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Risk categories in COVID-19 based on degrees of inflammation: data on more than 17,000 patients from the Spanish SEMI-COVID-19 registry Rubio-Rivas, Manuel Corbella, Xavier Formiga Pérez, Francesc Menéndez Fernández, Estela Martín Escalante, María Dolores Baños Fernández, Isolina Arnalich Fernández, Francisco Corral-Beamonte, Esther del Lalueza, Antonio Parra Virto, Alejandro Roy Vallejo, Emilia Loureiro Amigo, José Álvarez Suárez, Ana María Abadía-Otero, Jesica Navarro de la Chica, María Estévez González, Raquel Hernández Milián, Almudena Areses Manrique, María Blázquez Encinar, Julio César González Noya, Amara González Ferrer, Ruth Pérez Aguilera, María Gil Sánchez, Ricardo Millán Núñez-Cortés, Jesús Casas Rojo, José SEMI-COVID-19 Network COVID-19 Citoquines Mortalitat COVID-19 Cytokines Mortality Background: the inflammation or cytokine storm that accompanies COVID-19 marks the prognosis. This study aimed to identify three risk categories based on inflammatory parameters on admission. Methods: retrospective cohort study of patients diagnosed with COVID-19, collected and followed-up from 1 March to 31 July 2020, from the nationwide Spanish SEMI-COVID-19 Registry. The three categories of low, intermediate, and high risk were determined by taking into consideration the terciles of the total lymphocyte count and the values of C-reactive protein, lactate dehydrogenase, ferritin, and D-dimer taken at the time of admission. Results: a total of 17,122 patients were included in the study. The high-risk group was older (57.9 vs. 64.2 vs. 70.4 years; p < 0.001) and predominantly male (37.5% vs. 46.9% vs. 60.1%; p < 0.001). They had a higher degree of dependence in daily tasks prior to admission (moderate-severe dependency in 10.8% vs. 14.1% vs. 17%; p < 0.001), arterial hypertension (36.9% vs. 45.2% vs. 52.8%; p < 0.001), dyslipidemia (28.4% vs. 37% vs. 40.6%; p < 0.001), diabetes mellitus (11.9% vs. 17.1% vs. 20.5%; p < 0.001), ischemic heart disease (3.7% vs. 6.5% vs. 8.4%; p < 0.001), heart failure (3.4% vs. 5.2% vs. 7.6%; p < 0.001), liver disease (1.1% vs. 3% vs. 3.9%; p = 0.002), chronic renal failure (2.3% vs. 3.6% vs. 6.7%; p < 0.001), cancer (6.5% vs. 7.2% vs. 11.1%; p < 0.001), and chronic obstructive pulmonary disease (5.7% vs. 5.4% vs. 7.1%; p < 0.001). They presented more frequently with fever, dyspnea, and vomiting. These patients more frequently required high flow nasal cannula (3.1% vs. 4.4% vs. 9.7%; p < 0.001), non-invasive mechanical ventilation (0.9% vs. 3% vs. 6.3%; p < 0.001), invasive mechanical ventilation (0.6% vs. 2.7% vs. 8.7%; p < 0.001), and ICU admission (0.9% vs. 3.6% vs. 10.6%; p < 0.001), and had a higher percentage of in-hospital mortality (2.3% vs. 6.2% vs. 23.9%; p < 0.001). The three risk categories proved to be an independent risk factor in multivariate analyses. Conclusion: the present study identifies three risk categories for the requirement of high flow nasal cannula, mechanical ventilation, ICU admission, and in-hospital mortality based on lymphopenia and inflammatory parameters. 2021-06-03T16:02:00Z 2021-06-03T16:02:00Z 2021-05-01 2021-06-03T16:02:00Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.3390/jcm10102214 Journal of Clinical Medicine, 2021, vol. 10, num. 10, p. 2214 https://doi.org/10.3390/jcm10102214 cc-by (c) Rubio-Rivas, Manuel et al., 2021 https://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess MDPI Articles publicats en revistes (Ciències Clíniques)