%0 Journal Article 
%A Fernández Barat, Laia
%A Motos, Ana
%A Canseco Ribas, Joan
%A Gabarrús, Albert
%A López Aladid, Rubén
%A Álvaro Meca, Alejandro
%A Ceccato, Adrián
%A García, Nadia
%A Ferrer, Miquel
%A Battaglini, Denise
%A Ávarez-Napagao, Sergio
%A GarcÍa Gasulla, Dario
%A Ferrer, Ricard
%A de Gonzalo Calvo, David
%A Lorente, José Ángel
%A Menéndez, Rosario
%A Peñuelas, Oscar
%A Riera, Jordi
%A Rodrıíguez, Alejandro
%A Amaya Villar, Rosario
%A Añón, José M.
%A Balan Mariño, Ana
%A Barberà, Carme
%A Barberán, José
%A Blandino Ortiz, Aaron
%A Boado, Maria Victoria
%A Bofill, Neus
%A Bustamante Munguira, Elena
%A Caballero, Jesús
%A Cantón-Bulnes, María Luisa
%A Carbajales Pérez, Cristina
%A Carbonell, Nieves
%A Catalán González, Mercedes
%A de la Torre, Maria del Carmen
%A Díaz, Emili
%A Estella García, Ángel
%A Figueras, Albert
%A de Frutos, Raul
%A Franco, Nieves
%A Galbán, Cristóbal
%A Gallego, Elena
%A García Garmendia, José Luis
%A González, Jessica
%A Gómez, José M.
%A Gumucio-Sanguino, Víctor D.
%A Huerta, Arturo
%A Jorge García, Ruth Noemí
%A Loza Vázquez, Ana
%A Marin Corral, Judith
%A Martin Delgado, María Cruz
%A Martínez de la Gándara, Amalia
%A Martínez Varela, Ignacio
%A Albaiceta, Guillermo M.
%A Nieto, Maite
%A Peñasco, Yhivian
%A Pérez Bastida, Leire
%A Pérez García, Felipe
%A Pozo Laderas, Juan Carlos
%A Ricart, Pilar
%A Sagredo, Víctor
%A Sánchez Miralles, Ángel
%A Sancho Chinesta, Susana
%A Socias, Lorenzo
%A Solé Violan, Jordi
%A Suárez Sipmann, Fernando
%A Tamayo Lomas, Luis
%A Trenado, José
%A Úbeda, Alejandro
%A Valdivia, Luis Jorge
%A Vidal, Pablo
%A Bermejo Martin, Jesús
%A Barbe, Ferran
%A Torres, Antoni
%T Outcomes and predictors of mortality in patients with severe COVID-19 and COPD admitted to ICU: A multicenter study
%D 2025
%@ 2352-5568
%U http://hdl.handle.net/10498/39386
%X 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.
%K Chronic obstructive pulmonary disease
%K Respiratory support
%K Biomarkers
%K Acute respiratory distress syndrome
%K High flow nasal cannulas
%~ Universidad de Cádiz