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1. Chronic hyperglycemia and intracranial meningiomas

Author

Orešković, D., Madero Pohlen, A., Cvitković, I., Alen, J.F., Raguž, M., Álvarez-Sala de la Cuadra, A., Bazarra Castro, G.J., Bušić, Z., Konstantinović, I., Ledenko, V., Martínez Macho, C., Müller, D., Žarak, M., Jovanov-Milosevic, N., Chudy, D., and Marinović, T.

Published
2024
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2. Chronic hyperglycemia and intracranial meningiomas

Author

D. Orešković, A. Madero Pohlen, I. Cvitković, J.F. Alen, M. Raguž, A. Álvarez-Sala de la Cuadra, G.J. Bazarra Castro, Z. Bušić, I. Konstantinović, V. Ledenko, C. Martínez Macho, D. Müller, M. Žarak, N. Jovanov-Milosevic, D. Chudy, and T. Marinović

Subjects
Meningioma, Hyperglycaemia, Dexamethasone, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Meningiomas are among the most common primary tumors of the central nervous system. Previous research into the meningioma histological appearance, genetic markers, transcriptome and epigenetic landscape has revealed that benign meningiomas significantly differ in their glucose metabolism compared to aggressive lesions. However, a correlation between the systemic glucose metabolism and the metabolism of the tumor hasn’t yet been found. We hypothesized that chronic levels of glycaemia (approximated with glycated hemoglobin (HbA1c)) are different in patients with aggressive and benign meningiomas. The study encompassed 71 patients with de novo intracranial meningiomas, operated on in three European hospitals, two in Croatia and one in Spain. Our results show that patients with WHO grade 2 meningiomas had significantly higher HbA1c values compared to patients with grade 1 lesions (P = 0.0290). We also found a significant number of patients (19/71; 26.7%) being hyperglycemic, harboring all the risks that such a condition entails. Finally, we found a significant correlation between our patients’ age and their preoperative HbA1c levels (P = 0.0008, ρ(rho) = 0.388), suggesting that older meningioma patients are at a higher risk of having their glycaemia severely dysregulated. These findings are especially important considering the current routine and wide-spread use of corticosteroids as anti-edematous treatment. Further research in this area could lead to better understanding of meningiomas and have immediate clinical impact.

Published
2024
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5. Glycemia and Coagulation in Patients with Glioblastomas

Author

Orešković, Darko, Madero Pohlen, Alejandra, Cvitković, Ivna, Alen, Jose F., Álvarez-Sala de la Cuadra, Amelia, Bazarra Castro, Guillermo J., Bušić, Željko, Kaštelančić, Anđelo, Konstantinović, Ivan, Rotim, Ante, Lakić, Marin, Ledenko, Vlatko, Martínez Macho, Carlos, Raguž, Marina, Žarak, Marko, Chudy, Darko, and Marinović, Tonko

Published
2024
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7. Cardiovascular Events in Patients with Severe Asthma—A Retrospective Study of Two Cohorts: Asthma Type T2 Treated with Biologics and Non-Type T2

Author

Paula Granda, Elena Villamañán, Daniel Laorden, Carlos Carpio, Victoria Collada, Javier Domínguez-Ortega, Leticia de las Vecillas, David Romero-Ribate, Omar Fabián Chaparro-Díaz, Teresa Lázaro Miguel-Sin, Daniela Jose Alloca-Álvarez, Jorge Mauricio Correa-Borit, Itsaso Losantos, Patricia Mir-Ihara, Emilio José Narváez-Fernández, Santiago Quirce, and Rodolfo Álvarez-Sala

Subjects
asthma, cardiovascular disease, T2 asthma, Medicine
Abstract

Background: The prevalence of cardiovascular events (CVEs) in patients with asthma varies amongst studies, with little evidence as to their prevalence in patients treated with monoclonal antibodies (mAbs). In this retrospective, observational study, we aimed to evaluate the prevalence of CVEs in patients with T2 and non-T2 asthma and to identify risk factors associated with CVEs. Methods: A total of 206 patients with severe asthma were included. Demographic variables, respiratory comorbidities and cardiovascular risk factors were collected, along with respiratory function, laboratory parameters and respiratory pharmacotherapy, including treatment with mAbs. Results: A total of 10.7% of the patients had any CVE from the date of asthma diagnosis, with a higher risk in those patients with chronic obstructive pulmonary disease (odds ratio [OR] = 5.36, 95% CI 1.76–16.31; p = 0.003), arterial hypertension (OR = 2.71, 95% CI 1.13–6.55; p = 0.026) and dyslipidaemia (OR = 9.34, 95% CI 3.57–24.44; p < 0.001). No association between mAb treatment and a CVE or between time of mAb treatment and the event was found. No significant differences were observed between the T2 and non-T2 cohort. After a multivariate analysis, dyslipidaemia was identified as an independent risk factor (OR = 13.33, 95% CI 4.49–39.58; p < 0.001), whereas regular use of inhaled corticosteroids was associated with a reduced risk of a CVE (OR = 0.103, 95% CI 0.021–0.499; p = 0.005). Further research is needed to fully understand the relationship between severe asthma and CVEs. Conclusions: This study suggests that patients with severe asthma experience a higher percentage of CVEs compared with the general population.

Published
2024
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9. Should atelectasis be considered a pulmonary complication and indicator of poor prognosis in cystic fibrosis?

Author

María Martínez Redondo, Carlos Carpio Segura, Ester Zamarrón De Lucas, Rodolfo Álvarez-Sala Walther, and Concepción Prados Sánchez

Subjects
Medicine (General), R5-920
Abstract

Objective This study examined whether bronchoscopy leads to clinicoradiological improvement in cystic fibrosis (CF) and the predictive factors. The study also investigated whether pulmonary atelectasis is a poor prognostic factor in CF. Methods This multicenter, case–control, observational, retrospective study included two groups of patients with CF: a case group (patients with persistent atelectasis who were followed-up at least for 2 years) and a control group (patients without atelectasis matched 1:1 by sex and age [±3 years]). We recorded demographic data, lung function test results, pulmonary complications, comorbidities, treatments (including bronchoscopies, surgery and transplantation), and deaths. Results Each group included 55 patients (case group: 20 men, mean age 25.4 ± 10.4 years; control group: 20 men, mean age 26.1 ± 11.4 years). Bronchoscopy did not lead to clinicoradiological improvement. Allergic bronchopulmonary aspergillosis (ABPA) was more frequent in the case group. Patients in the case group more frequently used inhaled steroids, their pre-atelectasis lung function was statistically worse, and they had more exacerbations during follow-up. Conclusion Moderate-to-severe pulmonary disease and ABPA can favor atelectasis. Pulmonary atelectasis can be a poor prognostic factor in CF because it increases exacerbations. Despite our results, we recommend enhancing treatment, including bronchoscopy, to prevent persistent atelectasis.

Published
2024
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10. Air pollution exposure and its effects on idiopathic pulmonary fibrosis: clinical worsening, lung function decline, and radiological deterioration

Author

Pablo Mariscal-Aguilar, Luis Gómez-Carrera, Gema Bonilla, Mariana Díaz-Almirón, Francisco Gayá, Carlos Carpio, Ester Zamarrón, María Fernández-Velilla, Isabel Torres, Isabel Esteban, Rita Regojo, Elena Villamañán, Concepción Prados, and Rodolfo Álvarez-Sala

Subjects
air pollution, idiopathic pulmonary fibrosis, clinical worsening, lung function decline, radiological deterioration, Public aspects of medicine, RA1-1270
Abstract

IntroductionMajor urban pollutants have a considerable influence on the natural history of lung disease. However, this effect is not well known in idiopathic pulmonary fibrosis (IPF).AimThis study aimed to investigate the effects of air pollution on clinical worsening, lung function, and radiological deterioration in patients with IPF.MethodsThis exploratory retrospective cohort study included 69 patients with IPF, monitored from 2011 to 2020. Data on air pollution levels, including carbon monoxide (CO), nitrogen dioxide (NO2), particulate matter ≤ 2.5 μM (PM2.5), ozone (O3), and nitrogen oxides (NOx), were collected from the nearest air quality monitoring stations (

Published
2024
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13. Gut microbiota in nonalcoholic fatty liver disease: a PREDIMED-Plus trial sub analysis

Author

Ana María Gómez-Pérez, Patricia Ruiz-Limón, Jordi Salas-Salvadó, Jesús Vioque, Dolores Corella, Montse Fitó, Josep Vidal, Alessandro Atzeni, Laura Torres-Collado, Andrea Álvarez-Sala, María Ángeles Martínez, Albert Goday, David Benaiges, Jesús García-Gavilán, María Rosa Bernal López, Isabel Moreno-Indias, and Francisco J. Tinahones

Subjects
Microbiome, metabolic liver disease, hepatic steatosis index, the Fibrosis-4 score, Mediterranean diet, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

ABSTRACTTo evaluate the changes in the gut microbiota associated with changes in the biochemical markers of nonalcoholic fatty liver disease (NAFLD) after a lifestyle intervention with the Mediterranean diet. Participants (n = 297) from two centers of PREDIMED-Plus trial (Prevención con Dieta Mediterránea) were divided into three different groups based on the change tertile in the Hepatic Steatosis Index (HSI) or the Fibrosis−4 score (FIB−4) between baseline and one year of intervention. One-year changes in HSI were: tertile 1 (T1) (−24.9 to −7.51), T2 (−7.5 to −1.86), T3 (−1.85 to 13.64). The most significant differences in gut microbiota within the year of intervention were observed in the T1 and T3. According to the FIB−4, participants were categorized in non-suspected fibrosis (NSF) and with indeterminate or suspected fibrosis (SF). NSF participants showed higher abundances of Alcaligenaceae, Bacteroidaceae, Bifidobacteriaceae, Clostridiaceae, Enterobacteriaceae, Peptostreptococcaceae, Verrucomicrobiaceae compared to those with SF. Then, participants were divided depending on the FIB−4 tertile of change: T1 (−89.60 to −5.57), T2 (−5.56 to 11.4), and T3 (11.41 to 206.24). FIB−4 T1 showed a decrease in Akkermansia and an increase in Desulfovibrio. T2 had an increase in Victivallaceae, Clostridiaceae, and Desulfovibrio. T3 showed a decrease in Enterobacteriaceae, and an increase in Sutterella, Faecalibacterium, and Blautia. A relation between biochemical index changes of NAFLD/NASH (HSI and FIB−4) and gut microbiota changes were found. These observations highlight the importance of lifestyle intervention in the modulation of gut microbiota and the management of metabolic syndrome and its hepatic manifestations.

Published
2023
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24. Relationship between air pollution exposure and the progression of idiopathic pulmonary fibrosis in Madrid: Chronic respiratory failure, hospitalizations, and mortality. A retrospective study

Author

Pablo Mariscal-Aguilar, Luis Gómez-Carrera, Carlos Carpio, Ester Zamarrón, Gema Bonilla, María Fernández-Velilla, Isabel Torres, Isabel Esteban, Rita Regojo, Mariana Díaz-Almirón, Francisco Gayá, Elena Villamañán, Concepción Prados, and Rodolfo Álvarez-Sala

Subjects
air pollution, idiopathic pulmonary fibrosis, chronic respiratory failure, hospital admissions, mortality, Public aspects of medicine, RA1-1270
Abstract

IntroductionAir pollution has a significant impact on the morbidity and mortality of various respiratory diseases. However, this has not been widely studied in diffuse interstitial lung diseases, specifically in idiopathic pulmonary fibrosis.ObjectiveIn this study we aimed to assess the relationship between four major air pollutants individually [carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), and nitrogen oxides (NOx)] and the development of chronic respiratory failure, hospitalization due to respiratory causes and mortality in patients with idiopathic pulmonary fibrosis.MethodsWe conducted an exploratory retrospective panel study from 2011 to 2020 in 69 patients with idiopathic pulmonary fibrosis from the pulmonary medicine department of a tertiary hospital. Based on their geocoded residential address, levels of each pollutant were estimated 1, 3, 6, 12, and 36 months prior to each event (chronic respiratory failure, hospital admission and mortality). Data was collected from the air quality monitoring stations of the Community of Madrid located

Published
2023
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28. Cardiovascular Events in Patients with Severe Asthma—A Retrospective Study of Two Cohorts: Asthma Type T2 Treated with Biologics and Non-Type T2.

Author

Granda, Paula, Villamañán, Elena, Laorden, Daniel, Carpio, Carlos, Collada, Victoria, Domínguez-Ortega, Javier, de las Vecillas, Leticia, Romero-Ribate, David, Chaparro-Díaz, Omar Fabián, Lázaro Miguel-Sin, Teresa, Alloca-Álvarez, Daniela Jose, Correa-Borit, Jorge Mauricio, Losantos, Itsaso, Mir-Ihara, Patricia, Narváez-Fernández, Emilio José, Quirce, Santiago, and Álvarez-Sala, Rodolfo

Subjects
CHRONIC obstructive pulmonary disease, ASTHMATICS, CARDIOVASCULAR diseases risk factors, CARDIOVASCULAR diseases, ODDS ratio
Abstract

Background: The prevalence of cardiovascular events (CVEs) in patients with asthma varies amongst studies, with little evidence as to their prevalence in patients treated with monoclonal antibodies (mAbs). In this retrospective, observational study, we aimed to evaluate the prevalence of CVEs in patients with T2 and non-T2 asthma and to identify risk factors associated with CVEs. Methods: A total of 206 patients with severe asthma were included. Demographic variables, respiratory comorbidities and cardiovascular risk factors were collected, along with respiratory function, laboratory parameters and respiratory pharmacotherapy, including treatment with mAbs. Results: A total of 10.7% of the patients had any CVE from the date of asthma diagnosis, with a higher risk in those patients with chronic obstructive pulmonary disease (odds ratio [OR] = 5.36, 95% CI 1.76–16.31; p = 0.003), arterial hypertension (OR = 2.71, 95% CI 1.13–6.55; p = 0.026) and dyslipidaemia (OR = 9.34, 95% CI 3.57–24.44; p < 0.001). No association between mAb treatment and a CVE or between time of mAb treatment and the event was found. No significant differences were observed between the T2 and non-T2 cohort. After a multivariate analysis, dyslipidaemia was identified as an independent risk factor (OR = 13.33, 95% CI 4.49–39.58; p < 0.001), whereas regular use of inhaled corticosteroids was associated with a reduced risk of a CVE (OR = 0.103, 95% CI 0.021–0.499; p = 0.005). Further research is needed to fully understand the relationship between severe asthma and CVEs. Conclusions: This study suggests that patients with severe asthma experience a higher percentage of CVEs compared with the general population. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Anti-IL-5 and anti-IL-5R biologics for severe asthma. Are there any differences in their effects?

Author

Granda, Paula, Villamañán, Elena, Carpio, Carlos, Laorden, Daniel, Quirce, Santiago, and Álvarez-Sala, Rodolfo

Subjects
EMERGENCY room visits, ASTHMA, PULMONARY function tests, PULMONARY eosinophilia, BIOLOGICALS, VOCAL cord dysfunction, HOSPITAL admission & discharge
Abstract

The aim of this retrospective multicentre study is to describe the clinical characteristics of patients diagnosed with severe eosinophilic asthma receiving anti-IL-5/anti-IL-5Rα therapies and to compare their effectiveness. We collected and analysed results separately for anti-IL-5 and anti-IL-5Rα therapies from January 2016 until December 2021 in multidisciplinary severe asthma units. We collected demographic and clinical data, treatment with previous anti-IgE and/or anti-IL-5 agents, and comorbidities. We compared the number of exacerbations and admissions to the hospital, daily oral corticosteroid intake, pulmonary function tests, and Asthma Control Test scores before and after 12 months of therapy. 261 patients were included: 176 patients in the anti-IL-5 group and 85 in the anti-IL-5Rα group. Both groups led to statistically significant reductions in asthma exacerbations, hospital admissions, and visits to the Emergency Room. Although both groups showed a significant reduction in blood eosinophiliccount, we found a difference, although not significant, in the magnitude of reduction as benralizumab was able to decrease eosinophil counts to zero. Patients in the anti-IL-5 group achieved higher ACT scores after treatment, although this improvement was seen in both treatment groups. The anti-IL-5 and anti-IL-5Rα biologics have shown similar effectiveness despite having different mechanisms of action. The anti-IL-5 group appeared to be better than benralizumab at improving ACT scores and FEV1/FVC and at reducing the number of inhalers. Although these differences were not statistically significant, it is not clear whether they may have clinical relevance and they might highlight the need for further head-to-head studies comparing these treatments. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Changes in the Expression of TGF-Beta Regulatory Pathway Genes Induced by Vitamin D in Patients with Relapsing-Remitting Multiple Sclerosis

Author

Alberto Lozano-Ros, María L. Martínez-Ginés, José M. García-Domínguez, Sara Salvador-Martín, Haydee Goicochea-Briceño, Juan P. Cuello, Ariana Meldaña-Rivera, Yolanda Higueras-Hernández, María Sanjurjo-Sáez, Luis A. Álvarez-Sala-Walther, and Luis A. López-Fernández

Subjects
vitamin D, TGF-β pathway, BMP signaling, multiple sclerosis, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract

Vitamin D is an environmental factor related to multiple sclerosis that plays a significant role in immune regulation. TGF-β is a superfamily of cytokines with an important dual effect on the immune system. TGF-β inhibits the Th1 response while facilitating the preservation of regulatory T cells (FOXP3+) in an immunoregulatory capacity. However, when IL-6 is present, it stimulates the Th17 response. Our aim was to analyze the regulatory effect of vitamin D on the in vivo TGF-β signaling pathway in patients with relapsing-remitting multiple sclerosis (RRMS). A total of 21 patients with vitamin D levels < 30 ng/mL were recruited and supplemented with oral vitamin D. All patients were receiving disease-modifying therapy, with the majority being on natalizumab. Expression of SMAD7, ERK1, ZMIZ1, BMP2, BMPRII, BMP4, and BMP5 was measured in CD4+ lymphocytes isolated from peripheral blood at baseline and one and six months after supplementation. SMAD7 was overexpressed at six months with respect to baseline and month one. ERK1 was overexpressed at six months with respect to month one of treatment. No significant differences in expression were observed for the remaining genes. No direct correlation was found with serum vitamin D levels. BMPRII expression changed differentially in non–natalizumab- versus natalizumab-treated patients. Changes were observed in the expression of ERK1, BMP2, and BMP5 based on disease activity measured using the Rio-Score, BMP2 in patients who had relapses, and BMP5 in those whose EDSS worsened. Our results suggest indirect regulation of vitamin D in TGF-β pathway genes in patients with RRMS.

Published
2023
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31. Krebs von den Lungen-6 (KL-6) Levels in Post-COVID Follow-Up: Differences According to the Severity of COVID-19

Author

Carlos Carpio, Ana Qasem, Antonio Buño, Alberto M. Borobia, Francisco Arnalich, Vega Rey, Teresa Lázaro, Pablo Mariscal, Daniel Laorden, Giorgina Salgueiro, Alberto Moreno, Concepción Peiró, Óscar Lorenzo, and Rodolfo Álvarez-Sala

Subjects
post-acute COVID-19 syndrome, KL-6 antigen, human, COVID-19, Medicine
Abstract

To evaluate KL-6 levels in medium-term post-COVID and to compare them in three groups categorised by the severity of COVID-19, we conducted a real-world, retrospective, cohort study. Data from the COVID-19 episode and follow-up during the post-COVID phase were extracted from the COVID@HULP and POSTCOVID@HULP databases, respectively. For the post-COVID period we included demographics, medical history, symptoms, quality of life, physical activity, anxiety and depression status and laboratory results. Patients were categorised into three groups based on the severity of COVID-19: Group 1 (inpatient critical), Group 2 (inpatient non-critical) and Group 3 (hospitalised at home). KL-6 was measured during the follow-up of the three groups. In all, 802 patients were included (Group 1 = 59; Group 2 = 296; Group 3 = 447 patients). The median age was 59 years (48–70), and 362 (45.2%) were males. At admission, fibrinogen and ferritin levels were lower in Group 3 than in the other groups (p < 0.001). Follow-up data were obtained 124 days (97–149) after the diagnosis of COVID-19. The median levels of fibrinogen, ferritin and KL-6 at follow-up were 336 mg/dL (276–413), 80.5 ng/mL (36–174.3) and 326 U/mL (240.3–440.3), respectively. KL-6 levels were lower in Group 3 than in the other groups (298 U/mL (231.5–398) vs. 381.5 U/mL (304–511.8) (Group 1) and 372 U/mL (249–483) (Group 2) (p < 0.001)). KL-6 was associated with ferritin (p < 0.001), fibrinogen (p < 0.001), D-dimer (p < 0.001) and gamma-glutamyl transferase (p < 0.001). KL-6 levels are less elevated at medium-term post-COVID follow-up in patients with mild COVID-19 than in those with moderate or severe disease. KL-6 is associated with systemic inflammatory, hepatic enzyme and thrombosis biomarkers.

Published
2023
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32. Association between ultra-processed food consumption and gut microbiota in senior subjects with overweight/obesity and metabolic syndrome

Author

Alessandro Atzeni, María Ágeles Martínez, Nancy Babio, Prokopis Konstanti, Francisco J. Tinahones, Jesús Vioque, Dolores Corella, Montserrat Fitó, Josep Vidal, Isabel Moreno-Indias, Salvador Pertusa-Martinez, Andrea Álvarez-Sala, Olga Castañer, Albert Goday, Miguel Damas-Fuentes, Clara Belzer, Miguel Á. Martínez-Gonzalez, Frank B. Hu, and Jordi Salas-Salvadó

Subjects
ultra-processed food, gut microbiota, mediterranean diet, 16s sequencing, overweight, obesity, Nutrition. Foods and food supply, TX341-641
Abstract

The production and consumption of ultra-processed foods (UPF) has increased considerably during the last years worldwide. Collective evidence shows the association between UPF consumption and adverse health outcomes, including inflammatory gastro-intestinal disorders and obesity. The gut microbiota has been suggested as potential mediator of the effects of UPF consumption on metabolism and health. However, few studies have been conducted in order to elucidate these aspects. Therefore, the aim of the present study was to assess the cross-sectional associations between UPF consumption and gut microbiota in a population of senior subjects (n = 645) within the frame of the PREDIMED-Plus trial. Eligible participants were men and women (aged 55–75 years), without documented history of cardiovascular disease at enrollment, with overweight/obesity (body mass index ≤ 27 and

Published
2022
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36. Air pollution exposure and its effects on idiopathic pulmonary fibrosis: clinical worsening, lung function decline, and radiological deterioration

Author

Mariscal-Aguilar, Pablo, primary, Gómez-Carrera, Luis, additional, Bonilla, Gema, additional, Díaz-Almirón, Mariana, additional, Gayá, Francisco, additional, Carpio, Carlos, additional, Zamarrón, Ester, additional, Fernández-Velilla, María, additional, Torres, Isabel, additional, Esteban, Isabel, additional, Regojo, Rita, additional, Villamañán, Elena, additional, Prados, Concepción, additional, and Álvarez-Sala, Rodolfo, additional

Published
2024
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37. Identification and validation of clinical phenotypes with prognostic implications in patients admitted to hospital with COVID-19: a multicentre cohort study

Author

Aznar Muñoz, Esther, Gil Divasson, Pedro, González Muñiz, Patricia, Muñoz Aguirre, Clara, Retamar, Pilar, Valiente, Adoración, López-Cortés, Luis E., Sojo-Dorado, Jesús, Bravo-Ferrer, José, Salamanca, Elena, Palacios-Baena, Zaira R., Pérez-Palacios, Patricia, Gandullo-Moro, María, Ruíz-Hueso, Rocío, Moya-González, Natalia, Valido-Morales, Agustín, Pavón-Masa, María, Díaz Menéndez, Marta, De la Calle Prieto, Fernando, Arsuaga Vicente, Marta, Trigo Esteban, Elena, De Miguel Buckley, Rosa, Cadiñanos Loidi, Julen, Busca Arenzana, Carmen, Mican Rivera, Rafael, Mora Rillo, Marta, Loeches Yagüe, Belén, Bernardino de la Serna, José Ignacio, García Rodríguez, Julio, Montejano Sánchez, Rocío, Diaz Pollan, Beatriz, López, Juan Carlos, Ramírez-Schacke, Margarita, Gutiérrez, Isabel, Tejerina, Francisco, Aldámiz-Echevarría, Teresa, Díez, Cristina, Fanciulli, Chiara, Pérez-Latorre, Leire, Parras, Francisco, Catalán, Pilar, García-Leoni, María E, Pérez-Tamayo, Isabel, Puente, Luis, Cedeño, Jamil, Such-Diaz, Ana, Álvaro-Alonso, Elena, Izquierdo-García, Elsa, Torres-Macho, Juan, Cuevas, Guillermo, Notario, Helena, Mestre-Gómez, Beatriz, Jiménez-González de Buitrago, Eva, Fernández-Jiménez, Inés, Tebar-Martínez, Ana Josefa, Brañas, Fátima, Valencia, Jorge, Pérez-Butragueño, Mario, Alvarado, Marta, Abelenda-Alonso, Gabriela, Ardanuy, Carmen, Bergas, Alba, Cuervo, Guillermo, Domínguez, María Ángeles, Fernández-Huerta, Miguel, Gudiol, Carlota, Lorenzo-Esteller, Laia, Niubó, Jordi, Pérez-Recio, Sandra, Podzamczer, Daniel, Pujol, Miquel, Rombauts, Alexander, Trullen, Núria, Cisneros, José Miguel, Amodeo, Cristina, Camacho, Pedro, Espinosa, Nuria, García-Gutiérrez, Manuel, Jara-Palomares, Luis, González-León, Rocío, Molina, José, Nieto Martín, María Dolores, Paniagua, María, Poyato, Manuel, Rodríguez-Villodres, Ángel, Ruiz de Azua, Zaida, Salamanca, Celia, Sepúlveda Berrocal, Mº Antonia, Yera Bergua, Carmen, Toledano Sierra, Pilar, Cano Llorente, Verónica, Zafar Iqubal-Mirza, Sadaf, Muñiz, Gema, Martín Pérez, Inmaculada, Mozas Moriñigo, Helena, Alguacil, Ana, García Butenegro, María Paz, Peláez Ballesta, Ana Isabel, Morcillo Rodríguez, Elena, Goikoetxea Agirre, Josune, Blanco Vidal, María José, Nieto Arana, Javier, del Álamo Martínez de Lagos, Mikel, Pérez Hernández, Isabel A., Pérez Zapata, Inés, Silvariño Fernández, Rafael, Ugalde Espiñeira, Jon, Rivas-Carmenado, María, Suárez Pérez, Lucia, Suárez Diaz, Silvia, Yllera Gutiérrez, Carmen, Boix, Vicente, Díez Martínez, Marcos, Carreres Candela, Melissa, Gómez-Ayerbe, Cristina, Sánchez-Lora, Javier, Velasco Garrido, José Luis, López-Jodar, María, Santos González, Jesús, Ruiz Aragón, Jesús, Virto Peña, Ianire, Alende Castro, Vanessa, Sande Llovo, Diana, Vega Molpeceres, Sonia, Pons Viñas, Estel, del Río Pérez, Oscar, Valero Rovira, Silvia, Villar-García, Judit, Gómez-Junyent, Joan, Cánepa, María Cecilia, Castañeda Espinosa, Silvia, Letang, Emilio, Arenas-Miras, María del Mar, Gómez-Zorrilla, Silvia, Sánchez Martínez, Francesca, Lerma-Chippirraz, Elisabet, García Vázquez, Elisa, Moral Escudero, Encarnación, Roura Piloto, Aychel Elena, García Almodóvar, Esther, Sáez Barberá, Carmen, Karroud, Zineb, Hernández Quero, José, Vinuesa García, David, García Fogeda, José Luis, Peregrina, José Antonio, Novella Mena, María, Hernández Gutiérrez, Cristina, Sanz Moreno, José, Pérez Tanoira, Ramón, Navarro López, Jorge, Balsa Vázquez, Javier, Gutiérrez García, Aida, Arranz Caso, Alberto, Cuadros González, Juan, Álvarez de Mon Soto, Melchor, Díaz De Brito Fernández, Vicente Ferrer, Sanmarti Vilamala, Montserrat, Gabarrell Pascuet, Aina, Molina Morant, Daniel, España Cueto, Sergio, Cámara Fernández, Jonathan, Sabater Gil, Albert, Muñoz López, Laura, Jorge García, Ruth, Molina Torres, Nora, Sempere Alcocer, Marco Antonio, De Castro Vega, Francisco Javier, De los Santos Gil, Ignacio, García-Fraile, Lucio, Sampedro Núñez, Miguel, Barrios Blandino, Ana, Rodríguez Franco, Carlos, Useros Brañas, Daniel, Villa Martí, Almudena, Oliver Ortega, Javier, Costanza Espiño Álvarez, Alexia, Sanz Sanz, Jesús, Rexach Fumaña, María, Policarpo Torres, Guillem, Ortega Montoliu, Meritxell, Sala Jofre, Clara, Casas Rodríguez, Susana, Tortajada Alamilla, Cecilia, Oltra, Carmina, Masiá Canuto, Mar, Gutiérrez Rodero, Félix, Oltra Sempere, María Rosa, Vela Berna, Sara, Pedromingo Kus, Miguel, Garcinuño, María Ángeles, De la Vega, Alexandra, Pérez Pinto, Sergio, Hernández Machín, Pilar, Alastrué Violeta, Alba, Fariñas Álvarez, María Carmen, González Rico, Claudia, Arnaiz de las Revillas, Francisco, Calvo, Jorge, Gozalo, Mónica, Mora Gómez, Francisco, Milagro Beamonte, Ana, Latorre-Millán, Miriam, Rezusta López, Antonio, Martínez Sapiña, Ana, Meije, Yolanda, Ribera Puig, Alba, Ortega Enciso, Lucía, Sanz Salvador, Xavier, Losa García, Juan Emilio, Velasco Arribas, María, Pérez-Rodríguez, M. Teresa, Pérez González, Alexandre, Belhassen-García, Moncef, Rodríguez-Alonso, Beatriz, López-Bernus, Amparo, Carbonell, Cristina, Torres Perea, Rafael, Cantón De Seoane, Juan, Alonso, Blanca, Kamal, Sara Lidia, Cajuela, Lucía, Roa, David, Cervero, Miguel, Oreja, Alberto, Avilés, Juan Pablo, Martín, Lidia, Pelegrín Senent, Iván, Rouco Esteves Marques, Rosana, Parra Ruiz, Jorge, Ramos Sesma, Violeta, Abadia Otero, Jésica, Salillas Hernando, Juan, Torres Sánchez del Arco, Robert, Torralba González de Suso, Miguel, Serrano Martínez, Alberto, Gilaberte Reyzábal, Sergio, Pacheco Martínez-Atienza, Marina, Liébana Gómez, Mónica, Fernández Rodríguez, Sara, Varela Plaza, Álvaro, Calvo Sánchez, Henar, Martínez Martín, Patricia, González- Ruano, Patricia, Malmierca Corral, Eduardo, Rábago Lorite, Isabel, Pérez-Monte Mínguez, Beatriz, García Flores, Ángeles, Comas Casanova, Pere, Sirisi, Merce, Rojas, Richard, Díaz de Tuesta del Arco, José Luis, Figueroa Cerón, Ruth, González Sarria, Ander, Alemán Valls, Remedios, Alonso Socas, María del Mar, Sanz Peláez, Oscar, Mohamed Ramírez, Karim, Riera Jaume, Melchor, Vilchez, Helem Haydee, Albertí, Francesc, Cañabate, Ana Isabel, Moreno Cuerda, Víctor J, Álvarez Kaelis, Silvia, Álvarez Zapatero, Beatriz, García García, Alejandro, Isaba Ares, Elena, Morcate Fernández, Covadonga, Pérez Rodríguez, Andrea, Ramos Merino, Lucía, Castelo Corral, Laura, Rodríguez Mahía, María, González Bardanca, Mónica, Sánchez Vidal, Efrén, Míguez Rey, Enrique, Correa Ruiz, Ana, García de Lomas Guerrero, José Mº, Daniel López, Daniel, Marinas, Rebeca, Morando, Marta, Gómez García, Lucía, Boix Palop, Lucia, Dietl Gómez-Luengo, Beatriz, Pedrola Gorrea, Iris, Blasco Claramunt, Amparo, López Mestanza, Cristina, Fraile Villarejo, Esther, Jaén Sánchez, Nieves, Orihuela Martín, Jorge, Algado Rabasa, José Tomas, Garijo Saiz, Ana María, Amador Prous, Concepción, Salavert Lletí, Miguel, Hernández Belmonte, Adriana, Martínez Goñi, Raquel, Navarro Vilasaró, Marta, Calzado Isbert, Sonia, Cervantes García, Manuel, Gomila Grange, Aina, Gasch Blasi, Oriol, Machado Sicilia, María Luisa, Van den Eynde Otero, Eva, Falgueras López, Luis, Navarro Sáez, María del Carmen, Martínez, Esteban, Marcos, Mº Ángeles, Mosquera, Mar, Blanco, José Luis, Laguno, Montserrat, Rojas, Jhon, González-Cordón, Ana, Inciarte, Alexy, Torres, Berta, De la Mora, Lorena, Soriano, Alex, Martínez Macia, Olalla, Pérez Doñate, Virginia, Cabello Úbeda, Alfonso, Carrasco Antón, Nerea, Álvarez Álvarez, Beatriz, Petkova Saiz, Elizabet, Górgolas Hernández-Mora, Miguel, Prieto Pérez, Laura, Carrillo Acosta, Irene, Heili Frades, Sara, Villar Álvarez, Felipe, Fernández Roblas, Ricardo, Sánchez Pernaute, Olga, Fernández Espinilla, Virginia, Castrodeza Sanz, José Javier, Dueñas Gutiérrez, Carlos Jesús, González-Romo, Fernando, Merino Amador, Paloma, Rueda López, Alba, Martínez Jordán, Jorge, Medrano Pardo, Sara, Díaz de la Torre, Irene, Posada Franco, Yolanda, Delgado-Iribarren, Alberto, López-Contreras González, Joaquín, Pascual Alonso, Pablo, Pomar Solchaga, Virginia, Rabella García, Nuria, Benito Hernández, Natividad, Domingo Pedrol, Pere, Bonfill Cosp, Xavier, Padrós Selma, Rafael, Puig Campmany, Mireia, Mancebo Cortés, Jordi, Gurguí Ferrer, Mercè, Íñigo Pestaña, Melania, Pérez García, Alejandra, Sorní Moreno, Patricia, Izko Gartzia, Nora, Membrillo de Novales, Francisco Javier, Simón Sacristán, María, Zamora Cintas, Maribel, Martínez Martínez, Yolanda, Estébanez Muñoz, Miriam, Ramírez-Olivencia, Germán, Herrero Mendoza, María Dolores, De Dios García, Begoña, Mata Forte, Tatiana, Rodríguez Fernández, José María, Sáez de Adana Arróniz, Ester, Portu Zapirain, Joseba, Gainzarain Arana, Juan Carlos, Ortiz de Zárate Ibarra, Zuriñe, Moran Rodríguez, Miguel Ángel, Canut Blasco, Andrés, Hernáez Crespo, Silvia, Sanjosé Muñiz, Irene, Molina Iturritza, Estíbaliz, Ganchegui Aguirre, Maite, Urrestarazu Larrañag, Miren, De la Higuera Arranz, Carmen, Álvarez Padín, Pilar, Iglesias Llorente, Laura, Román Bernal, Berta, Sánchez Montalvá, Adrián, Espinosa Pereiro, Juan, Almirante, Benito, Miarons, Marta, Sellarés, Júlia, Larrosa, María, Villamarín, Miguel, Fernández, Nuria, Salvador, Fernando, Bosch-Nicolau, Pau, Pérez-Jorge Peremarch, Conchita, Resino Foz, Elena, Espigares Correa, Andrea, Álvarez de Espejo Montiel, Teresa, Navas Clemente, Iván, Quijano Contreras, María Isabel, Nieto Fernández del Campo, Luis Alberto, Jiménez Álvarez, Guillermo, Guillamón Sánchez, Mercedes, García García, Josefina, Muñoz Hornero, Constanza, Cosmen Sánchez, Ana, Mariño Callejo, Ana, Valcarce Pardeiro, Nieves, Smithson Amat, Alex, Chico Chumillas, Cristina, Sánchez Serrano, Adriana, Piñar Cabezos, Diana, Jiménez Martínez, Isabel, Estrada Fernández, Guillermo, Lorén Vargas, María, Parra Arribas, Nuria, Martínez Cilleros, Carmen, Villasante de la Puente, Aránzazu, García Delange, Teresa, Ruiz Rodríguez, María José, Robledo del Prado, Marta, Abad Almendro, Juan Carlos, Muñoz del Rey, José Román, Jiménez Álvaro, Montaña, Coy Coy, Javier, Poquet Catala, Inmaculada, Santos Peña, Marta, Mora Delgado, Juan, Manso Gómez, Tamara, Rubio Obanos, Teresa, Barbeito Castiñeiras, Gema, Domínguez Santalla, María Jesús, Mao Martín, Laura, Adalid Moll, María, Díaz Luperena, Javier, Ruiz Grinspan, Martín Sebastián, Barrós González, Raquel, Herrera Pacheco, Lourdes, Martínez Avilés, Rocío, Rodrigo González, Sara, Rodríguez Leal, Cristóbal Manuel, Romay Lema, Eva María, Suárez Gil, Roi, Bustinduy Odriozola, Maria Jesús, Marimón Ortiz de Zárate, José María, Vidaur Tello, Loreto, Kortajarena Urkola, Xabier, Arriola Martínez, Paula, Lartategi Iraurgi, Alazne, Álvarez de Castro, Maria, Martínez Mateu, Cintia María, Rodríguez Gómez, Francisco, Asschert Agüero, Isabel, Chamarro Martí, Elena, Franch Llasat, Diego, Zakariya-Yousef Breval, Ismail, Rico Rodríguez, Marta, Martínez López, Belén, García-López, María, Fernández Cruz, Ana, Calderón Parra, Jorge, Ramos Martínez, Antonio, Múñez Rubio, Elena, Vázquez Comendador, José Manuel, Diego Yagüe, Itziar, Expósito Palomo, Esther, Díaz de Santiago, Alberto, De la Fuente Moral, Sara, Pintos Pascual, Ilduara, Álvarez Franco, Raquel, Fernández de Orueta, Lucía, Vates Gómez, Roberto, Cardona Arias, Andrés Felipe, Marguenda Contreras, Pablo, Gaspar Alonso-Vega, Gabriel, Aranda Rife, Elena María, Martínez Cifre, Blanca, Roger Zapata, Daniel, Martín Rubio, Irene, Barbosa Ventura, André, Piñero, Iván, Bahamonde Carrasco, Alberto, Martínez Vidal, Ana, Talavera García, Eva, Mendoza Roy, Paula, Urrutia Losada, Ainhoa, Arteche Eguizabal, Lorea, Delgado Sánchez, Elisabet, Bañón Escandell, Sara, Caro Bragado, Sarah, Domínguez de Pablos, Gema, Herrero Rodríguez, Carmen, Liébana Martos, Carmen, Force Sanmartín, Luis, Aranega, Raquel, Mera Fidalgo, Arantzazu, Hortos Alsina, Miquel, Merchante Gutiérrez, Nicolas, León Jiménez, Eva María, Del Pozo, José L, Serralta Buades, Josefa, Cabrera Tejada, Ginger Giorgiana, Fernández-Ruiz, Mario, Aguado, José María, Maestro de la Calle, Guillermo, Vizcarra, Pilar, Rodriguez Dominguez, Mario José, Gioia, Francesca, Del Campo, Santos, Cantón Moreno, Rafael, Martín Dávila, Pilar, Casado, José Luis, Oteo Revuelta, José Antonio, Santibáñez Sáenz, Paula, Cervera Acedo, Cristina, Ruiz Martínez, Carlos, Blanco Ramos, José Ramón, Azcona Gutiérrez, José M., García García, Concepción, Alba Fernández, Jorge, Ibarra Cucalón, Valvanera, San Franco, Mercedes, Metola Sacristán, Luis, Meijide Míguez, Héctor, Gredilla Zubiría, Íñigo, Menéndez, Justo, Villares Fernández, Paula, Montes Andújar, Lara, Navarro Batet, Álvaro, Ferrer Santolaria, Anna, Padilla Salazar, María de la Luz, Abella Vázquez, Lucy, Hayek Peraza, Marcelino, García Pardo, Antonio, Hernández Carballo, Carolina, Ruiz Fernández, Andrés Javier, Barrio López, Isabel, Martakoush, Alí, Rojas-Vieyra, Agustín, García Calvo, Sonia, Villarreal García-Lomas, Mercedes, Vizcaíno Callejón, Marta, García García, María Pilar, Lérida Urteaga, Ana, Carrasco Fons, Natalia, María Sanjuan, Beatriz, Martín González, Lydia, Sanz Zamudio, Camilo, Alejos, Belén, Moreno, Cristina, Rava, Marta, Iniesta, Carlos, Izquierdo, Rebeca, Suárez-García, Inés, Díaz, Asunción, Ruiz-Alguero, Marta, Hernando, Victoria, Frías, Jesús, Ramírez, Elena, Martín-Quirós, Alejandro, Quintana-Díaz, Manuel, Mingorance, Jesús, Arnalich, Francisco, Moreno, Francisco, Figueiras, Juan Carlos, García-Arenzana, Nicolás, Montero-Vega, María Dolores, Romero-Gómez, María Pilar, Toro-Rueda, Carlos, García-Bujalance, Silvia, Ruiz-Carrascosa, Guillermo, Cendejas-Bueno, Emilio, Falces-Romero, Iker, Lázaro-Perona, Fernando, Ruiz-Bastián, Mario, Gutiérrez-Arroyo, Almudena, Girón De Velasco-Sada, Patricia, Dahdouh, Elie, Gómez-Arroyo, Bartolomé, García-Sánchez, Consuelo, Guedez-López, Virginia, Bloise-Sánchez, Iván, Alguacil-Guillén, Marina, Liras-Hernández, Maria Gracia, Sánchez-Castellano, Miguel Angel, García-Clemente, Paloma, González-Donapetry, Patricia, San José-Villar, S, de Pablos-Gómez, Manuela, Gómez-Gil, Rosa, Corcuera-Pindado, Maria Teresa, Rico-Nieto, Alicia, Herrero, Alicia, Prieto-Arribas, Daniel, Oliver-Saez, Paloma, Mora-Corcovado, Roberto, Fernández-Calle, Pilar, Alcaide-Martín, María José, Díaz-Garzón, Jorge, Fernández-Puntero, Belén, Nuñez-Cabetas, Rocío, Crespo-Sánchez, Gema, Rodriguez-Fraga, Olaia, Mendez del Sol, Helena, Duque-Alcorta, Marta, Gomez-Rioja, Rubén, Sanz de Pedro, María, Pascual-García, Lydia, Segovia-Amaro, Marta, Iturzaeta-Sánchez, Jose Manuel, Rodriguez-Gutiérrez, Mercedes, Perez-Garcia Morillón, Amparo, Martinez Gallego, Miguel Angel, Fabre-Estremera, Blanca, Martinez-Chavez, Estefanía, Moreno-Parra, Isabel, Rodriguez-Roca, Neila, Ortiz-Sánchez, Daniel, Simon-Velasco, Manuela, Gabriela-Tomoiu, Ileana, Pizarro-Sanchez, Cristina, Montero-San Martín, Blanca, Qasem-Moreno, Ana Laila, Gómez-López, Marta, Casares Guerrero, Ismael, Buño-Soto, Antonio, Martí de Gracia, Milagros, Parra-Gordo, Luz, Diez-Tascón, Aurea, Ossaba-Vélez, Silvia, Pinilla, Inmaculada, Cuesta, Emilio, Fernández-Velilla, María, Torres, Maria Isabel, Garzón, Gonzalo, Pérez-Blanco, Verónica, Quintás-Viqueira, Almudena, San Juan, Isabel, Cantero-Escribano, José Miguel, Pérez-Romero, César, Castro-Martínez, Mercedes, Hernández-Rivas, Lucía, Pedraz, Teresa, Fernández-Bretón, Eva, García-Vaz, Claudia, Robustillo-Rodela, Ana, Torres Santos-Olmo, Rosario María, Rivera-Núñez, Angélica, Fernández-Fernández, Ignacio, Noguerol-Gutiérrez, Marina, Martínez-Virto, Ana María, González-Viñolis, Manuel, Cabrera-Gamero, Regina, Mayayo-Alvira, Rosa, Marín-Baselga, Raquel, Lo-Iacono García, Victoria, Lerín-Baratas, Macarena, Romero Gallego-Acho, Paloma, Reche-Martínez, Begoña, Tejada-Sorados, Renzo, Rico-Briñas, Mikel, Deza-Palacios, Ricardo, Fabra-Cadenas, Sara, Arroyo-Rico, Isabel, Ben-Abdellah, Lubna Dani, Labajo-Montero, Laura, Soriano-Arroyo, Rubén, López-Corcuer, Lorena, Calvin-García, Elena, Martínez-Álvarez, Susana, López-Tappero Irazábal, Laura, Pilares-Barco, Martín, González-Peña, Olga, Bejarano-Redondo, Guillermina, Iglesias-Sigüenza, Alberto, Tung-Chen, Yale, Maroun Eid, Charbel, Bravo-Lizcano, Ruth, Silvestre-Niño, Miguel, Perdomo-García, Frank, Alonso-González, Berta, Antón-Huguet, Berta, Arenas-Berenguer, Isabel, Cabré-Verdiell Surribas, Clara, Marqués-González, Francisco, Muñoz del Val, Elena, Ángeles Molina, María, Cancelliere-Fernández, Nataly, Pastor-Yvorra, Sivia, Frade-Pardo, Laura, López-Arévalo, Paloma, García, Isabel, Fernández-Capitán, Carmen, González-Garcia, Juan José, Herrero, Juan, Quesada Simón, María Angustias, Robles Marhuenda, Angel, Soto Abanedes, Clara, Noblejas Mozo, Ana María, Ramos, Juan Carlos, Jaras Hernandez, María Jesús, Martinez Robles, Elena, Moreno Fernandez, Alberto, Sanchez Purificación, Aquilino, Martin Gutiérrez, Juan Carlos, Martinez Hernández, Pedro Luis, Sancho Bueso, Teresa, Lorenzo Hernández, Alicia, Gutierrez Sancerni, Belén, Salgueiro, Giorgina, Martin Carbonero, Luz, Mostaza, Jose María, Martinez-López, María Angeles, Hontañón, Victor, Menéndez, Araceli, Alvarez Troncoso, Jorge, Castellano, Arancha, Marcelo-Calvo, Cristina, Vives-Beltrán, Ivo, Ramos Ruperto, Luis, Daroca-Bengoa, Germán, Arcos Rueda, María, Vasquez-Manau, Julia, Fernández Cidón, Pelayo, Rosario Herrero Gil, Carmen, Palmier Peláez, Esmeralda, Untoria Tabares, Yeray, Lahoz, Carlos, Estirado, Eva, Hernández, Clara, Garcia-Iglesias, Francisca, Monteoliva, Enrique, Martínez, Mónica, Vara, Marta, González Alegre, Teresa, Valencia, Maria Eulalia, Moreno, Victoria, Montes, Maria Luisa, Alcolea-Batres, Sergio, Cabanillas-Martín, Juan José, Carpio-Segura, Carlos, Casitas-Mateo, Raquel, Fernández-Bujarrabal Villoslada, Jaime, Fernández-Navarro, Isabel, Fernández-Lahera, Juan, García-Quero, Cristina, Hidalgo-Sánchez, María, Galera-Martínez, Raúl, García-Río, Francisco, Gómez-Carrera, Luis, Gómez-Mendieta, María Antonia, Mangas-Moro, Alberto, Martínez-Cerón, Elisabet, Martínez-Redondo, María, Martínez-Abad, Yolanda, Martínez-Verdasco, Antonio, Plaza-Moreno, Cristina, Quirós-Fernández, Sarai, Romera-Cano, Delia, Romero-Ribate, David, Sánchez-Sánchez, Begoña, Santiago-Recuerda, Ana, Villasante, Carlos, Zamarrón de Lucas, Ester, Arnalich-Montiel, Victoria, Mariscal-Aguilar, Pablo, Falcone, Adalgisa, Laorden-Escudero, Daniel, Prados Sánchez, María Concepción, Álvarez-Sala Walther, Rodolfo, García, Andony, Arévalo, Cristina, Gutiérrez, Carola, Yus, Santiago, Asensio, Maria José, Sánchez, Manolo, Añón, Jose Manuel, Manzanares, Jesús, García de Lorenzo, Abelardo, Perales, Eva, Civantos, Belén, Cachafeiro, Lucía, Agrifoglio, Alexander, Estébanez, Belén, Flores, Eva, Hernández, Mónica, Millán, Pablo, Rodríguez, Montserrat, Nanwani, Kapil, Arizcun, Beatriz, Pérez-Costa, Elena, Rodríguez-Álvarez, Diego, Sánchez-Martín, María, Quesada, Úrsula, Román-Hernández, Carmen, Dorao, Paloma, Álvarez-Rojas, Elena, Menéndez, Juan José, Verdú, Cristina, Gómez-Zamora, Ana, Schüffelmann, Cristina, Calderón-Llopis, Belén, Laplaza-González, María, Río-García, Miguel, Amores-Hernández, Irene, Rodríguez-Rubio, Miguel, de la Oliva, Pedro, Ruiz, Jose, Rosillo, Sandra, González, Oscar, Iniesta, Angel, Ponz, Ines, Muñoz-Ramón, José María, Hernández-Gancedo, María, Uña Orejón, Carmen R., Sanabria-Carretero, Pascual, Moreno Gómez-Limón, Isidro, Seiz-Martinez, Alverio, Guasch-Arévalo, Emilia, Martín-Carrasco, Cristina, Alvar, Elena, Serrá, Lucía, Iannuccelli, Fabricio, Latorre, Julieta, Casares, Sandra, Valbuena, Isabel, Díaz Díez Picazo, Luis, Rodríguez Roca, Cristina, Cervera, Omar, García de las Heras, Esteban, Durán, Pilar, Castro, Carmen, Manrique de Lara, Carlos, Veganzones, Javier, López-Tofiño, Araceli, Fernandez-Cerezo, Estefanía, Zurita, Sergio, López-Martinez, Mercedes, Prim, Teresa, Alvárez del Vayo, Julía, Alcaraz, Gabriela, Castro, Luis, Yagüe, Julio, Díaz-Carrasco, Sofía, González-Pizarro, Patricio, Montero, Ana, Sagra, Francisco Javier, Suárez, Alejandro, Díez-Porres, Leyre, Varela-Cerdeira, María, Alonso-Babarro, Alberto, Abellán Martínez, Francisco, Alonso-Eiras, Jorge Ignacio, Álvarez Brandt, Alejandra, Archinà, Martina, Arribas-Terradillos, Silvia, Baselga-Puente, Trinidad, Barco Núñez, Pilar, Barrera-López, Natalia Guadalupe, Barrera-López, Lorena, Bartrina-Tarrio, Andres, Bassani, Gemma, Betancort de la Torre, Paula, Blanco-Bartolomé, Irene, Blasco-Andres, Celia, Brieba-Plata, Lucía, Cadenas-Gota, Fernando, Carrera-Vázquez, Paloma, Cascajares-Sanz, Carlota, Catino, Arianna, Cavallé-Pulla, Raquel, Ceniza-Pena, Daniel, Conde-Alonso, Ylenia María, Currás-Sánchez, Laura, Daltro-Lage, Marcelo, Esteban-Romero, Ana, Fernández Vidal, María Luisa, Ferrer Ortiz, Inés, de la Fuente Regaño, Lydia, Galindo-Ballesteros, Pablo, Garcia-Bellido Ruiz, Sara, García-Mochales Fortún, Carlos, Gómez-Ballesteros, Teresa, Gómez-Domínguez, Cecilia, González-Aguado, Nelsa, González-García, Sofía, Guisández Martín, Jorge, Hernández-Liebo, Paula Alejandra, Hernando Nieto, Raquel, Llorente-Cortijo, Irene María, Marín-García, Antonio, López-Pirez, Pilar, Mejuto-Illade, Lucía, Palma, Marco, Peña-Hidalgo, Adrian, Platero-Dueñas, Lucía, Pujol-Pocull, David, Ramírez-Verdyguer, Miguel, Redondo-Gutierrez, Marta, Reinoso-Lozano, Francisco, Rodríguez-Revillas, Ana, Rodríguez Saenz de Urturi, Alejandro, Romero-Imaz, Lucía, Sánchez-Rico, Susana, Sánchez-Santiuste, Mónica, Serrano de la Fuente, Patricia, Serrano-Martín, Henar, Silva-Freire, Thamires, Soria-Alcaide, Eva, Suárez-Plaza, Andrés Enrique, Tejero-Soriano, Beatriz, Torrecillas-Mainez, Andrea, Torres-Cortés, Javier, Valentín-Pastrana Aguilar, María de las Mercedes, Villanueva-Freije, Angélica, Virgós-Varela, Marta, Yagüe-Barrado, Marta, Yustas-Benitez, Natalia, Nuñez, María Concepción, Montserrat, Jaime, Queiruga, Javier, Rodriguez-Mariblanca, Amelia, Martínez de Soto, Lucía, Urroz, Mikel, Seco, Enrique, Zubimendi, Mónica, Stuart, Stephan, Díaz, Lucía, García, Irene, García Morales, María Teresa, Martín-Vega, Alberto, Caro, Abel, Martínez-Alés, Gonzalo, Gutiérrez-Gutiérrez, Belén, del Toro, María Dolores, Borobia, Alberto M, Carcas, Antonio, Jarrín, Inmaculada, Yllescas, María, Ryan, Pablo, Pachón, Jerónimo, Carratalà, Jordi, Berenguer, Juan, Arribas, Jose Ramón, and Rodríguez-Baño, Jesús

Published
2021
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38. Atrial Fibrillation and Diabetes Mellitus: Dangerous Liaisons or Innocent Bystanders?

Author

Ana Lorenzo-Almorós, Jesús Casado Cerrada, Luis-Antonio Álvarez-Sala Walther, Manuel Méndez Bailón, and Óscar Lorenzo González

Subjects
atrial fibrillation, diabetes mellitus, atrial remodeling, thrombotic risk, Medicine
Abstract

Atrial fibrillation (AF) is the most common arrhythmia in adults and diabetes mellitus (DM) is a major risk factor for cardiovascular diseases. However, the relationship between both pathologies has not been fully documented and new evidence supports the existence of direct and independent links. In the myocardium, a combination of structural, electrical, and autonomic remodeling may lead to AF. Importantly, patients with AF and DM showed more dramatic alterations than those with AF or DM alone, particularly in mitochondrial respiration and atrial remodeling, which alters conductivity, thrombogenesis, and contractile function. In AF and DM, elevations of cytosolic Ca2⁺ and accumulation of extra cellular matrix (ECM) proteins at the interstitium can promote delayed afterdepolarizations. The DM-associated low-grade inflammation and deposition/infiltration of epicardial adipose tissue (EAT) enforce abnormalities in Ca2+ handling and in excitation-contraction coupling, leading to atrial myopathy. This atrial enlargement and the reduction in passive emptying volume and fraction can be key for AF maintenance and re-entry. Moreover, the stored EAT can prolong action of potential durations and progression from paroxysmal to persistent AF. In this way, DM may increase the risk of thrombogenesis as a consequence of increased glycation and oxidation of fibrinogen and plasminogen, impairing plasmin conversion and resistance to fibrinolysis. Additionally, the DM-associated autonomic remodeling may also initiate AF and its re-entry. Finally, further evidence of DM influence on AF development and maintenance are based on the anti-arrhythmogenic effects of certain anti-diabetic drugs like SGLT2 inhibitors. Therefore, AF and DM may share molecular alterations related to Ca2+ mobility, mitochondrial function and ECM composition that induce atrial remodeling and defects in autonomic stimulation and conductivity. Likely, some specific therapies could work against the associated cardiac damage to AF and/or DM.

Published
2023
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40. MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children

Author

Rafael Peñalver Penedo, Marta Rupérez Lucas, Luis Antonio Álvarez-Sala Walther, Alicia Torregrosa Benavent, María Luisa Casas Losada, Luis Bañuelos Andrio, Ana Belén Rebolledo Poves, and Mercedes Bueno Campaña

Subjects
Proadrenomedullin, Biomarker, Urinary tract infection, Pediatric, Renal scarring, Pediatrics, RJ1-570
Abstract

Abstract Background Midregional-proadrenomedullin (MR-proADM) is a useful prognostic peptide in severe infectious pathologies in the adult population. However, there are no studies that analyze its utility in febrile urinary tract infection (fUTI) in children. An accurate biomarker would provide an early detection of patients with kidney damage, avoiding other invasive tests like renal scintigraphy scans. Our objective is to study the usefulness of MR-proADM as a biomarker of acute and chronic renal parenchymal damage in fUTI within the pediatric population. Methods A prospective cohort study was conducted in pediatric patients with fUTI between January 2015 and December 2018. Plasma and urine MR-proADM levels were measured at admission in addition to other laboratory parameters. After confirmation of fUTI, renal scintigraphy scans were performed during the acute and follow-up stages. A descriptive study has been carried out and sensitivity, specificity and ROC curves for MR-proADM, C-reactive protein, and procalcitonin were calculated. Results 62 pediatric patients (34 female) were enrolled. Scintigraphy showed acute pyelonephritis in 35 patients (56.5%). Of those patients, the median of plasmatic MR-proADM (P-MR-proADM) showed no differences compared to patients without pyelonephritis. 7 patients (11.3%) developed renal scars (RS). Their median P-MR-proADM levels were 1.07 nmol/L (IQR 0.66–1.59), while in patients without RS were 0.48 nmol/L (0.43–0.63) (p

Published
2021
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41. Mortality rate in rheumatoid arthritis-related interstitial lung disease: the role of radiographic patterns

Author

Maria A. Nieto, Maria J. Rodriguez-Nieto, Olga Sanchez-Pernaute, Fredeswinda Romero-Bueno, Leticia Leon, Cristina Vadillo, Dalifer D. Freites-Nuñez, Juan A. Jover, Jose L. Álvarez-Sala, and Lydia Abasolo

Subjects
Rheumatoid arthritis, Interstitial lung disease, Mortality, Diseases of the respiratory system, RC705-779
Abstract

Abstract Background To assess mortality rate (MR) and standardized mortality rate (SMR) of rheumatoid arthritis-related interstitial lung disease (RA-ILD) patients and to evaluate the role of radiographic patterns in mortality. Methods A longitudinal multicentric study was conducted in RA-ILD patients from 2005 to 2015 and followed-up until October 2018 in Madrid. Patients were included in the Neumologia-Reumatología y Enfermedades Autoinmunes Registry, from diagnosis of ILD. The main outcome was all-cause mortality. The radiographic pattern at baseline [usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), or others] was the independent variable. Covariables included sociodemographic and clinical data. Survival techniques were used to estimate MR, expressed per 1000 persons-year with their 95% confidence intervals [CI]. Cox multiple regression model was run to examine the influence of radiographic patterns on survival. SMR [CI] was calculated comparing MR obtained with MR expected in the general population of Madrid by indirect age-gender standardization. Results 47 patients were included with a follow-up 242 patients-year. There were 16 (34%) deaths, and most frequent causes were acute ILD exacerbation and pneumonia. MR was 64.3 [39.4–104.9], and 50% of the patients died at 8.3 years from ILD diagnosis. After adjusting for confounders, (UIP compared to NSIP was associated with higher mortality risk. The overall SMR was 2.57 [1.4–4.17]. Women of 60–75 years of age were the group with the highest SMR. Conclusions RA-ILD is associated with an excess of mortality compared to general population. Our results support that UIP increases the risk of mortality in RA-ILD, regardless other factors.

Published
2021
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42. Psycho-demographic profile in severe asthma and effect of emotional mood disorders and hyperventilation syndrome on quality of life

Author

Lucía Dafauce, David Romero, Carlos Carpio, Paula Barga, Santiago Quirce, Carlos Villasante, María Fe Bravo, and Rodolfo Álvarez-Sala

Subjects
Asthma, Quality of life, Anxiety, Depression, Alexithymia, Hyperventilation syndrome, Psychology, BF1-990
Abstract

Abstract Background Severe asthma affects a small population but carries a high psychopathological risk. Therefore, the psychodemographic profile of these patients is of interest. A substantial prevalence of anxiety, depression, alexithymia and hyperventilation syndrome in severe asthma is known, but contradictory results have been observed. These factors can also affect patients’ quality of life. For this reasons, our purpose is to evaluate the psychodemographic profile of patients with severe asthma and assess the prevalence of anxiety, depression, alexithymia and hyperventilation syndrome and their impact on the quality of life of patients with severe asthma. Methods A cross-sectional study of 63 patients with severe asthma. Their psychodemographic profile was evaluated using the Hospital Anxiety and Depression Scale (HADS), Toronto Alexithymia Scale (TAS-20), Nijmegen questionnaire and Asthma Control Test (ACT) to determine the state of anxiety and depression, alexithymia, hyperventilation syndrome and control of asthma, respectively. Quality of life was assessed with the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ). Results The mean age was 60 ± 13.6 years. Personal psychopathological histories were found in 65.1% of participants, and 8% reported previous suicidal attempts. The rate of anxiety and/or depression (HADS ≥ 11) was 68.3%. These patients present higher scores on the TAS-20 (p

Published
2021
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43. Timing of Meals and Sleep in the Mediterranean Population: The Effect of Taste, Genetics, Environmental Determinants, and Interactions on Obesity Phenotypes

Author

Rocío Barragán, Rebeca Fernández-Carrión, Eva María Asensio-Márquez, Carolina Ortega-Azorín, Andrea Álvarez-Sala, Alejandro Pérez-Fidalgo, José Vicente Sorlí, Olga Portolés, Inmaculada González-Monje, Marie Pierre St-Onge, and Dolores Corella

Subjects
sleep, mealtimes, taste perception, obesity, Mediterranean diet, Nutrition. Foods and food supply, TX341-641
Abstract

Circadian rhythms regulate the sleep–wake and feeding–fasting cycles. Sleep and feeding constitute a complex cycle that is determined by several factors. Despite the importance of sleep duration and mealtimes for many obesity phenotypes, most studies on dietary patterns have not investigated the contribution of these variables to the phenotypes analyzed. Likewise, they have not investigated the factors related to sleep or mealtimes. Thus, our aims were to investigate the link between taste perception and eating/sleep patterns and to analyze the effect of the interactions between sleep/meal patterns and genetic factors on obesity phenotypes. We conducted a cross-sectional analysis on 412 adults from the Mediterranean population. We measured taste perception (bitter, sweet, salty, sour, and umami) and assessed sleep duration and waketime. The midpoint of sleep and social jetlag was computed. From the self-reported timing of meals, we estimated the eating window, eating midpoint, and eating jetlag. Adherence to the Mediterranean diet was measured with a validated score. Selected polymorphisms in the TAS2R38, CLOCK, and FTO genes were determined, and their associations and interactions with relevant phenotypes were analyzed. We found various associations between temporal eating, sleep patterns, and taste perception. A higher bitter taste perception was associated with an earlier eating midpoint (p = 0.001), breakfast time (p = 0.043), dinner time (p = 0.009), waketime (p < 0.001), and midpoint of sleep (p = 0.009). Similar results were observed for the bitter taste polymorphism TAS2R38-rs713598, a genetic instrumental variable for bitter perception, increasing the causality of the associations. Moreover, significant gene–sleep interactions were detected between the midpoint of sleep and the TAS2R38-rs713598 (p = 0.032), FTO-rs9939609 (p = 0.037), and CLOCK-rs4580704 (p = 0.004) polymorphisms which played a role in determining obesity phenotypes. In conclusion, our study provided more information on the sleep and mealtime patterns of the general Spanish Mediterranean population than on their main relationships. Moreover, we were able to show significant associations between taste perception, specifically bitter taste; sleep time; and mealtimes as well as an interaction between sleep time and several genetic variants linked to obesity phenotypes. However, additional research is needed to better characterize the causality and mechanisms behind these associations.

Published
2023
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44. Association of anti-SARS-COV-2 vaccine with increased incidence of myositis-related anti-RNA-synthetases auto-antibodies

Author

Laura García-Bravo, Myriam Calle-Rubio, Miguel Fernández-Arquero, Kauzar Mohamed Mohamed, Teresa Guerra-Galán, María Guzmán-Fulgencio, Antonia Rodríguez de la Peña, Cristina Cañizares, Bárbara López, Cristina Vadillo, Jorge Matías-Guiu, Asunción Nieto Barbero, José Luis Álvarez-Sala Walther, Silvia Sánchez-Ramón, and Juliana Ochoa-Grullón

Subjects
Myositis, Interstitial lung disease, Myositis specific antibodies, COVID19, SARS-CoV-2 vaccines, Immunologic diseases. Allergy, RC581-607
Abstract

Introduction: SARS-CoV-2 is a RNA virus that associates with heterogeneous clinical manifestations and complications. Auto-antibodies are identified in approximately 50% of hospitalized COVID-19 patients. Objectives: To determine the global incidence of myositis-related auto-antibodies (non Jo1-RNA synthetases: anti-PL7, anti-PL12, anti-EJ, anti-OJ and RNA-sensor: anti-MDA5) in our laboratory during COVID-19 pandemics, and to describe the clinical and laboratory features of these patients. Study design: A retrospective study was performed from 2015 to 2021 in a cohort of 444 patients with suspected inflammatory myopathy. The incidence of positive results for the MSA was expressed as absolute value per year for the reference population. Immunoblot analysis, indirect immunofluorescence and HLA typing of 36 patients with positivity for MSAs were collected and analyzed. Results: We observed MSA positive in 28 patients in 2020 and 36 patients in 2021, representing a mean increase of 6-fold respect to previous years since 2015 (range, 0 to 19). In 2020, the most common antibody detected was anti-MDA5 (68%). In contrast, in 2021 the most common antibodies were anti-PL7 and/or anti-PL12 (69%). All patients in 2021 with positive anti-synthetases were fully vaccinated, 4 had previous documented infection, with median time from vaccine to MSA positivity of 5 months. Eight out of 36 patients (22%) reported clinical onset after SARS-CoV-2 vaccination and 6 out of 36 (17%) presented clinical and/or radiological worsening after SARS-CoV-2 vaccination. All patients presented with a known human leukocyte antigen (HLA)-DRB1* allele associated with ASS. The most prevalent alleles identified were DRB1*03:01, DRB1*04, DRB1*11:01, corresponding to 70% (16/23) of our cohort. Conclusions: Our preliminary data show an increased incidence of anti-synthetase antibodies during COVID-19 pandemic and SARS-CoV-2 vaccination associated to HLA DRB1* risk allele. Differential profiles of MSA specificities were observed: mainly against RNA-sensors in 2020 and against RNA-synthetases in 2021. Further studies are needed to support the association between SARS-CoV-2 infection and/or vaccination and the occurrence of this autoimmune syndrome.

Published
2022
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50. 1020 - POLICONDRITIS RECIDIVANTE, A PROPÓSITO DE DOS CASOS

Author

Paúl, Gracia Villarreal, primary, Collada, Juan Molina, additional, Frías, Lucía Ibares, additional, Guerrero, María Barrientos, additional, García, Cristina Ausín, additional, Walther, Luis Álvarez-Sala, additional, García, Maria Victoria Villalba, additional, and Olleros, Cristina Lavilla, additional

Published
2023
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