Long-Term Outcomes of Patients with Coronavirus Disease 2019 at One Year after Hospital Discharge.

BACKGROUND: The long-term effects of COVID-19 remain largely unclear. This study aims to investigate post-acute health consequences and mortality one year after hospital discharge. METHODS: All surviving adult patients who were discharged after hospital admission due to acute COVID-19 in the first wave of the pandemic underwent a comprehensive interview. Functional assessment was performed in patients aged over 65. Clinical and hospital records were reviewed and mortality causes assessed. RESULTS: A total of 587 patients with COVID-19 were discharged from hospital, including 266 after hospital admission and 321 from the emergency room. Mortality within the following year occurred in 34/266 (12.8%) and 10/321 (3.1%), respectively, due to causes directly or possibly related to COVID-19 in 20.5% and 25% of patients. Post-COVID-19 syndrome was assessed in 543 patients at one year from discharge. Any clinical complaint was reported by 90.1% of patients who needed hospitalization and 80.4% of those discharged from the emergency room (p = 0.002), with breathlessness (41.6%), tiredness (35.4%), ageusia (30.2%), and anosmia (26.3%) being the most common complaints. Ongoing symptoms attributed to COVID-19 were reported by 66.8% and 49.5% of patients, respectively (p < 0.001). Newly developed COPD, asthma, diabetes, heart failure, and arthritis-as well as worsening of preexisting comorbidities-were found. CONCLUSIONS: One-year mortality among survivors of acute COVID-19 was 7.5%. A significant proportion of COVID-19 patients experienced ongoing symptoms at 1 year from onset of the disease.

Utilidad de la cistatina C como marcador pronóstico en la enfermedad tromboembólica venosa / Usefulness of cystatin C as a prognostic marker in venous thromboembolism

Fundamento y objetivo: La cistatina C (cisC) es un marcador pronóstico en pacientes con hipertensión arterial, enfermedad coronaria e insuficiencia cardíaca. El objetivo de este trabajo es determinar el valor pronóstico de los valores de cisC obtenida en el momento del diagnóstico, en pacientes con enfermedad tromboembólica venosa (ETEV). Pacientes y método: Estudio retrospectivo de una cohorte de 226 pacientes consecutivos con ETEV, seguidos durante 6 meses. Se obtuvieron muestras de suero para la determinación de cisC, creatinina, y la fracción N-terminal prohormone of brain natriuretic peptide (NT-proBNP, «N-terminal del propéptido natriurético cerebral») en el momento del diagnóstico. Resultados: El valor de cisC de mayor poder discriminatorio de fallecimiento en 6meses fue de 1.175 mg/dl (sensibilidad del 76%, especificidad del 65%, valor predictivo positivo del 26%, valor predictivo negativo del 94%). Por encima del punto de corte fallecieron 17/48 pacientes frente a 9/152 que tenían niveles inferiores (odds ratio 5,98; intervalo de confianza del 95% [IC 95%] 2,50-14,29; p < 0,001). El hazard ratio ajustado en un modelo multivariante fue de 3,76 (IC 95% 1,46-9,66). La precisión de este parámetro fue similar al de creatinina (1,24 mg/dl), pero inferior al del NT-proBNP (435 pg/ml). Los pacientes que superaban los valores límite de cisC y de NT-proBNP conjuntamente no tenían mayor riesgo de fallecimiento que los que superaban solo los de NT-proBNP (odds ratio 9,43; IC 95% 3,90-22,81; p < 0,001). No hubo ningún valor que se asociara de forma significativa con los episodios de hemorragia o recidiva. Conclusión: La concentración de cisC en el momento del diagnóstico de los pacientes con ETEV tiene valor pronóstico, similar al de creatinina sérica e inferior al del NT-proBNP (AU)

Background and objective: Cystatin C (cysC) is a prognostic marker in patients with hypertension, coronary heart disease and heart failure. The aim of this study was to determine the prognostic value of cysC levels obtained at the time of diagnosis in patients with venous thromboembolism (VTE). Material and method: Retrospective study of a cohort of 226 consecutive patients with VTE, followed for 6 months. Serum samples were obtained for the determination of cysC, creatinine, and the N-terminal fraction of the brain natriuretic peptide (NT-proBNP) at the time of diagnosis. Results: The highest discriminating power value of dying at 6 months for cysC was 1,175 mg/dl (sensitivity 76%, specificity 65%, positive predictive value 26%, negative predictive value 94%). Above the cut-off, 17/48 patients died, versus 9/152 that had lower levels (odds ratio: 5.98, 95% confidence interval [95% CI]: 2.50-14.29, P < .001). The adjusted hazard ratio in a multivariate model was 3.76 (95% CI 1.46-9.66). The accuracy of this parameter was similar to that for creatinine (1.24 mg/dl) but lower than the NT-proBNP (435 pg/ml). Patients who exceeded the limit values of cysC and NT-proBNP together had no greater risk of death than those above NT-proBNP only (odds ratio: 9.43, 95% CI 3.90-22.81, P < .001). There was no value, which was significantly associated with bleeding episodes or recurrent thromboembolism. Conclusion: CysC concentration at the time of diagnosis in VTE patients has prognostic value, which is similar to that of serum creatinine and lower than that of NT-proBNP (AU)

[Usefulness of cystatin C as a prognostic marker in venous thromboembolism]. / Utilidad de la cistatina C como marcador pronóstico en la enfermedad tromboembólica venosa.

BACKGROUND AND OBJECTIVE: Cystatin C (cysC) is a prognostic marker in patients with hypertension, coronary heart disease and heart failure. The aim of this study was to determine the prognostic value of cysC levels obtained at the time of diagnosis in patients with venous thromboembolism (VTE). MATERIAL AND METHOD: Retrospective study of a cohort of 226 consecutive patients with VTE, followed for 6 months. Serum samples were obtained for the determination of cysC, creatinine, and the N-terminal fraction of the brain natriuretic peptide (NT-proBNP) at the time of diagnosis. RESULTS: The highest discriminating power value of dying at 6 months for cysC was 1,175mg/dl (sensitivity 76%, specificity 65%, positive predictive value 26%, negative predictive value 94%). Above the cut-off, 17/48 patients died, versus 9/152 that had lower levels (odds ratio: 5.98, 95% confidence interval [95% CI]: 2.50-14.29, P<.001). The adjusted hazard ratio in a multivariate model was 3.76 (95% CI 1.46-9.66). The accuracy of this parameter was similar to that for creatinine (1.24mg/dl) but lower than the NT-proBNP (435pg/ml). Patients who exceeded the limit values of cysC and NT-proBNP together had no greater risk of death than those above NT-proBNP only (odds ratio: 9.43, 95% CI 3.90-22.81, P<.001). There was no value, which was significantly associated with bleeding episodes or recurrent thromboembolism. CONCLUSION: CysC concentration at the time of diagnosis in VTE patients has prognostic value, which is similar to that of serum creatinine and lower than that of NT-proBNP.