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Original article
Mortality risk factors in patients with SARS-CoV-2 infection and atrial fibrillation: Data from the SEMI-COVID-19 registry
Factores de riesgo de mortalidad en pacientes con infección por SARS-CoV-2 y fibrilación auricular: datos del registro SEMI-COVID-19
Javier Azaña Gómeza, Luis M. Pérez-Belmonteb, Manuel Rubio-Rivasc, José Bascuñanad, Raúl Quirós-Lópeze, María Luisa Taboada Martínezf, Esther Montero Hernandezg, Fernando Roque-Rojash, Manuel Méndez-Bailóna,
Corresponding author
manuel.mendez@salud.madrid.org

Corresponding author.
, Ricardo Gómez-Huelgasb, on behalf of the SEMI-COVID-19 Group ◊
a Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
b Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
c Servicio de Medicina Interna, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat (Barcelona), Spain
d Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain
e Servicio de Medicina Interna, Hospital Universitario Costa del Sol, Marbella, Málaga, Spain
f Servicio de Medicina Interna, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain
g Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
h Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">New coronavirus 2019 &#40;COVID-19&#41; disease&#44; caused by SARS-CoV-2&#44; has been and remains a challenge for health systems worldwide&#44; given its high contagiousness and morbidity and mortality<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; The pandemic caused by COVID-19 has affected more than 290 million people worldwide and has caused more than 5 million deaths as of January 2022<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; Spain is one of the most affected countries in the world<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#44; with more than 7&#44;164&#44;906 million cases and more than 89&#44;837 deaths since the start of the pandemic<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; This has led the Spanish Society of Internal Medicine &#40;SEMI&#41; to create a registry with data on hospitalized patients throughout the country in which more than 150 hospitals have participated&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The magnitude of the pandemic has led to a truly scientific revolution&#44; with studies to describe its clinical characteristics and risk factors&#44; clinical trials to discover effective treatments and the development of vaccines in record time&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Among the risk factors described to date&#44; cardiovascular disease has been associated with increased morbidity and mortality<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;7</span></a>&#46; On the other hand&#44; cardiovascular complications developed during admission in relation to COVID-19 are common and constitute a major cause of mortality<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#8211;12</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">However&#44; the role of atrial fibrillation &#40;AF&#41; and its management in relation to COVID-19 remains to be determined and not many studies have been published to date&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">AF is the most common sustained arrhythmia in the Spanish population&#44; with an overall prevalence of around 4&#37; and over 15&#37; in patients over 80 years of age<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#8211;15</span></a>&#46; It is a risk factor for the development of heart failure&#44; cardioembolic stroke and dementia<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;16</span></a>&#44; all of which have been independently associated with COVID-19 mortality&#46; On the other hand&#44; age&#44; hypertension&#44; diabetes mellitus&#44; obesity and ischaemic heart disease are factors that increase the risk of developing AF and have all been described as poor prognostic factors in COVID-19&#46; Bearing in mind all of the above&#44; given the impact that both diseases independently have on global health and the evident relationship between them&#44; this study aims to describe the clinical&#44; epidemiological&#44; radiological and laboratory characteristics of patients with AF admitted for COVID-19 in Spain&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A second aim is to identify those variables that are associated with mortality and poor prognosis of COVID-19 in patients with AF&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study design</span><p id="par0035" class="elsevierStylePara elsevierViewall">A nationwide retrospective&#44; observational&#44; multicenter study of patients hospitalized for COVID-19 was conducted from 1 March to 1 October 2020&#46; The data were obtained from the SEMI-COVID-19 Registry&#44; with the participation of 150 Spanish hospitals&#46; The SEMI-COVID-19 registry has consecutively enrolled older patients with microbiologically confirmed COVID-19 disease using a reverse transcription polymerase chain reaction test obtained from a nasopharyngeal&#44; sputum or bronchoalveolar lavage specimen&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">For this study&#44; we have selected patients with a history of AF during hospital admission for COVID-19&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Variables</span><p id="par0045" class="elsevierStylePara elsevierViewall">Clinical&#44; epidemiological&#44; radiological&#44; laboratory and therapeutic variables were analysed&#44; as well as mortality during admission or early readmission&#44; defined as a new episode of hospital admission within 30 days after discharge&#46; Data were collected retrospectively using an online data capture system&#46; The comorbidity burden of patients was established with the age-adjusted Charlson comorbidity index<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#46; To establish functional status prior to hospital admission&#44; the Barthel index was used<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> &#40;independent or mild dependency&#58; 100-91&#59; moderate dependency&#58; 90-61&#59; severe dependency&#58; &#8804;60&#41;&#46; Patients were considered to have hypertension&#44; diabetes mellitus or dyslipidaemia if they had a previous diagnosis in their medical history or were receiving medical treatment for them&#46; Diabetes mellitus was classified into 2 subgroups&#58; with target organ damage &#40;brain&#44; heart&#44; kidney&#44; or retina involvement&#41; or without target organ damage&#46; Chronic lung disease was defined as a previous diagnosis of chronic obstructive pulmonary disease or asthma&#46; Atherosclerotic cardiovascular disease was defined by a previous history of ischemic heart disease &#40;acute myocardial infarction&#44; acute coronary syndrome&#44; angina&#44; or coronary revascularization&#41;&#46; Neoplastic disease included all non-metastatic solid tumours &#40;excluding non-melanoma skin tumours&#41;&#46; Moderate-severe kidney disease was defined by a glomerular filtration rate below 45&#8239;ml&#47;min&#47;1&#46;73 m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> according to the CKD-EPI equation<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#46; Moderate-severe liver disease was defined as grade B or C in the Child-Pugh classification&#46; Obesity was defined by a body mass index &#8805; 30&#8239;kg&#47;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; Comorbidities were collected from the medical records of each hospital&#46; Laboratory data &#40;blood count&#44; biochemistry&#44; blood gases&#44; coagulation&#41; and imaging tests were collected on admission&#46; Regarding anticoagulation&#44; baseline anticoagulant treatment was classified into vitamin K antagonists &#40;VKA&#41; and direct oral anticoagulants &#40;DOAC&#41; since the frequency of low molecular weight heparin &#40;LMWH&#41; was negligible&#46; However&#44; 3&#8239;groups were differentiated in terms of anticoagulant treatment during admission&#58; VKA&#44; DOAC and LMWH&#46; In-hospital complications included&#58; admission to the intensive care unit&#44; presence of acute respiratory distress syndrome&#44; acute coronary syndrome&#44; arrhythmia&#44; <span class="elsevierStyleItalic">shock</span>&#44; sepsis&#44; acute renal failure&#44; venous thromboembolism and acute arterial ischemia&#46; Ventilatory support included invasive mechanical ventilation&#44; non-invasive mechanical ventilation and high-flow oxygen&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">Patients were divided according to the categorical variable of mortality into deceased or non-deceased&#46; Categorical and continuous variables were expressed as absolute values and percentages and as medians &#40;ranges&#41;&#44; respectively&#46; Differences between groups were analysed using the Student&#39;s t test or the Mann-Whitney U test for continuous variables or with Pearson&#39;s &#967;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> for categorical variables&#46; A value of <span class="elsevierStyleItalic">p</span> &#60; 0&#46;05 was considered statistically significant&#46; The measure of association was presented as the <span class="elsevierStyleItalic">odds ratio</span> &#40;OR&#41; with a 95&#37; confidence interval &#40;95&#37; CI&#41;&#46; Subsequently&#44; a multivariate analysis was performed expressed as adjusted OR&#44; 95&#37; CI&#46; Logistic regression analysis was used to identify independent factors at admission for in-hospital mortality&#44; including those variables with statistical significance in the bivariate analysis and with a percentage of missing values of less than 20&#37;&#46; The statistical analysis was done with the SPSS version 26&#46;0 software &#40;IBM SPSS Statistics &#169;&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Ethical aspects</span><p id="par0055" class="elsevierStylePara elsevierViewall">All patients gave their informed consent&#46; This study was conducted in accordance with the Helsinki Declaration and was approved by the Malaga Ethics Committee &#40;Code&#58; SEMI-COVID-19 03-27-20&#41;&#46; The STROBE initiative for the publication of observational studies was followed &#40;available at <a href="http://www.strobe-statement.org">www&#46;strobe-statement&#46;org</a>&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">A total of 16&#44;461 patients were entered into the SEMI-COVID-19 registry between 1 March and 1 October 2020&#46; Of these&#44; 1816 &#40;11&#37;&#41; had a history of AF&#46; A total of 1&#44;799 patients were finally analysed&#44; as 17 were excluded due to lack of basic data for correct aetiology&#46; The number of deaths among patients with AF was 738 &#40;41&#37;&#41;&#46; The epidemiological&#44; clinical&#44; laboratory and radiological characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; A specific table has been developed for anticoagulation treatment both before and during admission &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the treatments during admission and the complications&#46; <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the logistic regression&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Numerous variables showed statistically significant differences in the deceased group&#46; These were older and had a higher proportion of hypertensive and diabetic patients with target organ involvement&#46; However&#44; no statistically significant differences were found for dyslipidaemia and obesity&#44; although there was a greater trend in the deceased group&#46; A higher prevalence of cardiovascular history was also observed in the deceased&#58; heart failure&#44; acute myocardial infarction&#44; angina pectoris&#44; stroke&#44; and peripheral vascular disease&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Clinically&#44; deceased patients were admitted with a higher heart rate &#40;88&#46;38 vs&#46; 84&#46;95&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;0&#46;01&#41;&#44; with higher percentage of respiratory failure &#40;67&#46;2 vs&#46; 20&#46;1&#37;&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;0&#46;01&#41;&#44; higher tachypnoea &#40;58&#46;0 vs&#46; 30&#46;0&#37;&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;0&#46;01&#41; and greater dyspnoea and confusion on admission &#40;73&#46;6 vs&#46; 56&#46;8&#37;&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;0&#46;01 and 37&#46;1 vs&#46; 13&#46;3&#37;&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;0&#46;01&#44; respectively&#41;&#46; On the other hand&#44; deceased patients had statistically significantly higher levels of creatinine&#44; glucose&#44; C-reactive protein &#40;CRP&#41;&#44; ferritin and D-dimer&#44; as well as a higher percentage of bilateral pneumonia and pleural effusion&#46; No differences were found in INR values &#40;2&#46;51 vs&#46; 2&#46;41&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#61;&#8239;0&#46;56&#41;&#46; Deceased patients showed higher rates of complications&#44; except for pulmonary embolism &#40;0&#46;5 vs&#46; 0&#46;8&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#61;&#8239;0&#46;578&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">With regard to anticoagulant treatment&#44; it is noteworthy that deceased patients had a lower frequency of treatment with DOACs&#44; both at baseline &#40;29 vs&#46; 38&#46;3&#37;&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;0&#46;01&#41; and during admission &#40;6&#46;9 vs&#46; 19&#37;&#59; <span class="elsevierStyleItalic">p</span>&#8239;&#60;&#8239;0&#46;01&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Finally&#44; in the multivariate analysis&#44; the following were independent factors for mortality&#58; age&#44; hypertension&#44; Charlson index&#44; and elevated heart rate&#44; creatinine&#44; CRP&#44; ferritin and D-dimer values&#46; Treatment with DOACs had a protective role for mortality &#40;<a class="elsevierStyleCrossRef" href="#sec0065">Appendix C</a> Supplementary table of Annex B&#41;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">The results of our research show that patients with COVID-19 infection with a history of AF may have a high mortality rate during hospital admission&#46; In our series&#44; the mortality observed in this patient population exceeded 40&#37; during the first waves of the COVID-19 pandemic&#46; These findings have also been observed in other international multicenter registries such as HOPE&#44; in which the researchers also observed a mortality rate of 43&#37; for subjects with a history of AF<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">AF associates a series of comorbidities that have been described as poor prognostic factors in COVID-19<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46; Our series showed a higher proportion of hypertensive&#44; diabetic and patients with a history of cardiovascular disease &#40;heart failure&#44; acute myocardial infarction&#44; angina&#44; stroke and peripheral vascular disease&#41; among the deceased&#46; In terms of clinical characteristics at admission&#44; the following were associated with worse prognosis&#58; elevated heart rate&#44; baseline oxygen saturation below 94&#37;&#44; tachypnoea and the presence of dyspnoea and confusion&#46; These results are similar to those described in the literature in patients without AF<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; Likewise&#44; patients who had a significant inflammatory response on admission with increased lymphopenia and higher CRP&#44; D-dimer&#44; ferritin and creatinine levels had higher mortality<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;7</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Our research allows&#44; at the time of admission&#44; to identify a profile of patients with a history of AF and a high risk of mortality and complications&#46; Given the high mortality rate in patients with AF&#44; the mere fact of having AF poses a risk&#44; which is increased in the case of advanced age&#44; hypertension&#44; previously established cardiovascular diseases&#44; and a state of instability with respiratory failure and tachycardia with a high inflammatory response&#46; The number of complications developed by AF patients was also quite high&#44; all of them higher in the deceased group&#44; as expected&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">AF is the most common arrhythmia in patients with COVID-19 for two reasons&#58; on the one hand&#44; it is the most common arrhythmia in the general population and&#44; on the other hand&#44; COVID-19 favours its occurrence<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;10</span></a>&#46; The mechanisms by which COVID-19 increases the frequency of AF are beginning to be understood&#44; although they are not yet fully clear&#46; Among the hypotheses proposed&#44; the following have been postulated&#58; reduced availability of ACE-II receptors&#44; cytokine storm&#44; endothelial damage&#44; electrolyte disturbances&#44; hypoxaemia and increased activity of the sympathetic nervous system as mechanisms favouring the onset of AF due to its effects on cardiac remodelling<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; Recent studies show that patients with COVID-19 infection with a greater inflammatory reaction have a higher risk of developing AF&#44; as occurs with influenza infection<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The role of anticoagulation in the treatment of COVID-19 is yet to be determined&#46; Several studies have demonstrated the benefit of anticoagulation at prophylactic doses in relation to the prothrombotic state resulting from the massive inflammatory response occurring in COVID-19<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; Recent published evidence in non-critically ill patients with COVID-19 shows that an initial strategy of therapeutic dose anticoagulation with heparin increased the likelihood of survival to hospital discharge compared to routine thromboprophylaxis<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">One of the most relevant findings of our study is the observation of a higher proportion of patients treated with DOACs among the survivors&#44; both at baseline and during admission&#46; In fact&#44; it behaves as a protective factor in the multivariate analysis&#46; This finding is probably influenced by the fact that patients on baseline DOAC therapy are younger and in a better cardiorespiratory status&#44; which allows them to tolerate the oral route well&#46; However&#44; maintaining the DOAC during admission was not associated with increased mortality&#46; In this sense&#44; some authors have also observed these findings of benefit from the use of DOACs in patients with COVID-19 infection who required hospital admission<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The indication to maintain DOAC therapy in patients with AF already taking it at baseline and DOAC therapy in the prevention of thromboembolic events in COVID-19 is an attractive option to consider in outpatient management or hospitalised COVID patients with good cardiopulmonary function&#46; The main limitation would be its potential interaction with some of the treatments used at the beginning of the pandemic for COVID-19 such as lopinavir&#47;ritonavir&#44; although these treatments are currently out of use and no interactions have been described with corticosteroids&#44; remdesivir or anti-inflammatory biologics &#40;tocilizumab&#44; baricitinib&#44; etc&#46;&#41;&#44; which are the current reference treatments&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">We believe that our study meets the objective of describing a clinical profile of patients with AF admitted for COVID-19 in Spain and identifying poor prognostic factors associated with morbidity and mortality&#58; it is the first of its kind in Spain and one of the few worldwide&#46; Despite this&#44; it has several limitations&#46; Firstly&#44; this is a retrospective and observational study so&#44; despite a multivariate analysis and a logistic regression&#44; bias cannot be ruled out&#46; On the other hand&#44; the SEMI-COVID registry has involved a large number of investigators at different levels of care&#44; which means heterogeneity in the inclusion of data&#44; which&#44; moreover&#44; have been obtained from discharge reports and clinical records&#46; Analysing only hospitalised patients gives a profile of greater severity and the data may not be fully translatable to the rest of AF patients&#46; Despite these limitations&#44; a large number of AF patients from all over the country have been analysed&#44; as it is a multicentre registry&#44; which has made it possible to draw up a risk profile in patients hospitalised for COVID-19&#46; Future prospective studies are needed to confirm these initial data&#44; given that only retrospective studies have been published to date&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusions</span><p id="par0125" class="elsevierStylePara elsevierViewall">AF and its associated comorbidities are a risk factor for mortality&#44; morbidity&#44; and the development of complications in patients hospitalized for COVID-19&#46; Given the magnitude and importance of the pandemic&#44; this has meant that COVID-19 has become the leading cause of death in patients with AF&#44; replacing cardiovascular causes&#46; On the other hand&#44; the clinical&#44; laboratory and radiological data associated with a worse outcome in AF patients are similar to those previously described in the overall population&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Both pre-treatment with DOACs and treatment with DOACs during admission seem to have a protective role in patients with AF&#44; although this fact should be confirmed in prospective studies&#46; In any case&#44; with these findings&#44; there is no indication to modify the treatment with DOACs for LMWH in hospitalized patients and the door is opened to carry out clinical trials with DOACs as prevention of thromboembolic events occurring in COVID-19&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflict of interests</span><p id="par0135" class="elsevierStylePara elsevierViewall">The authors state that they have no conflict of interest in relation to this publication&#46;</p></span><span id="sec1050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Acknowledgements</span><p id="par0475" class="elsevierStylePara elsevierViewall">We thank all participants and investigators of the SEMI-COVID-19 Registry&#46;</p></span><span id="sec1550" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1115">Annex A&#46; List of investigators of the SEMI-COVID-19 Registry</span><p id="par0145" class="elsevierStylePara elsevierViewall">SEMI-COVID-19 Registry Coordinator&#58; Jose Manuel Casas Rojo&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Members of the Scientific Committee of the SEMI-COVID-19 Registry&#58; Jos&#233; Manuel Casas Rojo&#44; Jos&#233; Manuel Ramos Rinc&#243;n&#44; Carlos Lumbreras Bermejo&#44; Jes&#250;s Mill&#225;n N&#250;&#241;ez-Cort&#233;s&#44; Juan Miguel Ant&#243;n Santos&#44; Ricardo G&#243;mez Huelgas&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Members of the SEMI-COVID-19 Group</span></p><p id="par0160" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Bellvitge University Hospital &#40;L&#39;Hospitalet de Llobregat&#44; Barcelona&#41;V</span></p><p id="par0165" class="elsevierStylePara elsevierViewall">Xavier Corbella&#44; Francesc Formiga P&#233;rez&#44; Narc&#237;s Homs&#44; Abelardo Montero&#44; Jos&#233; Mar&#237;a Mora-Luj&#225;n&#44; Manuel Rubio-Rivas</p><p id="par0170" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">de Octubre University Hospital &#40;Madrid&#41;</span></p><p id="par0175" class="elsevierStylePara elsevierViewall">Paloma Agudo de Blas&#44; Coral Ar&#233;valo Ca&#241;as&#44; Blanca Ayuso&#44; Jos&#233; Bascu&#241;ana Morej&#243;n&#44; Samara Campos Escudero&#44; Mar&#237;a Carnevali Fr&#237;as&#44; Santiago Coss&#237;o Tejido&#44; Borja de Miguel Campo&#44; Carmen D&#237;az Pedroche&#44; Raquel D&#237;az Sim&#243;n&#44; Ana Garc&#237;a Reyne&#44; Laura Ibarra Veganzones&#44; Luc&#237;a Jorge Huerta&#44; Antonio Lalueza Blanco&#44; Jaime Laureiro Gonzalo&#44; Jaime Lora-Tamayo&#44; Carlos Lumbreras Bermejo&#44; Guillermo Maestro de la Calle&#44; Rodrigo Miranda Godoy&#44; B&#225;rbara Otero Perpi&#241;a&#44; Diana Paredes Ruiz&#44; Marcos S&#225;nchez Fern&#225;ndez&#44; Javier Tejada Montes</p><p id="par0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Costa del Sol Hospital &#40;Marbella&#44; Malaga&#41;</span></p><p id="par0185" class="elsevierStylePara elsevierViewall">Victoria August&#237;n Bandera&#44; Javier Garc&#237;a Alegr&#237;a&#44; Nicol&#225;s Jim&#233;nez-Garc&#237;a&#44; Jairo Luque del Pino&#44; Mar&#237;a Dolores Mart&#237;n Escalante&#44; Francisco Navarro Romero&#44; Victoria N&#250;&#241;ez Rodr&#237;guez&#44; Juli&#225;n Olalla Sierra</p><p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Gregorio Mara&#241;&#243;n University Hospital &#40;Madrid&#41;</span></p><p id="par0195" class="elsevierStylePara elsevierViewall">Laura Abarca Casas&#44; &#193;lvaro Alejandre de O&#241;a&#44; Rub&#233;n Alonso Beato&#44; Leyre Alonso Gonzalo&#44; Jaime Alonso Mu&#241;oz&#44; Christian Mario Amodeo Oblitas&#44; Cristina Aus&#237;n Garc&#237;a&#44; Marta Bacete Cebri&#225;n&#44; Jes&#250;s Baltasar Corral&#44; Mar&#237;a Barrientos Guerrero&#44; Alejandro D&#46; Bendala Estrada&#44; Mar&#237;a Calder&#243;n Moreno&#44; Paula Carrascosa Fern&#225;ndez&#44; Raquel Carrillo&#44; Sabela Casta&#241;eda P&#233;rez&#44; Eva Cervilla Mu&#241;oz&#44; Agust&#237;n Diego Chac&#243;n Moreno&#44; Mar&#237;a Carmen Cuenca Carvajal&#44; Sergio de Santos&#44; Andr&#233;s Enr&#237;quez G&#243;mez&#44; Eduardo Fern&#225;ndez Carracedo&#44; Mar&#237;a Mercedes Ferreiro-Maz&#243;n Jenaro&#44; Francisco Galeano Valle&#44; Alejandra Garc&#237;a&#44; Irene Garc&#237;a Fernandez-Bravo&#44; Mar&#237;a Eugenia Garc&#237;a Leoni&#44; Mar&#237;a G&#243;mez Ant&#250;nez&#44; Candela Gonz&#225;lez San Narciso&#44; Anthony Alexander Gurjian&#44; Lorena Jim&#233;nez Ib&#225;&#241;ez&#44; Cristina Lavilla Olleros&#44; Cristina Llamazares Mendo&#44; Sara Luis Garc&#237;a&#44; V&#237;ctor Mato Jimeno&#44; Clara Mill&#225;n Nohales&#44; Jes&#250;s Mill&#225;n N&#250;&#241;ez-Cort&#233;s&#44; Sergio Morag&#243;n Ledesma&#44; Antonio Mui&#241;o M&#237;guez&#44; Cecilia Mu&#241;oz Delgado&#44; Luc&#237;a Ordieres Ortega&#44; Susana Pardo S&#225;nchez&#44; Alejandro Parra Virto&#44; Mar&#237;a Teresa P&#233;rez Sanz&#44; Blanca Pinilla Llorente&#44; Sandra Piqueras Ruiz&#44; Guillermo Soria Fern&#225;ndez-Llamazares&#44; Mar&#237;a Toledano Mac&#237;as&#44; Neera Toledo Samaniego&#44; Ana Torres do Rego&#44; Mar&#237;a Victoria Villalba Garc&#237;a&#44; Gracia Villarreal&#44; Mar&#237;a Zurita Etayo&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Cabue&#241;es Hospital &#40;Gijon&#44; Asturias&#41;</span></p><p id="par0205" class="elsevierStylePara elsevierViewall">Ana Mar&#237;a &#193;lvarez Su&#225;rez&#44; Carlos Delgado Verg&#233;s&#44; Rosa Fern&#225;ndez-Madera Mart&#237;nez&#44; Eva M&#46;&#170; Fonseca Aizpuru&#44; Alejandro G&#243;mez Carrasco&#44; Cristina Helguera Amez&#250;a&#44; Juan Francisco L&#243;pez Caleya&#44; Diego L&#243;pez Mart&#237;nez&#44; Mar&#237;a del Mar Mart&#237;nez L&#243;pez&#44; Aleida Mart&#237;nez Zapico&#44; Carmen Olabuenaga &#205;scar&#44; Luc&#237;a P&#233;rez Casado&#44; Mar&#237;a Luisa Taboada Mart&#237;nez&#44; Lara Mar&#237;a Tamargo Chamorro&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Regional University Hospital of Malaga &#40;Malaga&#41;</span></p><p id="par0215" class="elsevierStylePara elsevierViewall">M&#46;&#170; Mar Ayala-Guti&#233;rrez&#44; Rosa Bernal L&#243;pez&#44; Jos&#233; Bueno Fonseca&#44; Ver&#243;nica Andrea Buonaiuto&#44; Luis Francisco Caballero Mart&#237;nez&#44; Lidia Cobos Palacios&#44; Clara Costo Muriel&#44; Francis de Windt&#44; Ana Teresa Fern&#225;ndez-Truchaud Christophel&#44; Paula Garc&#237;a Oca&#241;a&#44; Ricardo G&#243;mez Huelgas&#44; Javier Gorospe Garc&#237;a&#44; Jos&#233; Antonio Hurtado Oliver&#44; Sergio Jansen-Chaparro&#44; Mar&#237;a Dolores L&#243;pez-Carmona&#44; Pablo L&#243;pez Quirantes&#44; Almudena L&#243;pez Sampalo&#44; Elizabeth Lorenzo-Hern&#225;ndez&#44; Juan Jos&#233; Mancebo Sevilla&#44; Jesica Mart&#237;n Carmona&#44; Luis Miguel P&#233;rez-Belmonte&#44; Iv&#225;n P&#233;rez de Pedro&#44; Araceli Pineda-Cantero&#44; Carlos Romero G&#243;mez&#44; Michele Ricci&#44; Jaime Sanz C&#225;novas&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">La Paz University Hospital &#40;Madrid&#41;</span></p><p id="par0225" class="elsevierStylePara elsevierViewall">Jorge &#193;lvarez Troncoso&#44; Francisco Arnalich Fern&#225;ndez&#44; Francisco Blanco Quintana&#44; Carmen Busca Arenzana&#44; Sergio Carrasco Molina&#44; Ar&#225;nzazu Castellano Candalija&#44; Germ&#225;n Daroca Bengoa&#44; Alejandro de Gea Grela&#44; Alicia de Lorenzo Hern&#225;ndez&#44; Alejandro D&#237;ez Vidal&#44; Carmen Fern&#225;ndez Capit&#225;n&#44; Mar&#237;a Francisca Garc&#237;a Iglesias&#44; Borja Gonz&#225;lez Mu&#241;oz&#44; Carmen Rosario Herrero Gil&#44; Juan Mar&#237;a Herrero Mart&#237;nez&#44; V&#237;ctor Honta&#241;&#243;n&#44; Mar&#237;a Jes&#250;s Jaras Hern&#225;ndez&#44; Carlos Lahoz&#44; Cristina Marcelo Calvo&#44; Juan Carlos Mart&#237;n Guti&#233;rrez&#44; M&#243;nica Mart&#237;nez Prieto&#44; Elena Mart&#237;nez Robles&#44; Araceli Men&#233;ndez Salda&#241;a&#44; Alberto Moreno Fern&#225;ndez&#44; Jos&#233; Mar&#237;a Mostaza Prieto&#44; Ana Noblejas Mozo&#44; Carlos Manuel O&#241;oro L&#243;pez&#44; Esmeralda Palmier Pel&#225;ez&#44; Marina Palomar Pampyn&#44; Mar&#237;a Angustias Quesada Sim&#243;n&#44; Juan Carlos Ramos&#44; Luis Ramos Ruperto&#44; Aquilino S&#225;nchez Purificaci&#243;n&#44; Teresa Sancho Bueso&#44; Raquel Sorriguieta Torre&#44; Clara Itziar Soto Abanedes&#44; Yeray Untoria Tabares&#44; Marta Varas Mayoral&#44; Julia V&#225;squez Manau&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Royo Villanova Hospital &#40;Zaragoza&#41;</span></p><p id="par0235" class="elsevierStylePara elsevierViewall">Nicol&#225;s Alcal&#225; Rivera&#44; Anxela Crestelo Vieitez&#44; Esther del Corral Beamonte&#44; Jes&#250;s D&#237;ez Manglano&#44; Isabel Fiteni Mera&#44; Mar&#237;a del Mar Garc&#237;a Andreu&#44; 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Pedro Dur&#225;n del Campo&#44; Gabriela Escudero L&#243;pez&#44; Esther Exp&#243;sito Palomo&#44; Ana Fern&#225;ndez Cruz&#44; Amy Gal&#225;n G&#243;mez&#44; Sonia Garc&#237;a Prieto&#44; Beatriz Garc&#237;a Revilla&#44; Miguel &#193;ngel Garc&#237;a Viejo&#44; Javier G&#243;mez Irusta&#44; Patricia Gonz&#225;lez Merino&#44; Edith Vanessa Guti&#233;rrez Abreu&#44; Isabel Guti&#233;rrez Mart&#237;n&#44; &#193;ngela Guti&#233;rrez Rojas&#44; Andrea Guti&#233;rrez Villanueva&#44; Jes&#250;s Herr&#225;iz Jim&#233;nez&#44; F&#225;tima Ib&#225;&#241;ez Est&#233;llez&#44; Pedro Laguna del Estal&#44; M&#46;&#170; Carmen M&#225;inez S&#225;iz&#44; Carmen de Mendoza Fern&#225;ndez&#44; Mar&#237;a Mart&#237;nez Urbistondo&#44; Fernando Mart&#237;nez Vera&#44; Mar&#237;a Mateos Seirullo&#44; Susana Mellor Pita&#44; Patricia A&#46; Mills S&#225;nchez&#44; Esther Montero Hern&#225;ndez&#44; Alberto Mora Vargas&#44; V&#237;ctor Moreno-Torres Concha&#44; Ignacio Morr&#225;s de la Torre&#44; Elena M&#250;&#241;ez Rubio&#44; Rosa Mu&#241;oz de Benito&#44; Alejandro Mu&#241;oz Serrano&#44; Pablo Navarro Palomo&#44; Ilduara Pintos Pascual&#44; Arturo Jos&#233; Ramos Mart&#237;n-Vegue&#44; Antonio Ramos Mart&#237;nez&#44; Celia Rodr&#237;guez Olleros&#44; Alberto Rold&#225;n Montaud&#44; Yolanda Romero Pizarro&#44; Silvia Rosado Garc&#237;a&#44; Diana Ruiz de Domingo&#44; David S&#225;nchez Ortiz&#44; Enrique S&#225;nchez Chica&#44; Irene Solano Almena&#44; Elena Suanzes Mart&#237;n&#44; Yale Tung Chen&#44; Pablo Tutor de Ureta&#44; &#193;ngela Valencia Alijo&#44; Jos&#233; Manuel V&#225;zquez Comendador&#44; Juan Antonio Vargas N&#250;&#241;ez&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Dr&#46; Peset University Hospital &#40;Valencia&#41;</span></p><p id="par0275" class="elsevierStylePara elsevierViewall">Juan Alberto Aguilera Ayll&#243;n&#44; Arturo Artero&#44; Mar&#237;a del Mar Carmona Mart&#237;n&#44; Mar&#237;a Jos&#233; Fabi&#225; Valls&#44; Mar&#237;a de Mar Fern&#225;ndez Garc&#233;s&#44; 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Esther Ja&#233;n Ferrer&#44; Alejandro Mace&#237;n Rodr&#237;guez&#44; Alejandro Marcelles de Pedro&#44; Rub&#233;n &#193;ngel Mart&#237;n S&#225;nchez&#44; Manuel M&#233;ndez Bail&#243;n&#44; Sara Miguel &#193;lvarez&#44; Mar&#237;a Jos&#233; N&#250;&#241;ez Orantos&#44; Carolina Olmos Mata&#44; Eva Orviz Garc&#237;a&#44; David Oteo Mata&#44; Cristina Outon Gonz&#225;lez&#44; Juncal P&#233;rez-Somarriba&#44; Pablo P&#233;rez Mateos&#44; Mar&#237;a Esther Ramos Mu&#241;oz&#44; Xabier Rivas Regaira&#44; Laura M&#46;&#170; Rodr&#237;guez Gallardo&#44; &#205;&#241;igo Sagastagoitia Fornie&#44; Alejandro Salinas Botr&#225;n&#44; Miguel Su&#225;rez Robles&#44; Maddalena Elena Urbano&#44; Andrea Mar&#237;a Vellisca Gonz&#225;lez&#44; Miguel Villar Mart&#237;nez&#44; Borja Sainz Rodr&#237;guez&#46;</p><p id="par0290" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Badajoz University Hospital Complex &#40;Badajoz&#41;</span></p><p id="par0295" class="elsevierStylePara elsevierViewall">Rafael Arag&#243;n Lara&#44; Inmaculada Cimadevilla Fern&#225;ndez&#44; Juan Carlos Cira Garc&#237;a&#44; Gema Mar&#237;a Garc&#237;a&#44; Julia Gonz&#225;lez Granados&#44; Beatriz Guerrero S&#225;nchez&#44; Francisco Javier Monreal Peri&#225;&#241;ez&#44; Mar&#237;a Josefa Pascual P&#233;rez&#46;</p><p id="par0300" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">University Hospital San Juan de Alicante &#40;Alicante&#41;</span></p><p id="par0305" class="elsevierStylePara elsevierViewall">Marisa Asensio Tom&#225;s&#44; David Balaz&#44; David Bonet Tur&#44; Ruth Ca&#241;izares Navarro&#44; Paloma Chazarra P&#233;rez&#44; Jes&#250;s Corbacho Redondo&#44; Eliana Damonte White&#44; Mar&#237;a Escamilla Esp&#237;nola&#44; Leticia Espinosa del Barrio&#44; Pedro Jes&#250;s Esteve Ati&#233;nzar&#44; Carles Garc&#237;a Cervera&#44; David Francisco Garc&#237;a N&#250;&#241;ez&#44; Francisco Garrido Navarro&#44; Vicente Giner Galva&#241;&#44; Angie G&#243;mez Uranga&#44; Javier Guzm&#225;n Mart&#237;nez&#44; Isidro Hern&#225;ndez Isasi&#44; Lourdes Lajara Villar&#44; Ver&#243;nica Mart&#237;nez Sempere&#44; Juan Manuel N&#250;&#241;ez Cruz&#44; Sergio Palacios Fern&#225;ndez&#44; Juan Jorge Peris Garc&#237;a&#44; Rafael Pi&#241;ol Pleguezuelos&#44; Andrea Ria&#241;o P&#233;rez&#44; Jos&#233; Miguel Segu&#237; Ripoll&#44; Azucena Sempere Mira&#44; Philip Wikman-Jorgensen&#46;</p><p id="par0310" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">General University Hospital of Elda &#40;Alicante&#41;</span></p><p id="par0315" class="elsevierStylePara elsevierViewall">Carmen Cort&#233;s Saavedra&#44; Jennifer Fern&#225;ndez G&#243;mez&#44; Borja Gonz&#225;lez L&#243;pez&#44; Mar&#237;a Soledad Hern&#225;ndez Garrido&#44; Ana Isabel L&#243;pez Amor&#243;s&#44; Santiago L&#243;pez Gil&#44; Mar&#237;a de los Reyes Pascual P&#233;rez&#44; Nuria Ram&#237;rez Perea&#44; Andrea Torregrosa Garc&#237;a&#46;</p><p id="par0320" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Infanta Cristina University Hospital &#40;Parla&#44; 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Estefan&#237;a Martul Pego&#44; Carmen Mella P&#233;rez&#44; Ana Pazos Ferro&#44; Sabela S&#225;nchez Trigo&#44; Dolores Su&#225;rez Sambade&#44; Mar&#237;a Trigas Ferr&#237;n&#44; Mar&#237;a del Carmen V&#225;zquez Friol&#44; Laura Vilari&#241;o Maneiro&#46;</p><p id="par0390" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Infanta Margarita Hospital &#40;Cabra&#44; Cordoba&#41;</span></p><p id="par0395" class="elsevierStylePara elsevierViewall">Mar&#237;a Esther Guisado Espartero&#44; Lorena Montero Rivas&#44; Mar&#237;a de la Sierra Navas Alc&#225;ntara&#44; Raimundo Tirado-Miranda&#46;</p><p id="par0400" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">University Healthcare Complex of Salamanca &#40;Salamanca&#41;</span></p><p id="par0405" class="elsevierStylePara elsevierViewall">Gloria Mar&#237;a Alonso Claudio&#44; V&#237;ctor Barreales Rodr&#237;guez&#44; Cristina Carbonell Mu&#241;oz&#44; Adela Carpio P&#233;rez&#44; Mar&#237;a Victoria Coral Orbes&#44; Daniel Encinas S&#225;nchez&#44; Sandra In&#233;s Revuelta&#44; Miguel Marcos Mart&#237;n&#44; Jos&#233; Ignacio Mart&#237;n Gonz&#225;lez&#44; Jos&#233; &#193;ngel Mart&#237;n Oterino&#44; Leticia Moralejo Alonso&#44; Sonia Pe&#241;a Balbuena&#44; Mar&#237;a Luisa P&#233;rez Garc&#237;a&#44; Ana Ram&#243;n Prados&#44; Beatriz Rodr&#237;guez-Alonso&#44; &#193;ngela Romero Alegr&#237;a&#44; Mar&#237;a S&#225;nchez Ledesma&#44; Rosa Juana Tejera P&#233;rez&#46;</p><p id="par0410" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Virgen del Roc&#237;o University Hospital &#40;Seville&#41;</span></p><p id="par0415" class="elsevierStylePara elsevierViewall">Reyes Aparicio Santos&#44; M&#225;ximo Bernabeu-Wittel&#44; Santiago Rodr&#237;guez Su&#225;rez&#44; Mar&#237;a Nieto&#44; Luis Gim&#233;nez Miranda&#44; Rosa Mar&#237;a G&#225;mez Mancera&#44; F&#225;tima Espinosa Torre&#44; Carlos Hern&#225;ndez Quiles&#44; Concepci&#243;n Conde Guzm&#225;n&#44; Juan Delgado de la Cuesta&#44; Jara Elo&#237;sa Ternero Vega&#44; Mar&#237;a del Carmen L&#243;pez R&#237;os&#44; Pablo D&#237;az Jim&#233;nez&#44; Bosco Bar&#243;n Franco&#44; Carlos Jim&#233;nez de Juan&#44; Sonia Guti&#233;rrez Rivero&#44; Julia Lanseros Tenllado&#44; Ver&#243;nica Alfaro Lara&#44; Aurora Gonz&#225;lez Estrada&#46;</p><p id="par0420" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Public Hospital of Monforte de Lemos &#40;Lugo&#41;</span></p><p id="par0425" class="elsevierStylePara elsevierViewall">Jos&#233; L&#243;pez Castro&#44; Manuel Lorenzo L&#243;pez Reboiro&#44; Cristina Sardi&#241;a Gonz&#225;lez&#46;</p><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Marina Baixa Hospital &#40;Villajoyosa&#44; Alicante&#41;</span><p id="par0430" class="elsevierStylePara elsevierViewall">Javier Ena&#44; Jos&#233; Enrique G&#243;mez Segado&#46;</p><p id="par0435" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Defense General Hospital &#40;Zaragoza&#41;</span></p><p id="par0440" class="elsevierStylePara elsevierViewall">Anyuli Gracia Guti&#233;rrez&#44; 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Ana Mar&#237;a Baz Lomba&#44; Ruth Brea Aparicio&#44; Marta Fern&#225;ndez Morales&#44; Jes&#250;s Manuel Fern&#225;ndez Villar&#44; Mar&#237;a Teresa L&#243;pez Monteagudo&#44; Cristina P&#233;rez Garc&#237;a&#44; Lorena Rodr&#237;guez Ferreira&#44; Diana Sande Llovo&#44; Mar&#237;a Bego&#241;a Valle Feijoo&#46;</p></span></span></span>"
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    "fechaAceptado" => "2022-01-10"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1603390"
          "palabras" => array:6 [
            0 => "Atrial fibrillation"
            1 => "COVID-2019"
            2 => "Hospitalization"
            3 => "Risk factor"
            4 => "Mortality"
            5 => "Anticoagulation"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1603391"
          "palabras" => array:6 [
            0 => "Fibrilaci&#243;n auricular"
            1 => "COVID-2019"
            2 => "Hospitalizaci&#243;n"
            3 => "Factor de riesgo"
            4 => "Mortalidad"
            5 => "Anticoagulaci&#243;n"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Atrial fibrillation and associated comorbidities pose a risk factor for mortality&#44; morbidity and development of complications in patients admitted for COVID-19&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">To describe the clinical&#44; epidemiological&#44; radiological and analytical characteristics of patients with AF admitted for COVID-19 in Spain&#46; Secondarily&#44; we aim to identify those variables associated with mortality and poor prognosis of COVID-19 in patients with AF&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Retrospective&#44; observational&#44; multicenter&#44; nationwide&#44; retrospective study of patients hospitalized for COVID-19 from March 1 to October 1&#44; 2020&#46; Data were obtained from the SEMI-COVID-19 Registry of the Spanish Society of Internal Medicine &#40;SEMI&#41; in which 150 Spanish hospitals participate&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Between March 1 and October 1&#44; 2020&#44; data from a total of 16&#44;461 patients were entered into the SEMI-COVID-19 registry&#46; 1&#44;816 &#40;11&#37;&#41; had a history of AF and the number of deaths among AF patients amounted to 738 &#40;41&#37;&#41;&#46; Regarding clinical characteristics&#44; deceased patients were admitted with a higher heart rate &#40;88&#46;38 vs 84&#46;95&#59; p&#8239;&#62;&#8239;0&#46;01&#41;&#44; with a higher percentage of respiratory failure &#40;67&#46;2&#37; vs 20&#46;1&#37;&#59; p&#8239;&#60;&#8239;0&#46;01&#41; and high tachypnea &#40;58&#37; vs 30&#37;&#59; p&#8239;&#60;&#8239;0&#46;01&#41;&#46; The comorbidities that presented statistically significant differences in the deceased group were&#58; age&#44; hypertension and diabetes with target organ involvement&#46; There was also a higher prevalence of a history of cardiovascular disease in the deceased&#46; On multivariate analysis&#44; DOACs treatment had a protective role for mortality &#40;OR&#58;0&#44;597&#41; IC &#40;0&#44;402-0&#44;888 &#59; p&#8239;&#61;&#8239;0&#46;011&#41;&#46;</p></span> <span id="abst1020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect3025">Conclusions</span><p id="spar1055" class="elsevierStyleSimplePara elsevierViewall">Previous treatment with DOACs and DOACs treatment during admission seem to have a protective role in patients with AF&#44; although this fact should be verified in prospective studies&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objectives"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst1020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">La fibrilaci&#243;n auricular y las comorbilidades asociadas a ella suponen un factor de riesgo de mortalidad&#44; morbilidad y desarrollo de complicaciones en los pacientes ingresados por COVID-19&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Objetivos</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Describir las caracter&#237;sticas cl&#237;nicas&#44; epidemiol&#243;gicas&#44; radiol&#243;gicas y anal&#237;ticas de los pacientes con FA ingresados por COVID-19 en Espa&#241;a&#46; De forma secundaria&#44; se pretende identificar aquellas variables que se asocian con mortalidad y mal pron&#243;stico de la COVID-19 en pacientes que presentan FA&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">M&#233;todos</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo&#44; observacional y multic&#233;ntrico de &#225;mbito nacional de pacientes hospitalizados por COVID-19 desde el 1 de marzo al 1 de octubre de 2020&#46; Los datos fueron obtenidos del Registro SEMI-COVID-19 de la Sociedad Espa&#241;ola de Medicina Interna &#40;SEMI&#41; en el que participan 150 hospitales espa&#241;oles&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">De un total de 16&#46;461 pacientes en el registro SEMI-COVID-19&#44; 1&#46;816 &#40;11&#37;&#41; ten&#237;an antecedente de FA y el n&#250;mero de fallecidos entre los pacientes con FA ascendi&#243; a 738 &#40;41&#37;&#41;&#46; En cuanto a la cl&#237;nica&#44; los pacientes fallecidos ingresaron con una frecuencia card&#237;aca mayor &#40;88&#44;38 vs 84&#44;95&#59; p&#8239;&#62;&#8239;0&#44;01&#41;&#44; con mayor porcentaje de insuficiencia respiratoria &#40;67&#44;2&#37; vs 20&#44;1&#37;&#59; p&#8239;&#60;&#8239;0&#44;01&#41; y mayor taquipnea &#40;58&#37; vs 30&#37;&#59; p&#8239;&#60;&#8239;0&#44;09&#41;&#46; En el an&#225;lisis multivariante&#44; el tratamiento con ACOD tuvo un papel protector para la mortalidad por infecci&#243;n por COVID 19 &#40;OR&#58;0&#44;597&#59; IC &#40;0&#44;402-0&#44;888&#59; p&#8239;&#61;&#8239;0&#46;011&#41;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">El tratamiento previo con ACOD como el tratamiento con ACOD durante el ingreso parecen tener un papel protector en los pacientes con FA&#44; aunque este hecho deber&#237;a ser comprobado con estudios prospectivos&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Objetivos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:3 [
        "etiqueta" => "&#9674;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Doctors M&#233;ndez-Bail&#243;n and G&#243;mez-Huelgas share the final authorship&#46;</p>"
        "identificador" => "fn0005"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0485" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0065"
          ]
        ]
      ]
    ]
    "multimedia" => array:5 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Table "
            "rol" => "short"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">ASA&#58;</span> acetylsalicylic acid&#59; <span class="elsevierStyleBold">ARBs&#58;</span> angiotensin receptor blockers&#59; <span class="elsevierStyleBold">COPD&#58;</span> chronic obstructive pulmonary disease&#59; <span class="elsevierStyleBold">CKD&#58;</span> chronic kidney disease&#59; <span class="elsevierStyleBold">PVD&#58;</span> peripheral vascular disease&#59; <span class="elsevierStyleBold">HR&#58;</span> heart rate&#59; <span class="elsevierStyleBold">RR&#58;</span> respiratory rate&#59; <span class="elsevierStyleBold">HBP&#58;</span> high blood pressure&#59; <span class="elsevierStyleBold">AMI&#58;</span> acute myocardial infarction&#59; <span class="elsevierStyleBold">HF&#58;</span> heart failure&#59; <span class="elsevierStyleBold">ACEI&#58;</span> angiotensin converting enzyme inhibitors&#59; <span class="elsevierStyleBold">BMI&#58;</span> body mass index&#59; <span class="elsevierStyleBold">TO&#58;</span> target organ&#59; <span class="elsevierStyleBold">CRP&#58;</span> C-reactive protein&#59; <span class="elsevierStyleBold">SpO<span class="elsevierStyleInf">2</span>&#58;</span> oxygen saturation&#59; <span class="elsevierStyleBold">SBP&#58;</span> systolic blood pressure&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus n &#40;&#37;&#41;</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>Without TO lesion&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">119 &#40;16&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Dementia n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">200 &#40;27&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">165 &#40;15&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">88&#46;38&#8239;&#177;&#8239;21&#46;76&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">126&#46;5&#8239;&#177;&#8239;25&#46;09&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">130&#46;73&#8239;&#177;&#8239;23&#46;50&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">90&#46;07&#8239;&#177;&#8239;7&#46;51&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">415 &#40;58&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">313 &#40;30&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">540 &#40;73&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">602 &#40;56&#46;8&#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\ttable-entry\n
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                  \t\t\t\t">273 &#40;37&#46;1&#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"><span class="elsevierStyleHsp" style=""></span>Creatinine mg&#47;dl&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;25&#8239;&#177;&#8239;0&#46;93&nbsp;\t\t\t\t\t\t\n
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                  \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 &#40;mg&#47;dl&#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">150&#46;01&#8239;&#177;&#8239;72&#46;46&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">129&#46;57&#8239;&#177;&#8239;61&#46;91&nbsp;\t\t\t\t\t\t\n
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                  \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 &#40;mg&#47;L&#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\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
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                  """
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          "leyenda" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">ASA&#58;</span> acetylsalicylic acid&#59; <span class="elsevierStyleBold">NSAIDs&#58;</span> nonsteroidal anti-inflammatory drugs&#59; <span class="elsevierStyleBold">ARBs&#58;</span> angiotensin receptor blockers&#59; <span class="elsevierStyleBold">AMI&#58;</span> acute myocardial infarction&#59; <span class="elsevierStyleBold">HF&#58;</span> heart failure&#59; <span class="elsevierStyleBold">ACEI&#58;</span> angiotensin converting enzyme inhibitors&#59; <span class="elsevierStyleBold">AKF&#58;</span> acute kidney failure&#59; <span class="elsevierStyleBold">HFO&#58;</span> high-flow oxygen therapy&#59; <span class="elsevierStyleBold">ARDS&#58;</span> acute respiratory distress syndrome&#59; <span class="elsevierStyleBold">PTE&#58;</span> pulmonary thromboembolism&#59; <span class="elsevierStyleBold">IMV&#58;</span> invasive mechanical ventilation&#59; <span class="elsevierStyleBold">NIMV&#58;</span> Non-invasive mechanical ventilation&#46;</p>"
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t">91 &#40;12&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">195 &#40;18&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">75 &#40;10&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">109 &#40;15&#46;0&#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">240 &#40;2&#46;9&#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 ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1 &#40;0&#46;1&#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;1&#46;0&#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;04&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>Other NSAIDs&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">20 &#40;2&#46;8&#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">37 &#40;3&#46;5&#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;03&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>Corticosteroids&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">320 &#40;43&#46;8&#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">387 &#40;35&#46;9&#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;0&#46;01&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>Lopinavir&#47;ritonavir&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">302 &#40;41&#46;2&#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">481 &#40;44&#46;5&#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;17&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>Remdesivir&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 &#40;0&#46;3&#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;1&#46;4&#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;0&#46;01&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>Hydroxychloroquine&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">500 &#40;68&#46;4&#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">878 &#40;81&#46;1&#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;0&#46;01&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>Chloroquine&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;3&#46;7&#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">33 &#40;3&#46;1&#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&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>Colchicine&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">10 &#40;1&#46;4&#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">9 &#40;0&#46;8&#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&nbsp;\t\t\t\t\t\t\n
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Article information
ISSN: 23870206
Original language: English
DOI:10.1016/j.medcle.2022.01.020
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