ArticleThe Lancet regional health. Europe2022
Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study.
Article in The Lancet regional health. Europe, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Global prevalence of post-COVID-19 condition: a systematic review and meta-analysis of prospective evidence.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2025Pooled it
- Integration of the circulating miRNome and clinical information to predict 90-day mortality in elderly COVID-19 subphenotypes.iScience · 2026Article
- The Impact of Comorbidities on Health-Related Quality of Life Among Patients with Rheumatoid Arthritis.Healthcare (Basel, Switzerland) · 2026Article
- A transfer triage tool for COVID-19 mass critical care surges.Scientific reports · 2025Observational
- Latent class analysis of hospitalization, ICU admission, and mortality among COVID-19 patients in Iran.Scientific reports · 2024Article
- Neural network-assisted humanisation of COVID-19 hamster transcriptomic data reveals matching severity states in human disease.EBioMedicine · 2024Article
- Two-year survival after scheduled extubation in patients with pneumonia or ARDS: a prospective observational study.BMC anesthesiology · 2024Observational
- Do critical illness survivors with multimorbidity need a different model of care?Critical care (London, England) · 2023Review
- Sociodemographic and clinical characteristics associated with delirium in hospitalized patients with COVID-19: are immigrants a vulnerable group?Internal and emergency medicine · 2023Article
- Acute kidney injury in Coronavirus disease-19 related pneumonia in the intensive care unit: a retrospective multicenter study, Saudi Arabia.Multidisciplinary respiratory medicine · 2023Article
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Authors and funding
72 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The clinical heterogeneity of COVID-19 suggests the existence of different phenotypes with prognostic implications. We aimed to analyze comorbidity patterns in critically ill COVID-19 patients and assess their impact on in-hospital outcomes, response to treatment and sequelae. Methods: Multicenter prospective/retrospective observational study in intensive care units of 55 Spanish hospitals. 5866 PCR-confirmed COVID-19 patients had comorbidities recorded at hospital admission; clinical and biological parameters, in-hospital procedures and complications throughout the stay; and, clinical complications, persistent symptoms and sequelae at 3 and 6 months. Findings: Latent class analysis identified 3 phenotypes using training and test subcohorts: low-morbidity (n=3385; 58%), younger and with few comorbidities; high-morbidity (n=2074; 35%), with high comorbid burden; and renal-morbidity (n=407; 7%), with chronic kidney disease (CKD), high comorbidity burden and the worst oxygenation profile. Renal-morbidity and high-morbidity had more in-hospital complications and higher mortality risk than low-morbidity (adjusted HR (95% CI): 1.57 (1.34-1.84) and 1.16 (1.05-1.28), respectively). Corticosteroids, but not tocilizumab, were associated with lower mortality risk (HR (95% CI) 0.76 (0.63-0.93)), especially in renal-morbidity and high-morbidity. Renal-morbidity and high-morbidity showed the worst lung function throughout the follow-up, with renal-morbidity having the highest risk of infectious complications (6%), emergency visits (29%) or hospital readmissions (14%) at 6 months (p<0.01). Interpretation: Comorbidity-based phenotypes were identified and associated with different expression of in-hospital complications, mortality, treatment response, and sequelae, with CKD playing a major role. This could help clinicians in day-to-day decision making including the management of post-discharge COVID-19 sequelae. Funding: ISCIII, UNESPA, CIBERES, FEDER, ESF.
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