes of Health; Available: https://www.covid19treatmentguidelines.nih.gov/ PubMed

Greenland S, Pearl J, Robins JM. Causal Diagrams for Epidemiologic Research: Epidemiology. 1999;10: 37–48. doi: 10.1097/00001648-199901000-00008 PubMed DOI

Arah OA. Analyzing Selection Bias for Credible Causal Inference: When in Doubt, DAG It Out. Epidemiology. 2019;30: 517–520. doi: 10.1097/EDE.0000000000001033 PubMed DOI PMC

Lodi S, Phillips A, Lundgren J, Logan R, Sharma S, Cole SR, et al.. Effect Estimates in Randomized Trials and Observational Studies: Comparing Apples With Apples. American Journal of Epidemiology. 2019;188: 1569–1577. doi: 10.1093/aje/kwz100 PubMed DOI PMC

Hernán MA, Sauer BC, Hernández-Díaz S, Platt R, Shrier I. Specifying a target trial prevents immortal time bias and other self-inflicted injuries in observational analyses. Journal of Clinical Epidemiology. 2016;79: 70–75. doi: 10.1016/j.jclinepi.2016.04.014 PubMed DOI PMC

Meier AS, Richardson BA, Hughes JP. Discrete Proportional Hazards Models for Mismeasured Outcomes. Biometrics. 2003;59: 947–954. doi: 10.1111/j.0006-341X.2003.00109.x PubMed DOI

Chen Y, Lawrence J, Hung HMJ, Stockbridge N. Methods for Employing Information About Uncertainty of Ascertainment of Events in Clinical Trials. Ther Innov Regul Sci. 2021;55: 197–211. doi: 10.1007/s43441-020-00206-3 PubMed DOI

Steyerberg EW, Moons KGM, van der Windt DA, Hayden JA, Perel P, Schroter S, et al.. Prognosis Research Strategy (PROGRESS) 3: Prognostic Model Research. PLoS Med. 2013;10: e1001381. doi: 10.1371/journal.pmed.1001381 PubMed DOI PMC

Altman DG, Royston P. The cost of dichotomising continuous variables. BMJ. 2006;332: 1080.1. doi: 10.1136/bmj.332.7549.1080 PubMed DOI PMC

Thoresen M. Spurious interaction as a result of categorization. BMC Med Res Methodol. 2019;19: 28. doi: 10.1186/s12874-019-0667-2 PubMed DOI PMC

Smith G. Step away from stepwise. J Big Data. 2018;5: 32. doi: 10.1186/s40537-018-0143-6 DOI

Gupta RK, Marks M, Samuels THA, Luintel A, Rampling T, Chowdhury H, et al.. Systematic evaluation and external validation of 22 prognostic models among hospitalised adults with COVID-19: an observational cohort study. Eur Respir J. 2020;56: 2003498. doi: 10.1183/13993003.03498-2020 PubMed DOI PMC

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...