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Pulmonology . Clustering patients with COVID-19 according to respiratory support requirements, and its impact on short- and long-term outcome (RECOV

tetano

Editor, Senior Moderator
Pulmonology


. 2025 Dec 31;31(1):2442175.
doi: 10.1080/25310429.2024.2442175. Epub 2025 Jan 3. Clustering patients with COVID-19 according to respiratory support requirements, and its impact on short- and long-term outcome (RECOVID study)

Rosario Menéndez[SUP] 1 2 [/SUP], Raúl Méndez[SUP] 1 2 [/SUP], Ana Latorre[SUP] 2 [/SUP], Paula González-Jiménez[SUP] 1 2 [/SUP], Germán Peces-Barba[SUP] 3 [/SUP], María Molina-Molina[SUP] 4 [/SUP], Pedro Pablo España[SUP] 5 [/SUP], Estela García[SUP] 6 [/SUP], Angélica Consuegra-Vanegas[SUP] 7 [/SUP], Marta María García-Clemente[SUP] 8 [/SUP], Carolina Panadero[SUP] 9 [/SUP], Juan Marco Figueira-Gonçalves[SUP] 10 [/SUP], David De la Rosa-Carrillo[SUP] 11 [/SUP], Oriol Sibila[SUP] 12 [/SUP], María Dolores Martínez-Pitarch[SUP] 13 [/SUP], Nuria Toledo-Pons[SUP] 14 [/SUP], Cecilia López-Ramírez[SUP] 15 [/SUP], Wanda Almonte-Batista[SUP] 16 [/SUP], Abigail Macías-Paredes[SUP] 17 [/SUP], Mercedes Villamon[SUP] 18 [/SUP], Marisol Domínguez-Álvarez[SUP] 19 [/SUP], Eli Nancy Pérez-Rodas[SUP] 20 [/SUP], Javier Lázaro[SUP] 21 [/SUP], Sarai Quirós[SUP] 22 [/SUP], Rosa Cordovilla[SUP] 23 [/SUP], Irene Cano-Pumarega[SUP] 24 [/SUP], Antoni Torres[SUP] 12 [/SUP]; RECOVID



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Free article Abstract

Introduction: The Spanish Society of Pulmonology and Thoracic Surgery created a registry for hospitalised patients with COVID-19 and the different types of respiratory support used (RECOVID). Objectives. To describe the profile of hospitalised patients with COVID-19, comorbidities, respiratory support treatments and setting. In addition, we aimed to identify varying profiles of patients according to outcomes and the complexity of respiratory support needed.
Methods: Multicentre, observational study in 49 Spanish hospitals. A protocol collected demographic data, comorbidities, respiratory support, treatment setting and 1-year follow-up. Patients were described using either frequency and percentages or median and interquartile range, as appropriate. A cluster analysis made it possible to identify different types of profile among the patients.
Results: In total, 2148 of 2454 hospitalised patients (87.5%) received care in the conventional ward, whilst 126 in IRCU and 180 in ICU. In IRCU, 30% required high-flow nasal oxygen whilst 25%, non-invasive mechanical ventilation and 17%, mechanical ventilation. Four clusters of patients were identified. Two clusters were more likely to require IRCU/ICU admission, although primarily Cluster 2: Cluster (C) 1 consisted of patients without comorbidities and C2, those with comorbidities. Both presented higher inflammatory levels and lower lymphocyte count and SpO2/FiO2; however, C2 showed worse values. Two different clusters identified patients requiring less complex respiratory support. C3 presented higher comorbidities and elevated lymphocyte count, SpO2/FiO2 and low C-reactive protein (CRP). C4 included those without comorbidities except for arterial hypertension, lymphopenia and an intermediate CRP. In-hospital mortality and subsequent 1-year mortality were greater for C2 (28.6% and 7.1%) and C1 (11.1%, 8.3%) than for C4 (3.3%, 1.8%) and C3 (0%, 0%).
Conclusions: The cluster analysis identified four clinical phenotypes requiring distinct types of respiratory support, with great differences present per characteristics and outcomes.

Keywords: COVID-19; NIMV; RECOVID; SARS-CoV-2; SEPAR.

 
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