ArticleInfectious diseases and therapy2023
Characteristics and Outcomes by Ceiling of Care of Subjects Hospitalized with COVID-19 During Four Waves of the Pandemic in a Metropolitan Area: A Multicenter Cohort Study.
Article in Infectious diseases and therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Ceiling of Care in Acute Care Settings: A Concept Analysis.Journal of nursing management · 2026Pooled it
- A multicenter COVID-19 database from four waves in the south metropolitan area of Barcelona, Catalonia.Scientific data · 2026Article
- Clinical effectiveness of intensive care unit admission in older adults with COVID-19 during the first pandemic wave in Spain.BMC geriatrics · 2026Observational
- Impact of ceiling of care on mortality across four COVID-19 epidemic waves in Catalonia: a multicentre prospective cohort study.BMJ open · 2025Article
- Predictive risk models for COVID-19 patients using the multi-thresholding meta-algorithm.Scientific reports · 2024Article
- End-of-Life Care during the COVID-19 Pandemic: Decreased Hospitalization of Nursing Home Residents at the End of Life.Healthcare (Basel, Switzerland) · 2024Article
- Development and validation of a model to predict ceiling of care in COVID-19 hospitalized patients.BMC palliative care · 2024Article
- COVID-19 patient profiles over four waves in Barcelona metropolitan area: A clustering approach.PloS one · 2024Article
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Authors and funding
14 authors at 7 institutions in 1 country.
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Abstract
introductionThe profiles of patients with COVID-19 have been widely studied, but little is known about differences in baseline characteristics and in outcomes between subjects with a ceiling of care assigned at hospital admission and subjects without a ceiling of care. The aim of this study is to compare, by ceiling of care, clinical features and outcomes of hospitalized subjects during four waves of COVID-19 in a metropolitan area in Catalonia.
methodsObservational study conducted during the first (March-April 2020), second (October-November 2020), third (January-February 2021), and fourth wave (July-August 2021) of COVID-19 in five centers of Catalonia. All subjects were adults (> 18 years old) hospitalized with a proven SARS-CoV-2 infection and with therapeutic ceiling of care assessed by the attending physician at hospital admission.
resultsA total of 5813 subjects were analyzed. Subjects with a ceiling of care were mainly older (difference in median age of 20 years), with more comorbidities (Charlson index 3 points higher) and with fewer clinical signs at baseline than patients without a ceiling of care. Some features of their clinical profiles changed among waves. There were differences in treatments received during hospital admission across waves, but not between subjects with and without a ceiling of care. Subjects with a ceiling of care had a death incidence more than four times the death incidence of subjects a without a ceiling of care (risk ratio (RR) ranging from 3.5 in the first wave to almost 6 in the third and fourth). Incidence of severe pneumonia and complications for subjects with a ceiling of care was around 1.5 times the incidence in subjects without a ceiling of care. DISCUSSION: Analysis of hospitalized subjects with SARS-CoV-2 infection should be stratified according to therapeutic ceiling of care to avoid bias and outcome misestimation.
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