{"id":22630,"date":"2022-12-20T11:23:15","date_gmt":"2022-12-20T10:23:15","guid":{"rendered":"https:\/\/idibell.cat\/?p=22630"},"modified":"2023-01-03T15:49:36","modified_gmt":"2023-01-03T14:49:36","slug":"desenvolupen-un-model-per-predir-levolucio-clinica-dels-pacients-amb-covid-19-quan-fan-lingres-hospitalari","status":"publish","type":"post","link":"https:\/\/idibell.cat\/2022\/12\/desenvolupen-un-model-per-predir-levolucio-clinica-dels-pacients-amb-covid-19-quan-fan-lingres-hospitalari\/","title":{"rendered":"Desenvolupen un model per predir l\u2019evoluci\u00f3 cl\u00ednica dels pacients amb COVID-19 quan fan l\u2019ingr\u00e9s hospitalari"},"content":{"rendered":"

Predir els casos d’alt risc entre els pacients de COVID-19 quan ingressen a l\u2019hospital \u00e9s clau per proporcionar-los un tractament adequat i tamb\u00e9 per optimitzar els recursos sanitaris, especialment en moments d\u2019alta incid\u00e8ncia de la malaltia i risc de col\u00b7lapse hospitalari, com els que s\u2019han viscut en les diferents onades de la pand\u00e8mia. Per aix\u00f2, \u00e9s necessari disposar de mecanismes d’anticipaci\u00f3 rigorosos que es basin en dades completes i precises.<\/p>\n

Amb aquesta idea s\u2019ha desenvolupat el projecte DIVINE<\/strong>, acr\u00f2nim de \u2018DynamIc eValuation of COVID-19 cliNical statEs and their prognostic factors to improve the intra-hospital patient management\u2019, finan\u00e7at per la Generalitat de Catalunya, en el marc de la convocat\u00f2ria Pand\u00e8mies 2020, i que s\u2019ha dut a terme al llarg del darrer any i mig. El projecte \u00e9s resultat de la col\u00b7laboraci\u00f3 del Grup de Recerca en Bioestad\u00edstica i Bioinform\u00e0tica (GRBIO)<\/a> \u2212format per investigadors de la Universitat Polit\u00e8cnica de Catalunya – BarcelonaTech (UPC) <\/strong>i de la Universitat de Barcelona (UB)\u2212, de l\u2019Hospital Universitari de Bellvitge (HUB)<\/a> i de la Unitat de Bioestad\u00edstica de l\u2019Institut d’Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL)<\/a>,\u00a0sota la coordinaci\u00f3 de Guadalupe G\u00f3mez<\/a> Melis<\/u>, investigadora del GRBIO i professora del Departament d’Estad\u00edstica i Investigaci\u00f3 Operativa<\/a> de la UPC.<\/p>\n

 <\/p>\n

Models predictius de l\u2019evoluci\u00f3 dels pacients<\/h3>\n

Com a resultat del projecte, s\u2019ha desenvolupat l\u2019aplicaci\u00f3 MSMpred<\/a>, una eina de predicci\u00f3 cl\u00ednica en l\u00ednia que presenta, per a cada pacient en concret i en diferents moments a partir de l\u2019ingr\u00e9s hospitalari, la probabilitat de patir pneum\u00f2nia severa, de necessitar ventilaci\u00f3 mec\u00e0nica o fins i tot de morir, aix\u00ed com el temps de transici\u00f3 entre aquests estats.<\/p>\n

Per crear aquesta eina, els investigadors han desenvolupat un model estad\u00edstic multiestat, que analitza els diferents estadis de la malaltia en cada pacient. S\u2019han analitzat i combinat dades de m\u00e9s de 5.000 pacients de COVID-19 ingressats durant les cinc primeres onades de la pand\u00e8mia. En concret, s\u2019han tingut en compte dades sociodemogr\u00e0fiques, antecedents m\u00e8dics coneguts i comorbiditats, s\u00edmptomes cl\u00ednics i informaci\u00f3 detallada sobre la gesti\u00f3 cl\u00ednica.<\/p>\n

Aquestes dades han estat recollides i codificades pels metges i metgesses especialistes de cinc hospitals de l\u2019\u00c0mbit Metropolit\u00e0 Sud: l\u2019Hospital Universitari de Bellvitge, l\u2019Hospital Mois\u00e8s Broggi, l\u2019Hospital de Viladecans, l\u2019Hospital de Sant Boi de Llobregat i el Consorci Hospitalari del Garraf.<\/p>\n

 <\/p>\n

Sostre terap\u00e8utic<\/h3>\n

Un factor clau per predir l\u2019evoluci\u00f3 del pacient ha estat l\u2019aplicaci\u00f3 o no d\u2019un sostre terap\u00e8utic, \u00e9s a dir, predeterminar el nivell m\u00e9s alt d’intervenci\u00f3, que \u00e9s una pr\u00e0ctica habitual en el tractament de persones amb un pron\u00f2stic cr\u00edtic. \u00a0En el punt \u00e0lgid de la pand\u00e8mia, les decisions sobre el sostre terap\u00e8utic es van haver d’adaptar a una situaci\u00f3 d’emerg\u00e8ncia. Aquest estudi \u00e9s pioner en descriure les caracter\u00edstiques cl\u00edniques, la mortalitat i les complicacions dels pacients amb COVID-19 en funci\u00f3 del sostre terap\u00e8utic. Els resultats d\u2019aquest treball es recullen a l\u2019article cient\u00edfic \u2018Characteristics and outcomes by ceiling of care of subjects hospitalized with COVID-19 during four waves of the pandemic in a metropolitan area: a multi-center cohort study\u2019<\/a>, publicat a la revista Infectious Diseases and Therapy<\/em>\u00a0d\u2019aquest mes de desembre.<\/p>\n

 <\/p>\n

Temps d\u2019incubaci\u00f3 i evoluci\u00f3 del perfil dels pacients<\/h3>\n

A m\u00e9s d\u2019identificar els factors m\u00e9s rellevants cl\u00ednicament que influeixen en una millor o pitjor evoluci\u00f3 en un pacient hospitalitzat per COVID-19, el projecte DIVINE ha perm\u00e8s fer una estimaci\u00f3 del temps d\u2019incubaci\u00f3 de la malaltia, des de la infecci\u00f3 fins a l\u2019aparici\u00f3 dels s\u00edmptomes, en diferents fases de la pand\u00e8mia. Els resultats d\u2019aquest treball es recullen a l\u2019article \u2018SARS-Cov-2 incubation period according to vaccination status during the fifth COVID-19 wave in a tertiary-care center in Spain: a cohort study\u2019<\/a>, publicat a la revista BMC Infectious Diseases<\/em> el novembre passat. En aquella fase del projecte, els investigadors van desenvolupar un marc estad\u00edstic, que seria aplicable a futures pand\u00e8mies derivades d\u2019altres malalties infeccioses.<\/p>\n

D\u2019altra banda, les dades recollides en el projecte DIVINE han perm\u00e8s tamb\u00e9 avaluar com ha anat evolucionant el perfil dels pacients hospitalitzats per COVID-19 durant les diferents onades de la pand\u00e8mia, a partir de diferents indicadors. S\u2019ha observat que a mesura que avan\u00e7ava la pand\u00e8mia, els pacients hospitalitzats tendien a ser m\u00e9s joves i amb menys comorbiditats i, conseq\u00fcentment, tenien un millor pron\u00f2stic.<\/p>\n

A m\u00e9s de Guadalupe G\u00f3mez Melis, investigadora principal, en el projecte han participat els investigadors del GRBIO Mireia Besal\u00fa<\/strong>, de la Universitat de Barcelona, i els investigadors de la UPC\u202fErik Cobo<\/a>, Jordi Cort\u00e9s<\/a>, Daniel Fern\u00e1ndez<\/a>, Leire Garmendia<\/strong>,\u202fKlaus Langohr<\/a>,<\/u> Nuria P\u00e9rez<\/a> i<\/u> Xavier Piulachs<\/a>.<\/strong> Per part de l\u2019IDIBELL i del HUB, el projecte l\u2019ha encap\u00e7alat l\u2019investigador Cristian Teb\u00e9<\/strong>, cap de la Unitat de Bioestad\u00edstica d\u2019aquest institut, i ha comptat amb la participaci\u00f3 dels metges i metgesses del Servei de Malalties Infeccioses de l\u2019HUB i dels investigadors Jordi Carratal\u00e0<\/strong>, Carlota Gudiol,<\/strong> Gabriela Abelenda, Alexander Rombauts Nat\u00e0lia Pallar\u00e8s, Gemma Molist, Pilar Hereu i Sebasti\u00e0 Videla.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Un projecte conjunt d\u2019investigadors de la UPC, la UB, l\u2019HUB i l\u2019IDIBELL ha perm\u00e8s estudiar la probabilitat de patir pneum\u00f2nia severa, de necessitar ventilaci\u00f3 o fins i tot de morir durant l\u2019ingr\u00e9s hospitalari per COVID-19. Fruit dels models estad\u00edstics creats, a partir de dades de m\u00e9s de 5.000 pacients ingressats a cinc hospitals en diferents onades de la pand\u00e8mia, s\u2019ha desenvolupat una aplicaci\u00f3 web per a la identificaci\u00f3 preco\u00e7 de pacients de COVID-19 potencialment d\u2019alt risc i la predicci\u00f3 del curs de la malaltia.<\/p>\n","protected":false},"author":8,"featured_media":22631,"comment_status":"closed","ping_status":"open","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-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-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-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-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-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-gradient":""}},"footnotes":""},"categories":[391,334,479],"tags":[],"publishpress_future_action":{"enabled":false,"date":"2024-05-09 20:49:46","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/22630"}],"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=22630"}],"version-history":[{"count":1,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/22630\/revisions"}],"predecessor-version":[{"id":22633,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/22630\/revisions\/22633"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/22631"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=22630"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=22630"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=22630"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}