@misc{10498/39386,
year = {2025},
url = {http://hdl.handle.net/10498/39386},
abstract = {Background: 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.},
publisher = {Elsevier},
keywords = {Chronic obstructive pulmonary disease},
keywords = {Respiratory support},
keywords = {Biomarkers},
keywords = {Acute respiratory distress syndrome},
keywords = {High flow nasal cannulas},
title = {Outcomes and predictors of mortality in patients with severe COVID-19 and COPD admitted to ICU: A multicenter study},
doi = {10.1016/J.ACCPM.2025.101558},
author = {Fernández Barat, Laia and Motos, Ana and Canseco Ribas, Joan and Gabarrús, Albert and López Aladid, Rubén and Álvaro Meca, Alejandro and Ceccato, Adrián and García, Nadia and Ferrer, Miquel and Battaglini, Denise and Ávarez-Napagao, Sergio and GarcÍa Gasulla, Dario and Ferrer, Ricard and de Gonzalo Calvo, David and Lorente, José Ángel and Menéndez, Rosario and Peñuelas, Oscar and Riera, Jordi and Rodrıíguez, Alejandro and Amaya Villar, Rosario and Añón, José M. and Balan Mariño, Ana and Barberà, Carme and Barberán, José and Blandino Ortiz, Aaron and Boado, Maria Victoria and Bofill, Neus and Bustamante Munguira, Elena and Caballero, Jesús and Cantón-Bulnes, María Luisa and Carbajales Pérez, Cristina and Carbonell, Nieves and Catalán González, Mercedes and de la Torre, Maria del Carmen and Díaz, Emili and Estella García, Ángel and Figueras, Albert and de Frutos, Raul and Franco, Nieves and Galbán, Cristóbal and Gallego, Elena and García Garmendia, José Luis and González, Jessica and Gómez, José M. and Gumucio-Sanguino, Víctor D. and Huerta, Arturo and Jorge García, Ruth Noemí and Loza Vázquez, Ana and Marin Corral, Judith and Martin Delgado, María Cruz and Martínez de la Gándara, Amalia and Martínez Varela, Ignacio and Albaiceta, Guillermo M. and Nieto, Maite and Peñasco, Yhivian and Pérez Bastida, Leire and Pérez García, Felipe and Pozo Laderas, Juan Carlos and Ricart, Pilar and Sagredo, Víctor and Sánchez Miralles, Ángel and Sancho Chinesta, Susana and Socias, Lorenzo and Solé Violan, Jordi and Suárez Sipmann, Fernando and Tamayo Lomas, Luis and Trenado, José and Úbeda, Alejandro and Valdivia, Luis Jorge and Vidal, Pablo and Bermejo Martin, Jesús and Barbe, Ferran and Torres, Antoni},
}