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dc.contributor.authorÁlvarez-Esteban, Pedro C
dc.contributor.authorDel Barrio, Eustasio
dc.contributor.authorRueda Palacio, Oscar
dc.contributor.authorRueda, Cristina
dc.date.accessioned2021-11-25T17:29:27Z
dc.date.available2021-11-25T17:29:27Z
dc.date.issued2021
dc.identifier.issn1932-6203
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/331193
dc.description.abstractThis paper analyses COVID-19 patients' dynamics during the first wave in the region of Castilla y León (Spain) with around 2.4 million inhabitants using multi-state competing risk survival models. From the date registered as the start of the clinical process, it is assumed that a patient can progress through three intermediate states until reaching an absorbing state of recovery or death. Demographic characteristics, epidemiological factors such as the time of infection and previous vaccinations, clinical history, complications during the course of the disease and drug therapy for hospitalised patients are considered as candidate predictors. Regarding risk factors associated with mortality and severity, consistent results with many other studies have been found, such as older age, being male, and chronic diseases. Specifically, the hospitalisation (death) rate for those over 69 is 27.2% (19.8%) versus 5.3% (0.7%) for those under 70, and for males is 14.5%(7%) versus 8.3%(4.6%)for females. Among patients with chronic diseases the highest rates of hospitalisation are 26.1% for diabetes and 26.3% for kidney disease, while the highest death rate is 21.9% for cerebrovascular disease. Moreover, specific predictors for different transitions are given, and estimates of the probability of recovery and death for each patient are provided by the model. Some interesting results obtained are that for patients infected at the end of the period the hazard of transition from hospitalisation to ICU is significatively lower (p < 0.001) and the hazard of transition from hospitalisation to recovery is higher (p < 0.001). For patients previously vaccinated against pneumococcus the hazard of transition to recovery is higher (p < 0.001). Finally, internal validation and calibration of the model are also performed.
dc.format.mediumElectronic-eCollection
dc.languageeng
dc.publisherPublic Library of Science (PLoS)
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectHumans
dc.subjectDisease Progression
dc.subjectCalibration
dc.subjectHospital Records
dc.subjectConfidence Intervals
dc.subjectProportional Hazards Models
dc.subjectProbability
dc.subjectReproducibility of Results
dc.subjectComorbidity
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectInfant
dc.subjectInfant, Newborn
dc.subjectHospitals
dc.subjectPrimary Health Care
dc.subjectSpain
dc.subjectFemale
dc.subjectMale
dc.subjectYoung Adult
dc.subjectCOVID-19
dc.titlePredicting COVID-19 progression from diagnosis to recovery or death linking primary care and hospital records in Castilla y León (Spain).
dc.typeArticle
prism.issueIdentifier9
prism.publicationDate2021
prism.publicationNamePLoS One
prism.startingPagee0257613
prism.volume16
dc.identifier.doi10.17863/CAM.78640
dc.identifier.doi10.17863/CAM.78640
dcterms.dateAccepted2021-09-03
rioxxterms.versionofrecord10.1371/journal.pone.0257613
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2021-01
dc.contributor.orcidÁlvarez-Esteban, Pedro C [0000-0002-8818-0194]
dc.contributor.orcidRueda Palacio, Oscar [0000-0003-0008-4884]
dc.identifier.eissn1932-6203
rioxxterms.typeJournal Article/Review
pubs.funder-project-idNational Institute for Health Research (NIHRDH-IS-BRC-1215-20014)
cam.issuedOnline2021-09-20


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International