{"id":16806,"date":"2021-03-09T15:09:11","date_gmt":"2021-03-09T14:09:11","guid":{"rendered":"https:\/\/idibell.cat\/?p=16806"},"modified":"2021-03-09T15:09:11","modified_gmt":"2021-03-09T14:09:11","slug":"identificats-tres-perfils-clinics-de-pacients-amb-covid-19-amb-implicacions-pronostiques","status":"publish","type":"post","link":"https:\/\/idibell.cat\/2021\/03\/identificats-tres-perfils-clinics-de-pacients-amb-covid-19-amb-implicacions-pronostiques\/","title":{"rendered":"Identificats tres perfils cl\u00ednics de pacients amb Covid-19 amb implicacions pron\u00f2stiques"},"content":{"rendered":"<p>La identificaci\u00f3 d\u2019aquests perfils pot facilitar el maneig cl\u00ednic dels pacients, ja que permetr\u00e0 <strong>distingir amb m\u00e9s precisi\u00f3 les persones de baix risc de les que necessiten un monitoratge m\u00e9s estret<\/strong> durant l\u2019hospitalitzaci\u00f3. Aix\u00ed mateix, pot donar peu a investigar els mecanismes fisiopatol\u00f2gics que hi ha al darrere de cada fenotip, cosa que permetr\u00e0 seleccionar millor els participants en assaigs de f\u00e0rmacs segons el mecanisme i l\u2019\u00fas cl\u00ednic de cada medicament.<\/p>\n<p>Ha estat un treball multic\u00e8ntric liderat per investigadors de l\u2019Hospital Universitario Virgen Macarena de Sevilla que ha tingut tamb\u00e9 entre els seus primers firmants el <strong>Dr. Jordi Carratal\u00e0<\/strong>, cap del Servei de Malalties Infeccioses de l\u2019HUB, coordinador del <a href=\"https:\/\/idibell.cat\/recerca\/area-de-medicina-translacional\/programa-de-malalties-infeccioses-i-transplantaments\/\">Programa de Malalties Infeccioses i Trasplantaments<\/a> de l\u2019IDIBELL i catedr\u00e0tic de Medicina de la Universitat de Barcelona.<\/p>\n<p>L\u2019estudi va analitzar les <strong>dades de dues cohorts de 4.035 i 2.226 pacients atesos a 127 hospitals d\u2019Espanya<\/strong> durant la primera onada de la pand\u00e8mia. Es van estudiar <strong>m\u00e9s de 70 variables<\/strong> d\u2019aquests pacients, com ara l\u2019edat, el sexe, els s\u00edmptomes, les malalties de base, o les dades de laboratori i de radiodiagn\u00f2stic, entre d\u2019altres.<\/p>\n<p>Els resultats van determinar que els pacients amb el fenotip A \u2013que tenen una mortalitat inferior al 5%\u2013 s\u00f3n persones m\u00e9s joves i majorit\u00e0riament dones, amb s\u00edmptomes v\u00edrics lleus i amb par\u00e0metres inflamatoris normals, entre d\u2019altres caracter\u00edstiques. Els pacients amb el fenotip B \u2013que tenen una mortalitat d\u2019entre el 15 i el 20%\u2013 s\u00f3n persones amb m\u00e9s obesitat, nivells baixos de limf\u00f2cits en sang i par\u00e0metres d\u2019inflamaci\u00f3 moderadament elevats. Finalment, els pacients amb el fenotip C \u2013que tenen una mortalitat d\u2019entre el 40 i el 60%\u2013 s\u00f3n persones m\u00e9s grans, amb m\u00e9s comorbiditats i par\u00e0metres inflamatoris m\u00e9s elevats.<\/p>\n<p>El gran nombre de variables necess\u00e0ries inicialment per identificar els fenotips va fer que els autors ideessin un model probabil\u00edstic m\u00e9s senzill, amb nom\u00e9s 16 variables, que permet ja predir quin fenotip pot assignar-se a cada pacient. Aquest model ha estat desenvolupat en forma d\u2019aplicaci\u00f3 per a tel\u00e8fon m\u00f2bil per al seu \u00fas en la pr\u00e0ctica cl\u00ednica.<\/p>\n<h3>\nModel de predicci\u00f3 de la mortalitat<\/h3>\n<p>D\u2019altra banda, un article de membres del mateix grup d\u2019investigadors de l\u2019estat espanyol publicat a la revista Thorax exposa el desenvolupament i la validaci\u00f3 d\u2019un model de predicci\u00f3 de la mortalitat en pacients amb Covid-19 que entren a urg\u00e8ncies hospital\u00e0ries. El treball ha estat coordinat des de l\u2019Hospital General Universitario Gregorio Mara\u00f1\u00f3n i hi han participat investigadors del Servei de Malalties Infeccioses de l\u2019HUB i de l\u2019IDIBELL, liderats pel Dr. Carratal\u00e0.<\/p>\n<p>Per al desenvolupament i la validaci\u00f3 d\u2019aquest model, s\u2019han utilitzat les dades de sengles cohorts de 4.035 i 2.126 pacients de 127 hospitals d\u2019Espanya. La conclusi\u00f3 ha estat que una puntuaci\u00f3 de predicci\u00f3 senzilla, basada en dades cl\u00edniques i de laboratori f\u00e0cilment disponibles, proporciona una eina \u00fatil per predir amb un alt grau de precisi\u00f3 la probabilitat de mortalitat als 30 dies. La seva simplicitat pot permetre als metges portar a terme una r\u00e0pida estratificaci\u00f3 del risc dels pacients.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Un estudi publicat a la prestigiosa revista The Lancet Infectious Diseases en el qual han participat l\u2019Hospital Universitari de Bellvitge (HUB) i l\u2019Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) ha aconseguit identificar tres fenotips (perfils cl\u00ednics o formes de presentaci\u00f3 dels pacients) de Covid-19, cadascun d\u2019ells amb una mortalitat diferent.<\/p>\n","protected":false},"author":8,"featured_media":16807,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[374,334,479],"tags":[],"class_list":["post-16806","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-immunitat-innata-i-patologia-del-malalt-critic","category-medicina-translacional","category-p-de-malalties-infeccioses-i-transplantaments"],"publishpress_future_action":{"enabled":false,"date":"2024-11-29 19:29:17","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/16806","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/comments?post=16806"}],"version-history":[{"count":0,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/16806\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/16807"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=16806"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=16806"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=16806"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}