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Clinical prediction rules for adverse outcomes in patients with SARS COV-2 infection by the omicron variant
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  • Janire Portuondo-Jimenez,
  • IRANTZU BARRIO,
  • Pedro Pablo España,
  • Julia Garcia-Asensio,
  • Mª José Legarreta,
  • Ane Villanueva,
  • María Gascón,
  • Lander Rodríguez,
  • Nere Larrea,
  • Susana García-Gutierrez,
  • Jose María Quintana-Lopez,
  • The COVID-Health Basque Country Research Group
Janire Portuondo-Jimenez
Basque Government Department of Health

Corresponding Author:janire.portuondojimenez@osakidetza.eus

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IRANTZU BARRIO
University of the Basque Country
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Pedro Pablo España
Hospital Galdakao-Usansolo
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Julia Garcia-Asensio
Basque Government Department of Health
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Mª José Legarreta
Hospital Galdakao-Usansolo
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Ane Villanueva
Hospital Galdakao-Usansolo
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María Gascón
Hospital Galdakao-Usansolo
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Lander Rodríguez
Basque Center for Applied Mathematics
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Nere Larrea
Hospital Galdakao-Usansolo
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Susana García-Gutierrez
Hospital Galdakao-Usansolo
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Jose María Quintana-Lopez
REDISSEC
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The COVID-Health Basque Country Research Group
Hospital Galdakao-Usansolo
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Abstract

Background. Factors related to an adverse evolution in COVID19 infection are needed for proper decision making. We try to identify factors related to hospitalization, ICU admission, and mortality related to the infection. Methods. Retrospective cohort study of patients with SARS-CoV-2 infection from March 1st 2020 to January 9th 2022. The sample was randomly divided into two subsamples, for the purposes of derivation and validation of the prediction rule, until omicron variant appearance and afterwards, respectively. Data collected for this study included sociodemographic data, baseline comorbidities and treatments, and other background data. Multivariable logistic regression models using Lasso logistic regression were used . Results. In the multivariable models, older age, male, peripheral vascular disease, heart failure, heart disease, cerebrovascular, dementia, liver, kidney, diabetes, hemiplegia, interstitial pulmonary disease, cystic fibrosis, malignant tumors, as well as diuretics and the chronic systemic use of steroids were common predictive factors of death. Similar predictors, except liver disease, plus arterial hypertension, were also related to adverse evolution. Similar predictors to the previous, including liver disease, plus dyslipidemia, inflammatory bowel disease, respiratory diseases, and the basal prescription of NSAIDs, heparin, bronchodilators, or immunosuppressants were related to hospital admission. All risk scores developed had AUCs from 0.79 (hospital admission) to 0.94 (death) in the validation in the omicron sample. Conclusions. We propose three risk scales for adverse outcomes and hospital admission easy to calculate and with high predictive capacity, which also work with the current omicron variant, which can help manage patients in primary, emergency, and hospital care.