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Therefore&#44; the identification of risk factors is a priority for the proper management of these patients&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The SEMI-COVID-19 Registry has revealed that mortality in Spain reached 21&#37;&#44; according to data from 2020<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46; In addition&#44; the percentage of hospitalized patients who required mechanical ventilation was as high as 65&#37;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of this study was to identify factors of poor progress in SARS-CoV-2 infection in patients hospitalized due to COVID-19&#46; Poor progress was defined as onset of severe ARDS during hospitalization &#40;P&#47;F ratio &#8804;100&#160;mmHg&#41;&#44; admission to the intensive care unit &#40;ICU&#41;&#44; or in-hospital death&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This is a nested case-control study within the COVID-19 Osakidetza cohort &#40;NCT04463706&#41;&#46; In this study&#44; cases were patients admitted to the hospitalization ward due to COVID-19 who presented with clinical deterioration &#40;presence during the hospitalization of severe ARDS &#40;PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span>&#160;&#8804;&#160;100&#160;mmHg&#41;&#44; admission to the ICU&#44; or in-hospital death&#41;&#46; The controls were patients hospitalized due to COVID-19 who did not present with severe ARDS&#46; Cases and controls were matched according to age groups&#46; The exclusion criteria were those who died in the emergency department&#44; those who were admitted directly to the ICU&#44; or those who presented with a P&#47;F ratio&#160;&#8804;&#160;100&#160;mmHg in the first 24&#160;h of hospitalization&#46; Two controls were identified per case&#46; The inclusion period was from March 3&#44; 2020 to April 10&#44; 2020&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The project was approved by the Basque Country Ethics Committee &#40;PI2020059&#41;&#46; Simple random sampling was used&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Variables were obtained from the Osakidetza-Basque Health System electronic medical record &#40;EMR&#41; data processing system by means of a review of the EMRs by trained reviewers supervised by collaborating clinicians&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The following variables were gathered&#58; sociodemographic variables &#40;age and sex&#41;&#59; personal medical history &#40;comorbidities included in the Charlson Comorbidity Index&#41;&#59; disease history &#40;symptoms and date of onset&#44; date of first contact with the healthcare system&#44; persistence of symptoms&#44; treatments indicated&#44; contact with primary care in the previous month&#41;&#59; current hospitalization episode &#40;symptoms upon arrival at the emergency department&#41;&#59; vital signs &#40;oxygen saturation as measured by a pulse oximeter &#40;SaO<span class="elsevierStyleInf">2</span>p&#41;&#59; clinical signs and physical examination&#59; laboratory tests upon admission &#40;biochemistry&#58; renal function&#44; albumin&#44; liver panel&#59; acute-phase reactants&#58; LDH&#44; CRP&#59; complete blood count and blood differential&#59; coagulation&#44; prothrombin time&#44; and <span class="elsevierStyleSmallCaps">d</span>-dimer&#41;&#59; pathological X-ray upon admission&#44; defined as an X-ray which showed previously unknown infiltrates or condensations or data indicative of ARDS &#40;presence of bilateral opacities not fully explained by effusion&#44; lobar collapse&#44; a collapsed lung&#44; or lung nodules&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The lowest P&#47;F ratio &#40;PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span>&#41; was calculated at various points in time&#58; upon arrival at the emergency department&#44; the day the patient was transferred to the hospital ward&#44; and through day three of the hospital stay&#46; In addition&#44; the lowest P&#47;F ratio reached during hospitalization was recorded for both the cases and the controls&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A case was defined as a patient who presented with clinical deterioration during hospitalization&#44; defined as presence of a P&#47;F ratio &#8804;100&#160;mmHg&#44; admission to the ICU&#44; or in-hospital death &#40;date&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0055" class="elsevierStylePara elsevierViewall">Descriptive statistics of the variables were performed&#46; Categorical variables are shown as frequency and percentages and continuous variables are shown as means and standard deviations or medians and interquartile ranges&#46; On the univariate analysis&#44; variables from cases and controls were compared using conditional logistic regression models&#46; The dependent variable was clinical deterioration and the rest were independent variables&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Laboratory tests upon admission&#44; which were recorded as continuous variables&#44; were also analyzed after being categorized into three groups&#58; normal range values &#40;defined in the tables&#41;&#44; lower values&#44; and higher values&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">For the conditional logistic regression model&#44; all independent variables with <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;20 on the univariate analysis were included&#46; Effects were considered significant when <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;05&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The odds ratio &#40;OR&#41; and 95&#37; confidence intervals &#40;95&#37; CI&#41; were calculated&#46; The model&#8217;s explanatory power was analyzed by calculating R<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and the area under the curve &#40;AUC&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Differences in the P&#47;F ratio between cases and controls were analyzed by means of a boxplot for the P&#47;F ratio values at different points of the hospitalization &#40;arrival at the emergency department&#59; arrival on the ward&#59; day one&#59; day two&#59; day three&#59; and the critical day&#44; defined as the day a patient presented with deterioration&#46; Longitudinal data analysis was performed in order to identify differences in the P&#47;F ratio trends&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">All statistical analyses were performed using SAS for Windows&#44; version 9&#46;4 &#40;SAS Institute&#44; Cary&#44; NC&#44; USA&#41; and R&#169;&#44; version 4&#46;0&#46;0</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0085" class="elsevierStylePara elsevierViewall">A total of 366 patients were randomly selected from the 4447 patients who were hospitalized during the study period in participating centers&#46; Once ineligible patients were excluded&#44; our sample comprised 99 cases and 205 controls&#44; of which 198 eligible patients were selected in order to have a case&#47;control ratio of 1&#58;2 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Males were more numerous among the cases than the controls &#40;79&#37; vs&#46; 65&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;014&#41; as were patients who had had an acute myocardial infarction &#40;AMI&#41; &#40;14&#37; vs&#46; 4&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;03&#41;&#44; diabetes with organ damage &#40;7&#37; vs&#46; 1&#46;5&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;025&#41;&#44; and hypertension &#40;63&#37; vs&#46; 49&#46;4&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;031&#41;&#46; A lower frequency was observed among cases versus controls for the symptoms of dry cough &#40;51&#46;5&#37; vs&#46; 65&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;021&#41; and sore throat &#40;5&#37; vs&#46; 18&#46;7&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;003&#41;&#46; More cases than controls had consulted with their primary care physicians &#40;48&#46;5&#37; vs&#46; 34&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;016&#41;&#46; The plain X-ray was more often pathological among the cases &#40;91&#37; vs&#46; 77&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;004&#41;&#46; There was an association between levels of glucose&#44; LDH&#44; CRP&#44; and platelets and clinical deterioration&#59; patients who deteriorated presented with higher figures of the first three parameters and lower platelet figures &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; All the variables described in the methods section were considered on the univariate analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">When these variables were combined on the multivariate model&#44; patients who presented with an O<span class="elsevierStyleInf">2</span> saturation in the emergency department of &#8804;90&#37; had an increased risk of clinical deterioration &#40;OR&#160;&#61;&#160;16&#46;57&#44; 95&#37; CI 4&#8211;68&#44; <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;001&#41; as well as those who had had AMI &#40;OR&#160;&#61;&#160;15&#46;72&#44; 95&#37; CI 3&#46;3&#8211;75&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;0006&#41;&#44; hypertension &#40;OR&#160;&#61;&#160;2&#46;21&#44; 95&#37; CI 1&#46;1&#8211;4&#46;4&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;024&#41;&#44; and COPD &#40;OR&#160;&#61;&#160;3&#46;05&#44; 95&#37; CI 1&#46;4&#8211;6&#46;5&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;004&#41;&#46; In addition&#44; a pathological X-ray entailed a risk that was 5&#46;6 times greater&#46; CRP levels &#62;100 were positively related to possibility of deterioration&#44; as were blood glucose levels &#62;200&#46; Patients with platelet levels less than 15&#160;&#215;&#160;10<span class="elsevierStyleSup">3</span>&#47;&#181;L presented with a risk of deterioration that was four times higher than those who had platelet levels within normal or elevated ranges &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The variability explained by the model measured by R<span class="elsevierStyleSup">2</span> was 25&#37; and the predictive power as measured by AUC was 0&#46;86&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The P&#47;F ratio was lower among the cases at the various moments it was analyzed &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;001 for all&#41;&#46; The difference in the P&#47;F ratio trend between cases and controls was also statistically significant overall &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;001&#41;&#44; but can be divided into two intervals&#58; the difference is not significant in measurements upon arrival at the emergency department and hospitalization day one&#59; furthermore&#44; the trends are practically parallel during this period &#40;<span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;064&#41;&#46; However&#44; after hospitalization day one&#44; the cases continued on a downward trend whereas controls stabilized more &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;001&#41;&#46; On the second day of hospitalization&#44; 75&#37; of the cases had values lower than 253&#46;6 whereas 75&#37; of the controls had values higher than 271&#46;4&#46; The decline in the third day of hospitalization until the day a patient presented with deterioration or the critical day was more marked among the cases &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion and conclusions</span><p id="par0110" class="elsevierStylePara elsevierViewall">This study sheds light on the main clinical characteristics of patients hospitalized due to COVID-19 who present with poor progress&#44; defined as PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> &#8804;100&#44; admission to the ICU&#44; or death&#46; In this work&#44; it was possible to determine that presence of SaO<span class="elsevierStyleInf">2</span> &#8804;90&#37;&#44; hyperglycemia&#44; elevated CRP levels&#44; thrombocytopenia&#44; a pathological X-ray upon admission&#44; and a previous associated disease &#40;AMI&#44; COPD&#44; or hypertension&#41; were associated with clinical deterioration&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Numerous studies coincide on highlighting age&#44; male sex&#44; and presence of dyspnea as predictive factors of mortality or ICU admission in COVID-19 patients<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; As this study paired cases and controls by age&#44; we were not able to evaluate this variable&#8217;s effect on outcomes&#46; In regard to sex&#44; 78&#46;79&#37; of patients who developed clinical deterioration in this study were men&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">A meta-analysis by Jain and Yuan<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> evaluated symptoms and comorbidities that were predictors of severity and ICU admission in patients with COVID-19 and found that dyspnea was the only predictive symptom of both outcomes&#46; Unlike other published works&#44; dyspnea was not significantly more frequent among the cases in our study&#46; This is probably related to the exclusion of patients who required mechanical ventilation in the first 24&#160;h&#44; given that patients who were admitted to the ICU in that time period were transferred due to presence of severe ARDS&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">It is important to note that our main objective was to identify patients who&#44; hospitalized in the pulmonary phase of the disease as per the phases proposed by Siddiqi and Mehra<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#44; presented with clinical deterioration during hospitalization&#46; Thus&#44; the cases more frequently had an SaO<span class="elsevierStyleInf">2</span>p that was lower than the controls upon arrival to the emergency department&#46; Despite the fact that the oxygen values were practically within normal ranges&#44; there was an objective clinical repercussion given that in addition&#44; the cases also presented with tachypnea more often&#44; which is undoubtedly a determining factor of poor progress in pneumonia and is included on COVID-19 severity scales<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Fu et al&#46;&#8217;s<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> study on 200 patients observed that both age and comorbidities such as low oxygenation were associated with greater mortality&#46; Therefore&#44; it seems that lower oxygenation values upon admission may predict later deterioration&#46; Beyond this&#44; as <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows&#44; there is a point of inflection in oxygenation&#44; which has been termed the &#8220;critical day&#8221; for patients&#46; Therefore&#44; proper identification of the clinical characteristics of patients at high risk of worsening is crucial&#46; Bilateral lung involvement and ground-glass opacities have been demonstrated to be the most frequent radiological form of presentation in the literature<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;12</span></a>&#46; However&#44; in our study&#44; we could not determine the type of radiological involvement&#59; it was only known that patients who developed clinical worsening during the course of the disease presented with some type of initial radiological abnormality versus the controls&#44; who had normal X-rays&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In regard to associated diseases&#44; it seems logical that patients with chronic diseases such as COPD who presented with chronic lung parenchyma inflammation&#44; limitation of expiratory flow&#44; and greater susceptibility to infections would be more vulnerable to the disease<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46; Likewise&#44; in line with other Spanish cohorts<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#44; a greater association between COPD and clinical deterioration has been observed&#44; which is likely related to presence of a greater number of comorbidities than COVID-19 patients usually have<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Hypertension and AMI are significantly related to clinical deterioration<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#46; Zhao et al&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> identified that age &#62;60 years&#44; cardiovascular disease&#44; hypertension&#44; and diabetes were independent factors of mortality due to COVID-19&#46; Another two recent studies indicated that these patients more often had myocardial damage and arrhythmias during the hospitalization&#44; which are associated with greater mortality<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a>&#46; Direct viral involvement as well as inflammation secondary to the cytokine storm in SARS-CoV-2 infection could be behind this myocardial damage<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46; The potential impact this damage may have in the long-term is still to be determined&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Lastly&#44; elevated glucose and CRP levels were predictors of clinical deterioration&#46; Both parameters have been widely studied in pneumonia&#46; Hyperglycemia that is either secondary to the stress of the infection or due to diabetes or an underlying metabolic syndrome could increase mortality in COVID-19 patients<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#8211;22</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Diabetes is one of the most frequent comorbidities in COVID-19 and can worsen its prognosis<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#46; An inappropriate immune response along with exacerbation of the proinflammatory storm could explain this association<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&#46; Undoubtedly&#44; proper management and control of glucose levels must be a key part of COVID-19 treatment&#46; In regard to CRP&#44; its elevation has been associated with disease severity and&#44; in addition&#44; it seems to have surpassed other biomarkers more commonly used in sepsis<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">On the other hand&#44; the cases presented with lower platelet levels than the controls&#46; A recent retrospective study which included 1476 patients observed that 20&#46;7&#37; of the sample presented with thrombocytopenia&#44; which was significantly associated with in-hospital mortality<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#46; It has been observed that disseminated intravascular coagulation is frequent among those who have died due to SARS-CoV-2 infection&#44; which could explain the increase in platelet consumption<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">This study has certain limitations inherent to its case-control design&#46; In addition&#44; it was not possible to identify the specific radiological involvement&#44; there were some missing analytical variables&#44; and the results are not able to be extrapolated to patients excluded from the study due to deterioration in the first 24&#160;h&#46; In regard to the study period&#44; in the initial phases of the pandemic&#44; it was less likely that patients with mild-moderate disease would have been admitted to the hospital&#59; the majority were severe patients&#46; In addition&#44; variables that were later determined to be predictors of poor progress in COVID-19 patients were not included because at the time of recruitment&#44; they were not routinely requested &#40;for example&#44; ferritin&#41;&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">New studies are needed that help identify patients at risk of clinical deterioration so that healthcare professionals can make appropriate decisions about their destination and treatment&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Funding</span><p id="par0170" class="elsevierStylePara elsevierViewall">This project has been funded by the <span class="elsevierStyleGrantSponsor" id="gs0005">Carlos III Institute of Health</span> in the extraordinary call for research projects on SARS-CoV-2 and COVID-19 disease&#44; file number COV20&#47;0459&#44; and the Network for <span class="elsevierStyleGrantSponsor" id="gs0010">Research in Chronic Disease Healthcare Departments</span> &#40;REDISSEC&#44; for its initials in Spanish&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicts of interest</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors declare that they do not have any conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">There is controversy regarding the best predictors of clinical deterioration in COVID-19&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">This work aims to identify predictors of risk factors for deterioration in patients hospitalized due to COVID-19&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods design</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Nested case-control study within a cohort&#46; Setting&#58; 13 acute care centers of the Osakidetza-Basque Health Service&#46; Participants&#58; patients hospitalized for COVID-19 with clinical deterioration&#8212;defined as onset of severe ARDS&#44; ICU admission&#44; or death&#8212;were considered cases&#46; Two controls were matched to each case based on age&#46; Sociodemographic data&#59; comorbidities&#59; baseline treatment&#59; symptoms&#59; date of onset&#59; previous consultations&#59; and clinical&#44; analytical&#44; and radiological variables were collected&#46; An explanatory model of clinical deterioration was created by means of conditional logistic regression&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">A total of 99 cases and 198 controls were included&#46; According to the logistic regression analysis&#44; the independent variables associated with clinical deterioration were&#58; emergency department O<span class="elsevierStyleInf">2</span> saturation &#8804;90&#37; &#40;OR 16&#46;6&#59; 95&#37;CI 4&#8211;68&#41;&#44; pathological chest X-ray &#40;OR 5&#46;6&#59; 95&#37;CI 1&#46;7&#8211;18&#46;4&#41;&#44; CRP&#160;&#62;&#160;100&#160;mg&#47;dL &#40;OR 3&#46;62&#59; 95&#37;CI 1&#46;62&#8211;8&#41;&#44; thrombocytopenia with &#60;150&#44;000 platelets &#40;OR 4&#59; 95&#37;CI 1&#46;84&#8211;8&#46;6&#41;&#59; and a medical history of acute myocardial infarction &#40;OR 15&#46;7&#59; 95&#37;CI&#44; 3&#46;29&#8211;75&#46;09&#41;&#44; COPD &#40;OR 3&#46;05&#59; 95&#37;CI 1&#46;43&#8211;6&#46;5&#41;&#44; or HT &#40;OR 2&#46;21&#59; 95&#37;CI 1&#46;11&#8211;4&#46;4&#41;&#46; The model&#8217;s AUC was 0&#46;86&#46; On the univariate analysis&#44; female sex and presence of dry cough and sore throat were associated with better clinical progress&#44; but were not found to be significant on the multivariate analysis&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The variables identified could be useful in clinical practice for the detection of patients at high risk of poor outcomes&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objective"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Methods design"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
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          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusion"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Existe controversia sobre los mejores factores predictores de deterioro cl&#237;nico en la COVID-19&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Identificar factores predictores de riesgo de deterioro en pacientes hospitalizados por COVID-19&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Dise&#241;o&#58; caso-control anidado dentro de una cohorte&#46; &#193;mbito&#58; 13 centros de agudos de Osakidetza-Servicio Vasco de Salud&#46; Participantes&#58; se consider&#243; casos a pacientes hospitalizados por COVID-19 con deterioro cl&#237;nico&#44; definido como la aparici&#243;n de s&#237;ndrome de distr&#233;s respiratorio del adulto grave&#44; ingreso en UCI o fallecimiento&#46; Se emparejaron 2 controles por caso en funci&#243;n de la edad&#46; Se recogieron variables sociodemogr&#225;ficas&#44; comorbilidades&#44; tratamientos basales&#44; s&#237;ntomas y fecha de inicio&#44; consultas previas&#44; as&#237; como variables cl&#237;nicas&#44; anal&#237;ticas y radiol&#243;gicas&#46; Se cre&#243; un modelo explicativo del deterioro cl&#237;nico mediante regresi&#243;n log&#237;stica condicional&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 99 casos y 198 controles&#46; Mediante an&#225;lisis de regresi&#243;n log&#237;stica las variables independientes asociadas con deterioro cl&#237;nico fueron&#58; saturaci&#243;n de O<span class="elsevierStyleInf">2</span> en Urgencias &#8804;90&#37; &#40;OR&#160;&#61;&#160;16&#44;6&#44; IC del 95&#37;&#44; 4&#8211;68&#41;&#44; radiograf&#237;a de t&#243;rax patol&#243;gica &#40;OR&#160;&#61;&#160;5&#44;6&#44; IC del 95&#37;&#44; 1&#44;7&#8211;18&#44;4&#41;&#44; PCR&#160;&#62;&#160;100&#160;mg&#47;dL &#40;OR&#160;&#61;&#160;3&#44;62&#44; IC del 95&#37; 1&#44;62&#8211;8&#41; y trombocitopenia&#160;&#60;&#160;150&#46;000 plaquetas &#40;OR&#160;&#61;&#160;4&#44; IC del 95&#37;&#44; 1&#44;84&#8211;8&#44;6&#41; y&#44; entre los antecedentes&#44; haber padecido infarto agudo de miocardio &#40;OR&#160;&#61;&#160;15&#44;7&#44; IC del 95&#37;&#44; 3&#44;29&#8211;75&#44;09&#41;&#44; EPOC &#40;OR&#160;&#61;&#160;3&#44;05&#44; IC del 95&#37;&#44; 1&#44;43&#8211;6&#44;5&#41; o hipertensi&#243;n arterial &#40;OR&#160;&#61;&#160;2&#44;21&#44; IC del 95&#37;1&#44;11&#8211;4&#44;4&#41;&#46; El &#225;rea bajo la curva alcanzado por el modelo fue 0&#44;86&#46; En el an&#225;lisis univariado&#44; se asociaron con mejor evoluci&#243;n cl&#237;nica el sexo femenino&#44; la presencia de tos seca y dolor de garganta&#44; pero no resultaron significativas en el an&#225;lisis multivariado&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusi&#243;n</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Las variables identificadas podr&#237;an ser de utilidad en la pr&#225;ctica cl&#237;nica para la detecci&#243;n de pacientes con alto riesgo de mala evoluci&#243;n&#46;</p></span>"
        "secciones" => array:5 [
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            "identificador" => "abst0030"
            "titulo" => "Introducci&#243;n"
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            "identificador" => "abst0035"
            "titulo" => "Objetivo"
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          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "M&#233;todos"
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          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
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            "identificador" => "abst0050"
            "titulo" => "Conclusi&#243;n"
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    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Please cite this article as&#58; Uranga A&#44; Villanueva A&#44; Lafuente I&#44; Gonz&#225;lez N&#44; Legarreta MJ&#44; Aguirre U&#44; et al&#46; Factores de riesgo de deterioro cl&#237;nico en pacientes ingresados por COVID-19&#58; estudio caso-control&#46; Rev Clin Esp&#46; 2022&#59;222&#58;22&#8211;30&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0040">The COVID-19-Osakidetza working group members are listed in Appendix <a class="elsevierStyleCrossRef" href="#sec0040">A</a>&#46;</p>"
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            "apendice" => "<p id="par0180" class="elsevierStylePara elsevierViewall">The COVID-Osakidetza working group includes the following investigators&#58; Susana Garc&#237;a-Guti&#233;rrez&#44; Miren Orive&#44; Nerea Gonz&#225;lez&#44; Iratxe Lafuente&#44; Ane Ant&#243;n&#44; Ane Villanueva&#44; Josune Mart&#237;n&#44; Cristina Mu&#241;oz&#44; Mar&#237;a Jos&#233; Legarreta&#44; Urko Aquirre&#44; and Jos&#233; Mar&#237;a Quintana &#40;Research Unit&#44; Galdakao-Usansolo Hospital&#41;&#59; Pedro Pablo Espa&#241;a Yandiola&#44; Ane Uranga&#44; Mikel Egurrola&#44; Amaia Aramburu&#44; Amaia Artaraz&#44; Leire Chasco&#44; Olaia Bronte&#44; Patricia Garc&#237;a&#44; Ana Jodar&#44; Virginia Fern&#225;ndez&#44; and Crist&#243;bal Esteban &#40;Respiratory Unit&#44; Galdakao-Usansolo Hospital&#41;&#59; Naia Mas &#40;ICU&#44; Galdakao-Usansolo Hospital&#41;&#59; Esther Pulido &#40;Emergency Department&#44; Galdakao-Usansolo Hospital&#41;&#59; Itxaso Bengoetxea &#40;At-Home Hospitalization&#44; Galdakao-Barrualde Healthcare Organization&#41;&#59; Antonio Escobar Mart&#237;nez&#44; Amaia Bilbao&#44; and I&#241;igo Gorostiza &#40;Research Unit&#44; Basurto University Hospital&#41;&#59; I&#241;aki Arriaga &#40;Respiratory Unit&#44; Basurto University Hospital&#41;&#59; Jos&#233; Joaqu&#237;n Portu Zapiarain &#40;Internal Medicine&#44; BioAraba Institute&#41;&#59; Naiara Parraza &#40;Research Unit&#44; BioAraba Institute&#41;&#59; Milagros Iriberri&#44; Rafael Zalaca&#237;n&#44; Luis Alberto Ruiz&#44; and Leyre Serrano &#40;Respiratory Unit&#44; Cruces University Hospital&#41;&#59; Adriana Couto and Oier Ateka &#40;Internal Medicine&#44; Donostia University Hospital&#41;&#59; Arantza Cano &#40;Respiratory Unit&#44; Santa Marina Hospital&#41;&#59; Maria Olatz Ibarra &#40;Pharmacy&#44; Urduliz Hospital&#41;&#59; Eduardo Mill&#225;n&#44; Mayte Bacigalupe&#44; Jon Letona&#44; and Andoni Arcelay &#40;Osakidetza Central Services&#41;&#59; and I&#241;aki Berraondo &#40;Health Department&#44; Government of the Basque Country&#41;&#46;</p>"
            "etiqueta" => "Appendix A"
            "identificador" => "sec0040"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Flowchart&#46;</p>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Evolution of P&#47;F ratio during the hospitalization&#46;</p>"
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          "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">DM&#58; diabetes mellitus&#59; COPD&#58; chronic obstructive pulmonary disease&#59; HT&#58; hypertension&#59; AMI&#58; acute myocardial infarction&#59; CI&#58; confidence interval&#59; LDH&#58; lactate dehydrogenase&#59; OR&#58; odds ratio&#59; P&#47;F ratio&#58; partial pressure of O<span class="elsevierStyleInf">2</span>&#47;fraction of inspired O<span class="elsevierStyleInf">2</span>&#59; CRP&#58; C-reactive protein&#46;</p>"
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_colgroup " colspan="2" align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Deterioration</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Yes &#40;cases&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">No &#40;controls&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">297&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">99 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">198 &#40;66&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0139</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">206 &#40;69&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78 &#40;78&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">128 &#40;64&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">91 &#40;30&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;21&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">70 &#40;35&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Prior follow-up</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Consultation in the last month for symptoms&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">81 &#40;81&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">177 &#40;89&#46;95&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Contact with primary care&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Time between onset of symptoms and first contact<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">3 &#91;1&#8211;5&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#91;1&#8211;5&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Symptoms</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Syncope&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0750</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dry cough&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">179 &#40;60&#46;68&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">50 &#40;51&#46;55&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">129 &#40;65&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0210</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asthenia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;13&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">39 &#40;19&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">1989</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sore throat&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">42 &#40;14&#46;19&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;5&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">37 &#40;18&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0032</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dyspnea&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">141 &#40;47&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">52 &#40;53&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">89 &#40;44&#46;95&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">1495</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Pathological X-ray</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">88 &#40;90&#46;72&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">5270</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>101&#8211;200&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">3 &#40;1&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;2&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;0&#46;51&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>201&#8211;300&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;4&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;4&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;4&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbidities</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AMI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0030</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peripheral vascular disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0828</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dementia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;3&#46;54&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>COPD&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">86 &#40;28&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">34 &#40;34&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">52 &#40;26&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">1327</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mild liver disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26 &#40;8&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;13&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;6&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0718</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DM with organ damage&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;3&#46;37&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;7&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;1&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0256</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Kidney disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">24 &#40;8&#46;08&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;11&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;6&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">1707</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HT&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">160 &#40;53&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">62 &#40;62&#46;63&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">98 &#40;49&#46;42&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0306</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coagulopathy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#946; &#40;e&#46;e&#46;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sex &#40;men vs&#46; women&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;35 &#40;0&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;016 &#40;1&#46;153&#8211;3&#46;526&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0139&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Prior follow-up</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Consultation in the last month for symptoms &#40;no vs&#46; yes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;35 &#40;0&#46;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;026 &#40;1&#46;001&#8211;4&#46;101&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0497&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Contact with primary care &#40;no vs&#46; yes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;31 &#40;0&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;858 &#40;1&#46;122&#8211;3&#46;078&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0161&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Time between onset of symptoms and first contact<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;029 &#40;0&#46;032&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;972 &#40;0&#46;913&#8211;1&#46;035&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;3731&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Symptoms</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Syncope &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;96 &#40;0&#46;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;147 &#40;0&#46;018&#8211;1&#46;214&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dry cough &#40;no vs&#46; yes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;30 &#40;0&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;829 &#40;1&#46;095&#8211;3&#46;054&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0210&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asthenia &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;22 &#40;0&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;639 &#40;0&#46;322&#8211;1&#46;266&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sore throat &#40;no vs&#46; yes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;79 &#40;0&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;43 &#40;1&#46;709&#8211;14&#46;295&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dyspnea &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;19 &#40;0&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;454 &#40;0&#46;874&#8211;2&#46;418&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1495&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pathological X-ray &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;65 &#40;0&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;692 &#40;1&#46;514&#8211;9&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0041&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Baseline P&#47;F ratio</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>101&#8211;200 vs&#46; &#62;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;46 &#40;0&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;250 &#40;0&#46;023&#8211;2&#46;757&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;3113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>201&#8722;300 vs&#46; &#62;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;46 &#40;0&#46;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;250 &#40;0&#46;017&#8211;3&#46;660&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;4235&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tachypnea in the emergency department &#40;yes</span> vs<span class="elsevierStyleItalic">&#46; no&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;36 &#40;0&#46;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;041 &#40;1&#46;096&#8211;3&#46;799&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">O<span class="elsevierStyleInf">2</span> saturation in the emergency department &#40;&#8804;90 vs&#46;</span>&#62;<span class="elsevierStyleItalic">90&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;92 &#40;0&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;291 &#40;2&#46;517&#8211;15&#46;722&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbidities</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AMI &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;78 &#40;0&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;785 &#40;1&#46;699&#8211;13&#46;477&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0030&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peripheral vascular disease &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;37 &#40;0&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;115 &#40;0&#46;907&#8211;4&#46;929&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0828&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dementia &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;10 &#40;0&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;826 &#40;0&#46;185&#8211;3&#46;697&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;8028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>COPD &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;21 &#40;0&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;526 &#40;0&#46;880&#8211;2&#46;646&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1327&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mild liver disease &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;36 &#40;0&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;066 &#40;0&#46;938&#8211;4&#46;552&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0718&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DM with organ damage &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;77 &#40;0&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;667 &#40;1&#46;207&#8211;18&#46;046&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0256&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Kidney disease &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;31 &#40;0&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;846 &#40;0&#46;768&#8211;4&#46;436&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1707&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HT &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;28 &#40;0&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;755 &#40;1&#46;054&#8211;2&#46;923&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0306&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coagulopathy &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;69 &#40;0&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;000 &#40;0&#46;733&#8722;21&#46;838&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1094&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Gastrointestinal bleeding &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;46 &#40;0&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;500 &#40;0&#46;671&#8722;9&#46;310&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asthma &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;04 &#40;0&#46;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;086 &#40;0&#46;546&#8722;2&#46;160&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;8137&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Baseline blood test</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinine<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;300 &#40;0&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;349 &#40;0&#46;901&#8211;2&#46;018&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1459&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glucose<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;011 &#40;0&#46;003&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;011 &#40;1&#46;005&#8211;1&#46;018&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>LDH<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;005 &#40;0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;005 &#40;1&#46;002&#8211;1&#46;007&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CRP<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;006 &#40;0&#46;002&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;006 &#40;1&#46;003&#8211;1&#46;010&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#946; &#40;e&#46;e&#46;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">16&#46;571 &#40;4&#46;030&#8211;68&#46;130&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Pathological X-ray &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">CRP&#160;&#62;&#160;100&#160;mg&#47;dL &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;0017&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Hyperglycemia<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a> &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Thrombocytopenia<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a> &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">R</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleBold">&#47;AUC &#40;95&#37; CI&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;2525&#47;0&#46;862 &#40;0&#46;818&#8211;0&#46;906&#41;</span></td></tr></tbody></table>
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Original article
Risk factors for clinical deterioration in patients admitted for COVID-19: A case-control study
Factores de riesgo de deterioro clínico en pacientes ingresados por COVID-19: estudio caso-control
A. Urangaa, A. Villanuevab, I. Lafuenteb, N. Gonzálezb,c, M.J. Legarretab, U. Aguirreb,c, P.P. Españaa, J.M. Quintanab,c, S. García-Gutiérrezb,c,
Corresponding author
, the COVID-19-Osakidetza working group 1
a Servicio de Respiratorio, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
b Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
c Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">COVID-19 is a disease that has challenged health systems all over the world<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The majority of patients progress favorably&#46; However&#44; 20&#37; of patients require hospitalization and their disease can progress rapidly to acute respiratory distress syndrome &#40;ARDS&#41;&#44; multiple organ dysfunction syndrome&#44; or even death<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; In addition&#44; the symptoms are characterized by a significant clinical-radiological dissociation&#44; such that clinical deterioration occurs suddenly<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; Therefore&#44; the identification of risk factors is a priority for the proper management of these patients&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The SEMI-COVID-19 Registry has revealed that mortality in Spain reached 21&#37;&#44; according to data from 2020<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46; In addition&#44; the percentage of hospitalized patients who required mechanical ventilation was as high as 65&#37;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of this study was to identify factors of poor progress in SARS-CoV-2 infection in patients hospitalized due to COVID-19&#46; Poor progress was defined as onset of severe ARDS during hospitalization &#40;P&#47;F ratio &#8804;100&#160;mmHg&#41;&#44; admission to the intensive care unit &#40;ICU&#41;&#44; or in-hospital death&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This is a nested case-control study within the COVID-19 Osakidetza cohort &#40;NCT04463706&#41;&#46; In this study&#44; cases were patients admitted to the hospitalization ward due to COVID-19 who presented with clinical deterioration &#40;presence during the hospitalization of severe ARDS &#40;PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span>&#160;&#8804;&#160;100&#160;mmHg&#41;&#44; admission to the ICU&#44; or in-hospital death&#41;&#46; The controls were patients hospitalized due to COVID-19 who did not present with severe ARDS&#46; Cases and controls were matched according to age groups&#46; The exclusion criteria were those who died in the emergency department&#44; those who were admitted directly to the ICU&#44; or those who presented with a P&#47;F ratio&#160;&#8804;&#160;100&#160;mmHg in the first 24&#160;h of hospitalization&#46; Two controls were identified per case&#46; The inclusion period was from March 3&#44; 2020 to April 10&#44; 2020&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The project was approved by the Basque Country Ethics Committee &#40;PI2020059&#41;&#46; Simple random sampling was used&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Variables were obtained from the Osakidetza-Basque Health System electronic medical record &#40;EMR&#41; data processing system by means of a review of the EMRs by trained reviewers supervised by collaborating clinicians&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The following variables were gathered&#58; sociodemographic variables &#40;age and sex&#41;&#59; personal medical history &#40;comorbidities included in the Charlson Comorbidity Index&#41;&#59; disease history &#40;symptoms and date of onset&#44; date of first contact with the healthcare system&#44; persistence of symptoms&#44; treatments indicated&#44; contact with primary care in the previous month&#41;&#59; current hospitalization episode &#40;symptoms upon arrival at the emergency department&#41;&#59; vital signs &#40;oxygen saturation as measured by a pulse oximeter &#40;SaO<span class="elsevierStyleInf">2</span>p&#41;&#59; clinical signs and physical examination&#59; laboratory tests upon admission &#40;biochemistry&#58; renal function&#44; albumin&#44; liver panel&#59; acute-phase reactants&#58; LDH&#44; CRP&#59; complete blood count and blood differential&#59; coagulation&#44; prothrombin time&#44; and <span class="elsevierStyleSmallCaps">d</span>-dimer&#41;&#59; pathological X-ray upon admission&#44; defined as an X-ray which showed previously unknown infiltrates or condensations or data indicative of ARDS &#40;presence of bilateral opacities not fully explained by effusion&#44; lobar collapse&#44; a collapsed lung&#44; or lung nodules&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The lowest P&#47;F ratio &#40;PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span>&#41; was calculated at various points in time&#58; upon arrival at the emergency department&#44; the day the patient was transferred to the hospital ward&#44; and through day three of the hospital stay&#46; In addition&#44; the lowest P&#47;F ratio reached during hospitalization was recorded for both the cases and the controls&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A case was defined as a patient who presented with clinical deterioration during hospitalization&#44; defined as presence of a P&#47;F ratio &#8804;100&#160;mmHg&#44; admission to the ICU&#44; or in-hospital death &#40;date&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0055" class="elsevierStylePara elsevierViewall">Descriptive statistics of the variables were performed&#46; Categorical variables are shown as frequency and percentages and continuous variables are shown as means and standard deviations or medians and interquartile ranges&#46; On the univariate analysis&#44; variables from cases and controls were compared using conditional logistic regression models&#46; The dependent variable was clinical deterioration and the rest were independent variables&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Laboratory tests upon admission&#44; which were recorded as continuous variables&#44; were also analyzed after being categorized into three groups&#58; normal range values &#40;defined in the tables&#41;&#44; lower values&#44; and higher values&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">For the conditional logistic regression model&#44; all independent variables with <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;20 on the univariate analysis were included&#46; Effects were considered significant when <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;05&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The odds ratio &#40;OR&#41; and 95&#37; confidence intervals &#40;95&#37; CI&#41; were calculated&#46; The model&#8217;s explanatory power was analyzed by calculating R<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and the area under the curve &#40;AUC&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Differences in the P&#47;F ratio between cases and controls were analyzed by means of a boxplot for the P&#47;F ratio values at different points of the hospitalization &#40;arrival at the emergency department&#59; arrival on the ward&#59; day one&#59; day two&#59; day three&#59; and the critical day&#44; defined as the day a patient presented with deterioration&#46; Longitudinal data analysis was performed in order to identify differences in the P&#47;F ratio trends&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">All statistical analyses were performed using SAS for Windows&#44; version 9&#46;4 &#40;SAS Institute&#44; Cary&#44; NC&#44; USA&#41; and R&#169;&#44; version 4&#46;0&#46;0</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0085" class="elsevierStylePara elsevierViewall">A total of 366 patients were randomly selected from the 4447 patients who were hospitalized during the study period in participating centers&#46; Once ineligible patients were excluded&#44; our sample comprised 99 cases and 205 controls&#44; of which 198 eligible patients were selected in order to have a case&#47;control ratio of 1&#58;2 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Males were more numerous among the cases than the controls &#40;79&#37; vs&#46; 65&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;014&#41; as were patients who had had an acute myocardial infarction &#40;AMI&#41; &#40;14&#37; vs&#46; 4&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;03&#41;&#44; diabetes with organ damage &#40;7&#37; vs&#46; 1&#46;5&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;025&#41;&#44; and hypertension &#40;63&#37; vs&#46; 49&#46;4&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;031&#41;&#46; A lower frequency was observed among cases versus controls for the symptoms of dry cough &#40;51&#46;5&#37; vs&#46; 65&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;021&#41; and sore throat &#40;5&#37; vs&#46; 18&#46;7&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;003&#41;&#46; More cases than controls had consulted with their primary care physicians &#40;48&#46;5&#37; vs&#46; 34&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;016&#41;&#46; The plain X-ray was more often pathological among the cases &#40;91&#37; vs&#46; 77&#37;&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;004&#41;&#46; There was an association between levels of glucose&#44; LDH&#44; CRP&#44; and platelets and clinical deterioration&#59; patients who deteriorated presented with higher figures of the first three parameters and lower platelet figures &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; All the variables described in the methods section were considered on the univariate analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">When these variables were combined on the multivariate model&#44; patients who presented with an O<span class="elsevierStyleInf">2</span> saturation in the emergency department of &#8804;90&#37; had an increased risk of clinical deterioration &#40;OR&#160;&#61;&#160;16&#46;57&#44; 95&#37; CI 4&#8211;68&#44; <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;001&#41; as well as those who had had AMI &#40;OR&#160;&#61;&#160;15&#46;72&#44; 95&#37; CI 3&#46;3&#8211;75&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;0006&#41;&#44; hypertension &#40;OR&#160;&#61;&#160;2&#46;21&#44; 95&#37; CI 1&#46;1&#8211;4&#46;4&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;024&#41;&#44; and COPD &#40;OR&#160;&#61;&#160;3&#46;05&#44; 95&#37; CI 1&#46;4&#8211;6&#46;5&#44; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;004&#41;&#46; In addition&#44; a pathological X-ray entailed a risk that was 5&#46;6 times greater&#46; CRP levels &#62;100 were positively related to possibility of deterioration&#44; as were blood glucose levels &#62;200&#46; Patients with platelet levels less than 15&#160;&#215;&#160;10<span class="elsevierStyleSup">3</span>&#47;&#181;L presented with a risk of deterioration that was four times higher than those who had platelet levels within normal or elevated ranges &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The variability explained by the model measured by R<span class="elsevierStyleSup">2</span> was 25&#37; and the predictive power as measured by AUC was 0&#46;86&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The P&#47;F ratio was lower among the cases at the various moments it was analyzed &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;001 for all&#41;&#46; The difference in the P&#47;F ratio trend between cases and controls was also statistically significant overall &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;001&#41;&#44; but can be divided into two intervals&#58; the difference is not significant in measurements upon arrival at the emergency department and hospitalization day one&#59; furthermore&#44; the trends are practically parallel during this period &#40;<span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;&#46;064&#41;&#46; However&#44; after hospitalization day one&#44; the cases continued on a downward trend whereas controls stabilized more &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;001&#41;&#46; On the second day of hospitalization&#44; 75&#37; of the cases had values lower than 253&#46;6 whereas 75&#37; of the controls had values higher than 271&#46;4&#46; The decline in the third day of hospitalization until the day a patient presented with deterioration or the critical day was more marked among the cases &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion and conclusions</span><p id="par0110" class="elsevierStylePara elsevierViewall">This study sheds light on the main clinical characteristics of patients hospitalized due to COVID-19 who present with poor progress&#44; defined as PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> &#8804;100&#44; admission to the ICU&#44; or death&#46; In this work&#44; it was possible to determine that presence of SaO<span class="elsevierStyleInf">2</span> &#8804;90&#37;&#44; hyperglycemia&#44; elevated CRP levels&#44; thrombocytopenia&#44; a pathological X-ray upon admission&#44; and a previous associated disease &#40;AMI&#44; COPD&#44; or hypertension&#41; were associated with clinical deterioration&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Numerous studies coincide on highlighting age&#44; male sex&#44; and presence of dyspnea as predictive factors of mortality or ICU admission in COVID-19 patients<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; As this study paired cases and controls by age&#44; we were not able to evaluate this variable&#8217;s effect on outcomes&#46; In regard to sex&#44; 78&#46;79&#37; of patients who developed clinical deterioration in this study were men&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">A meta-analysis by Jain and Yuan<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> evaluated symptoms and comorbidities that were predictors of severity and ICU admission in patients with COVID-19 and found that dyspnea was the only predictive symptom of both outcomes&#46; Unlike other published works&#44; dyspnea was not significantly more frequent among the cases in our study&#46; This is probably related to the exclusion of patients who required mechanical ventilation in the first 24&#160;h&#44; given that patients who were admitted to the ICU in that time period were transferred due to presence of severe ARDS&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">It is important to note that our main objective was to identify patients who&#44; hospitalized in the pulmonary phase of the disease as per the phases proposed by Siddiqi and Mehra<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#44; presented with clinical deterioration during hospitalization&#46; Thus&#44; the cases more frequently had an SaO<span class="elsevierStyleInf">2</span>p that was lower than the controls upon arrival to the emergency department&#46; Despite the fact that the oxygen values were practically within normal ranges&#44; there was an objective clinical repercussion given that in addition&#44; the cases also presented with tachypnea more often&#44; which is undoubtedly a determining factor of poor progress in pneumonia and is included on COVID-19 severity scales<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Fu et al&#46;&#8217;s<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> study on 200 patients observed that both age and comorbidities such as low oxygenation were associated with greater mortality&#46; Therefore&#44; it seems that lower oxygenation values upon admission may predict later deterioration&#46; Beyond this&#44; as <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows&#44; there is a point of inflection in oxygenation&#44; which has been termed the &#8220;critical day&#8221; for patients&#46; Therefore&#44; proper identification of the clinical characteristics of patients at high risk of worsening is crucial&#46; Bilateral lung involvement and ground-glass opacities have been demonstrated to be the most frequent radiological form of presentation in the literature<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;12</span></a>&#46; However&#44; in our study&#44; we could not determine the type of radiological involvement&#59; it was only known that patients who developed clinical worsening during the course of the disease presented with some type of initial radiological abnormality versus the controls&#44; who had normal X-rays&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In regard to associated diseases&#44; it seems logical that patients with chronic diseases such as COPD who presented with chronic lung parenchyma inflammation&#44; limitation of expiratory flow&#44; and greater susceptibility to infections would be more vulnerable to the disease<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46; Likewise&#44; in line with other Spanish cohorts<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#44; a greater association between COPD and clinical deterioration has been observed&#44; which is likely related to presence of a greater number of comorbidities than COVID-19 patients usually have<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Hypertension and AMI are significantly related to clinical deterioration<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#46; Zhao et al&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> identified that age &#62;60 years&#44; cardiovascular disease&#44; hypertension&#44; and diabetes were independent factors of mortality due to COVID-19&#46; Another two recent studies indicated that these patients more often had myocardial damage and arrhythmias during the hospitalization&#44; which are associated with greater mortality<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a>&#46; Direct viral involvement as well as inflammation secondary to the cytokine storm in SARS-CoV-2 infection could be behind this myocardial damage<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46; The potential impact this damage may have in the long-term is still to be determined&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Lastly&#44; elevated glucose and CRP levels were predictors of clinical deterioration&#46; Both parameters have been widely studied in pneumonia&#46; Hyperglycemia that is either secondary to the stress of the infection or due to diabetes or an underlying metabolic syndrome could increase mortality in COVID-19 patients<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#8211;22</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Diabetes is one of the most frequent comorbidities in COVID-19 and can worsen its prognosis<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#46; An inappropriate immune response along with exacerbation of the proinflammatory storm could explain this association<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&#46; Undoubtedly&#44; proper management and control of glucose levels must be a key part of COVID-19 treatment&#46; In regard to CRP&#44; its elevation has been associated with disease severity and&#44; in addition&#44; it seems to have surpassed other biomarkers more commonly used in sepsis<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">On the other hand&#44; the cases presented with lower platelet levels than the controls&#46; A recent retrospective study which included 1476 patients observed that 20&#46;7&#37; of the sample presented with thrombocytopenia&#44; which was significantly associated with in-hospital mortality<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#46; It has been observed that disseminated intravascular coagulation is frequent among those who have died due to SARS-CoV-2 infection&#44; which could explain the increase in platelet consumption<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">This study has certain limitations inherent to its case-control design&#46; In addition&#44; it was not possible to identify the specific radiological involvement&#44; there were some missing analytical variables&#44; and the results are not able to be extrapolated to patients excluded from the study due to deterioration in the first 24&#160;h&#46; In regard to the study period&#44; in the initial phases of the pandemic&#44; it was less likely that patients with mild-moderate disease would have been admitted to the hospital&#59; the majority were severe patients&#46; In addition&#44; variables that were later determined to be predictors of poor progress in COVID-19 patients were not included because at the time of recruitment&#44; they were not routinely requested &#40;for example&#44; ferritin&#41;&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">New studies are needed that help identify patients at risk of clinical deterioration so that healthcare professionals can make appropriate decisions about their destination and treatment&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Funding</span><p id="par0170" class="elsevierStylePara elsevierViewall">This project has been funded by the <span class="elsevierStyleGrantSponsor" id="gs0005">Carlos III Institute of Health</span> in the extraordinary call for research projects on SARS-CoV-2 and COVID-19 disease&#44; file number COV20&#47;0459&#44; and the Network for <span class="elsevierStyleGrantSponsor" id="gs0010">Research in Chronic Disease Healthcare Departments</span> &#40;REDISSEC&#44; for its initials in Spanish&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicts of interest</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors declare that they do not have any conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">There is controversy regarding the best predictors of clinical deterioration in COVID-19&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">This work aims to identify predictors of risk factors for deterioration in patients hospitalized due to COVID-19&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods design</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Nested case-control study within a cohort&#46; Setting&#58; 13 acute care centers of the Osakidetza-Basque Health Service&#46; Participants&#58; patients hospitalized for COVID-19 with clinical deterioration&#8212;defined as onset of severe ARDS&#44; ICU admission&#44; or death&#8212;were considered cases&#46; Two controls were matched to each case based on age&#46; Sociodemographic data&#59; comorbidities&#59; baseline treatment&#59; symptoms&#59; date of onset&#59; previous consultations&#59; and clinical&#44; analytical&#44; and radiological variables were collected&#46; An explanatory model of clinical deterioration was created by means of conditional logistic regression&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">A total of 99 cases and 198 controls were included&#46; According to the logistic regression analysis&#44; the independent variables associated with clinical deterioration were&#58; emergency department O<span class="elsevierStyleInf">2</span> saturation &#8804;90&#37; &#40;OR 16&#46;6&#59; 95&#37;CI 4&#8211;68&#41;&#44; pathological chest X-ray &#40;OR 5&#46;6&#59; 95&#37;CI 1&#46;7&#8211;18&#46;4&#41;&#44; CRP&#160;&#62;&#160;100&#160;mg&#47;dL &#40;OR 3&#46;62&#59; 95&#37;CI 1&#46;62&#8211;8&#41;&#44; thrombocytopenia with &#60;150&#44;000 platelets &#40;OR 4&#59; 95&#37;CI 1&#46;84&#8211;8&#46;6&#41;&#59; and a medical history of acute myocardial infarction &#40;OR 15&#46;7&#59; 95&#37;CI&#44; 3&#46;29&#8211;75&#46;09&#41;&#44; COPD &#40;OR 3&#46;05&#59; 95&#37;CI 1&#46;43&#8211;6&#46;5&#41;&#44; or HT &#40;OR 2&#46;21&#59; 95&#37;CI 1&#46;11&#8211;4&#46;4&#41;&#46; The model&#8217;s AUC was 0&#46;86&#46; On the univariate analysis&#44; female sex and presence of dry cough and sore throat were associated with better clinical progress&#44; but were not found to be significant on the multivariate analysis&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The variables identified could be useful in clinical practice for the detection of patients at high risk of poor outcomes&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Existe controversia sobre los mejores factores predictores de deterioro cl&#237;nico en la COVID-19&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Identificar factores predictores de riesgo de deterioro en pacientes hospitalizados por COVID-19&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Dise&#241;o&#58; caso-control anidado dentro de una cohorte&#46; &#193;mbito&#58; 13 centros de agudos de Osakidetza-Servicio Vasco de Salud&#46; Participantes&#58; se consider&#243; casos a pacientes hospitalizados por COVID-19 con deterioro cl&#237;nico&#44; definido como la aparici&#243;n de s&#237;ndrome de distr&#233;s respiratorio del adulto grave&#44; ingreso en UCI o fallecimiento&#46; Se emparejaron 2 controles por caso en funci&#243;n de la edad&#46; Se recogieron variables sociodemogr&#225;ficas&#44; comorbilidades&#44; tratamientos basales&#44; s&#237;ntomas y fecha de inicio&#44; consultas previas&#44; as&#237; como variables cl&#237;nicas&#44; anal&#237;ticas y radiol&#243;gicas&#46; Se cre&#243; un modelo explicativo del deterioro cl&#237;nico mediante regresi&#243;n log&#237;stica condicional&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 99 casos y 198 controles&#46; Mediante an&#225;lisis de regresi&#243;n log&#237;stica las variables independientes asociadas con deterioro cl&#237;nico fueron&#58; saturaci&#243;n de O<span class="elsevierStyleInf">2</span> en Urgencias &#8804;90&#37; &#40;OR&#160;&#61;&#160;16&#44;6&#44; IC del 95&#37;&#44; 4&#8211;68&#41;&#44; radiograf&#237;a de t&#243;rax patol&#243;gica &#40;OR&#160;&#61;&#160;5&#44;6&#44; IC del 95&#37;&#44; 1&#44;7&#8211;18&#44;4&#41;&#44; PCR&#160;&#62;&#160;100&#160;mg&#47;dL &#40;OR&#160;&#61;&#160;3&#44;62&#44; IC del 95&#37; 1&#44;62&#8211;8&#41; y trombocitopenia&#160;&#60;&#160;150&#46;000 plaquetas &#40;OR&#160;&#61;&#160;4&#44; IC del 95&#37;&#44; 1&#44;84&#8211;8&#44;6&#41; y&#44; entre los antecedentes&#44; haber padecido infarto agudo de miocardio &#40;OR&#160;&#61;&#160;15&#44;7&#44; IC del 95&#37;&#44; 3&#44;29&#8211;75&#44;09&#41;&#44; EPOC &#40;OR&#160;&#61;&#160;3&#44;05&#44; IC del 95&#37;&#44; 1&#44;43&#8211;6&#44;5&#41; o hipertensi&#243;n arterial &#40;OR&#160;&#61;&#160;2&#44;21&#44; IC del 95&#37;1&#44;11&#8211;4&#44;4&#41;&#46; El &#225;rea bajo la curva alcanzado por el modelo fue 0&#44;86&#46; En el an&#225;lisis univariado&#44; se asociaron con mejor evoluci&#243;n cl&#237;nica el sexo femenino&#44; la presencia de tos seca y dolor de garganta&#44; pero no resultaron significativas en el an&#225;lisis multivariado&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusi&#243;n</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Las variables identificadas podr&#237;an ser de utilidad en la pr&#225;ctica cl&#237;nica para la detecci&#243;n de pacientes con alto riesgo de mala evoluci&#243;n&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Please cite this article as&#58; Uranga A&#44; Villanueva A&#44; Lafuente I&#44; Gonz&#225;lez N&#44; Legarreta MJ&#44; Aguirre U&#44; et al&#46; Factores de riesgo de deterioro cl&#237;nico en pacientes ingresados por COVID-19&#58; estudio caso-control&#46; Rev Clin Esp&#46; 2022&#59;222&#58;22&#8211;30&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0040">The COVID-19-Osakidetza working group members are listed in Appendix <a class="elsevierStyleCrossRef" href="#sec0040">A</a>&#46;</p>"
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            "apendice" => "<p id="par0180" class="elsevierStylePara elsevierViewall">The COVID-Osakidetza working group includes the following investigators&#58; Susana Garc&#237;a-Guti&#233;rrez&#44; Miren Orive&#44; Nerea Gonz&#225;lez&#44; Iratxe Lafuente&#44; Ane Ant&#243;n&#44; Ane Villanueva&#44; Josune Mart&#237;n&#44; Cristina Mu&#241;oz&#44; Mar&#237;a Jos&#233; Legarreta&#44; Urko Aquirre&#44; and Jos&#233; Mar&#237;a Quintana &#40;Research Unit&#44; Galdakao-Usansolo Hospital&#41;&#59; Pedro Pablo Espa&#241;a Yandiola&#44; Ane Uranga&#44; Mikel Egurrola&#44; Amaia Aramburu&#44; Amaia Artaraz&#44; Leire Chasco&#44; Olaia Bronte&#44; Patricia Garc&#237;a&#44; Ana Jodar&#44; Virginia Fern&#225;ndez&#44; and Crist&#243;bal Esteban &#40;Respiratory Unit&#44; Galdakao-Usansolo Hospital&#41;&#59; Naia Mas &#40;ICU&#44; Galdakao-Usansolo Hospital&#41;&#59; Esther Pulido &#40;Emergency Department&#44; Galdakao-Usansolo Hospital&#41;&#59; Itxaso Bengoetxea &#40;At-Home Hospitalization&#44; Galdakao-Barrualde Healthcare Organization&#41;&#59; Antonio Escobar Mart&#237;nez&#44; Amaia Bilbao&#44; and I&#241;igo Gorostiza &#40;Research Unit&#44; Basurto University Hospital&#41;&#59; I&#241;aki Arriaga &#40;Respiratory Unit&#44; Basurto University Hospital&#41;&#59; Jos&#233; Joaqu&#237;n Portu Zapiarain &#40;Internal Medicine&#44; BioAraba Institute&#41;&#59; Naiara Parraza &#40;Research Unit&#44; BioAraba Institute&#41;&#59; Milagros Iriberri&#44; Rafael Zalaca&#237;n&#44; Luis Alberto Ruiz&#44; and Leyre Serrano &#40;Respiratory Unit&#44; Cruces University Hospital&#41;&#59; Adriana Couto and Oier Ateka &#40;Internal Medicine&#44; Donostia University Hospital&#41;&#59; Arantza Cano &#40;Respiratory Unit&#44; Santa Marina Hospital&#41;&#59; Maria Olatz Ibarra &#40;Pharmacy&#44; Urduliz Hospital&#41;&#59; Eduardo Mill&#225;n&#44; Mayte Bacigalupe&#44; Jon Letona&#44; and Andoni Arcelay &#40;Osakidetza Central Services&#41;&#59; and I&#241;aki Berraondo &#40;Health Department&#44; Government of the Basque Country&#41;&#46;</p>"
            "etiqueta" => "Appendix A"
            "identificador" => "sec0040"
          ]
        ]
      ]
    ]
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        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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            "identificador" => "at0005"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Flowchart&#46;</p>"
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        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Evolution of P&#47;F ratio during the hospitalization&#46;</p>"
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      2 => array:8 [
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        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
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          "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">DM&#58; diabetes mellitus&#59; COPD&#58; chronic obstructive pulmonary disease&#59; HT&#58; hypertension&#59; AMI&#58; acute myocardial infarction&#59; CI&#58; confidence interval&#59; LDH&#58; lactate dehydrogenase&#59; OR&#58; odds ratio&#59; P&#47;F ratio&#58; partial pressure of O<span class="elsevierStyleInf">2</span>&#47;fraction of inspired O<span class="elsevierStyleInf">2</span>&#59; CRP&#58; C-reactive protein&#46;</p>"
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td-with-role" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Deterioration</th><th class="td" title="\n
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                  \t\t\t\t" scope="col">N &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col">Yes &#40;cases&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">No &#40;controls&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">297&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">198 &#40;66&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0139</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Sex</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">206 &#40;69&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">78 &#40;78&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">128 &#40;64&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">91 &#40;30&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21 &#40;21&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#40;35&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Prior follow-up</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Consultation in the last month for symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">258 &#40;87&#46;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81 &#40;81&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">177 &#40;89&#46;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0497</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Contact with primary care&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">115 &#40;38&#46;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;48&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 &#40;33&#46;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0161</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Time between onset of symptoms and first contact<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#91;1&#8211;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#91;1&#8211;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#91;1&#8211;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;<span class="elsevierStyleBold">3731</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Symptoms</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Syncope&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;4&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;5&#46;56&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Tachypnea in the emergency department</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">O<span class="elsevierStyleInf">2</span> saturation in the emergency department</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbidities</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">22 &#40;7&#46;41&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;14&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;4&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0030</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peripheral vascular disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;9&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;13&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;7&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0828</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dementia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10 &#40;3&#46;37&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#40;3&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;3&#46;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;<span class="elsevierStyleBold">8028</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>COPD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86 &#40;28&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;34&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">52 &#40;26&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;<span class="elsevierStyleBold">1327</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mild liver disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;8&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;13&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;6&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0718</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DM with organ damage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10 &#40;3&#46;37&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7 &#40;7&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#40;1&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0256</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Kidney disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">24 &#40;8&#46;08&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;11&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">13 &#40;6&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">1707</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">160 &#40;53&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">62 &#40;62&#46;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">98 &#40;49&#46;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;<span class="elsevierStyleBold">0306</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coagulopathy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;2&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;4&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;1&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;<span class="elsevierStyleBold">1094</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Gastrointestinal bleeding&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;3&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;5&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;2&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;<span class="elsevierStyleBold">1720</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asthma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;14&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;15&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;14&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;<span class="elsevierStyleBold">8137</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Baseline blood test</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinine<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;01 &#40;0&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;09 &#40;0&#46;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;96 &#40;0&#46;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;<span class="elsevierStyleBold">1459</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glucose<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">109 &#91;97&#8722;126&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">117 &#91;102&#8722;140&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105 &#91;95&#8211;120&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;147 &#40;0&#46;018&#8211;1&#46;214&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dry cough &#40;no vs&#46; yes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;30 &#40;0&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;829 &#40;1&#46;095&#8211;3&#46;054&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0210&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asthenia &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;22 &#40;0&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;639 &#40;0&#46;322&#8211;1&#46;266&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sore throat &#40;no vs&#46; yes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;79 &#40;0&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;43 &#40;1&#46;709&#8211;14&#46;295&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dyspnea &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;19 &#40;0&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;454 &#40;0&#46;874&#8211;2&#46;418&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1495&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pathological X-ray &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;65 &#40;0&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;692 &#40;1&#46;514&#8211;9&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0041&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Baseline P&#47;F ratio</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>101&#8211;200 vs&#46; &#62;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;46 &#40;0&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;250 &#40;0&#46;023&#8211;2&#46;757&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;3113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>201&#8722;300 vs&#46; &#62;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;46 &#40;0&#46;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;250 &#40;0&#46;017&#8211;3&#46;660&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;4235&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tachypnea in the emergency department &#40;yes</span> vs<span class="elsevierStyleItalic">&#46; no&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;36 &#40;0&#46;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;041 &#40;1&#46;096&#8211;3&#46;799&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">O<span class="elsevierStyleInf">2</span> saturation in the emergency department &#40;&#8804;90 vs&#46;</span>&#62;<span class="elsevierStyleItalic">90&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;92 &#40;0&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;291 &#40;2&#46;517&#8211;15&#46;722&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbidities</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AMI &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;78 &#40;0&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;785 &#40;1&#46;699&#8211;13&#46;477&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0030&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peripheral vascular disease &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;37 &#40;0&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;115 &#40;0&#46;907&#8211;4&#46;929&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0828&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dementia &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;10 &#40;0&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;826 &#40;0&#46;185&#8211;3&#46;697&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;8028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>COPD &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;21 &#40;0&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;526 &#40;0&#46;880&#8211;2&#46;646&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1327&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mild liver disease &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;36 &#40;0&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;066 &#40;0&#46;938&#8211;4&#46;552&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0718&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DM with organ damage &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;77 &#40;0&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#46;667 &#40;1&#46;207&#8211;18&#46;046&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;0256&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Kidney disease &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;31 &#40;0&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;846 &#40;0&#46;768&#8211;4&#46;436&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;1707&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HT &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;28 &#40;0&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;755 &#40;1&#46;054&#8211;2&#46;923&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;0306&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coagulopathy &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;69 &#40;0&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#46;000 &#40;0&#46;733&#8722;21&#46;838&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1094&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Gastrointestinal bleeding &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;46 &#40;0&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;500 &#40;0&#46;671&#8722;9&#46;310&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;1720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asthma &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;04 &#40;0&#46;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;086 &#40;0&#46;546&#8722;2&#46;160&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;8137&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Baseline blood test</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinine<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;300 &#40;0&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;349 &#40;0&#46;901&#8211;2&#46;018&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;1459&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glucose<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;011 &#40;0&#46;003&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;011 &#40;1&#46;005&#8211;1&#46;018&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>LDH<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;005 &#40;0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;005 &#40;1&#46;002&#8211;1&#46;007&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0006&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CRP<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;006 &#40;0&#46;002&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;006 &#40;1&#46;003&#8211;1&#46;010&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sodium<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;010 &#40;0&#46;999&#8211;1&#46;022&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;035 &#40;0&#46;024&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Platelets<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AMI &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;76 &#40;0&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">15&#46;721 &#40;3&#46;291&#8211;75&#46;088&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;0006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">COPD &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;12 &#40;0&#46;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#46;052 &#40;1&#46;431&#8211;6&#46;509&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0039&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HT &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;79 &#40;0&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#46;211 &#40;1&#46;112&#8211;4&#46;397&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">O<span class="elsevierStyleInf">2</span> saturation &#8804;90&#37; in the emergency department &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#46;81 &#40;0&#46;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;571 &#40;4&#46;030&#8211;68&#46;130&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pathological X-ray &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;73 &#40;0&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;633 &#40;1&#46;725&#8211;18&#46;393&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0042&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CRP&#160;&#62;&#160;100&#160;mg&#47;dL &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;29 &#40;0&#46;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#46;624 &#40;1&#46;621&#8211;8&#46;099&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;0017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hyperglycemia<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a> &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;80 &#40;0&#46;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;066 &#40;1&#46;239&#8211;29&#46;703&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;0261&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Thrombocytopenia<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a> &#40;yes vs&#46; no&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;38 &#40;0&#46;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;972 &#40;1&#46;837&#8211;8&#46;585&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#46;0005&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">R</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleBold">&#47;AUC &#40;95&#37; CI&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;2525&#47;0&#46;862 &#40;0&#46;818&#8211;0&#46;906&#41;</span></td></tr></tbody></table>
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The need for an independent evaluation of the COVID-19 response in Spain"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Garc&#237;a-Basteiro"
                            1 => "C&#46; Alvarez-Dardet"
                            2 => "A&#46; Arenas"
                            3 => "R&#46; Bengoa"
                            4 => "C&#46; Borrell"
                            5 => "M&#46; del Val"
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                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(20)31713-X"
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                        "tituloSerie" => "Lancet"
                        "fecha" => "2020"
                        "volumen" => "396"
                        "numero" => "10250"
                        "paginaInicial" => "529"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32771082"
                            "web" => "Medline"
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              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan&#44; China&#58; a descriptive study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Chen"
                            1 => "M&#46; Zhou"
                            2 => "X&#46; Dong"
                            3 => "J&#46; Qu"
                            4 => "F&#46; Gong"
                            5 => "Y&#46; Han"
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                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(20)30211-7"
                      "Revista" => array:7 [
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                        "fecha" => "2020"
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                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32007143"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors associated with acute respiratory distress s&#237;ndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan&#44; China"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "Y&#46; Cai"
                            3 => "J&#46; Xia"
                            4 => "X&#46; Zhou"
                            5 => "S&#46; Xu"
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "JAMA Intern Med"
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                            2 => "J&#46; Mill&#225;n-N&#250;&#241;ez-Cort&#233;s"
                            3 => "C&#46; Lumbreras-Bermejo"
                            4 => "J&#46;M&#46; Ramos-Rinco&#769;n"
                            5 => "E&#46; Roy-Vallejo"
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                        "paginaInicial" => "480"
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                          0 => array:2 [
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                      "titulo" => "Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "X&#46; Li"
                            1 => "S&#46; Xu"
                            2 => "M&#46; Yu"
                            3 => "K&#46; Wang"
                            4 => "Y&#46; Tao"
                            5 => "Y&#46; Zhou"
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                        ]
                      ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2020.04.006"
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                        "tituloSerie" => "J Allergy Clin Immunol"
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                        "volumen" => "146"
                        "paginaInicial" => "110"
                        "paginaFinal" => "118"
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                            "web" => "Medline"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence&#44; clinical characteristics and prognostic factor of patients with COVID-19&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Ma"
                            1 => "J&#46; Gu"
                            2 => "P&#46; Hou"
                            3 => "L&#46; Zhang"
                            4 => "Y Bai"
                            5 => "Z&#46; Guo"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1101/2020.03.17.20037572"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46; Jain"
                            1 => "J&#46;-M&#46; Yuan"
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                    0 => array:2 [
                      "doi" => "10.1007/s00038-020-01390-7"
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Public Health"
                        "fecha" => "2020"
                        "volumen" => "65"
                        "paginaInicial" => "533"
                        "paginaFinal" => "546"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32451563"
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Article information
ISSN: 22548874
Original language: English
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