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. 2023 Jan 21;18(3):907–915. doi: 10.1007/s11739-023-03200-3

Validation of the RIM Score-COVID in the Spanish SEMI-COVID-19 Registry

José-Manuel Ramos-Rincón 1, Paula Sol Ventura 2, José-Manuel Casas-Rojo 3, Marc Mauri 4, Carlos Lumbreras Bermejo 5, Aitor Ortiz de Latierro 4, Manuel Rubio-Rivas 6, Luis Mérida-Rodrigo 7, Lucia Pérez-Casado 8, María Barrientos-Guerrero 9, Vicente Giner-Galvañ 10, Cristina Gallego-Lezaun 11, Almudena Hernández Milián 12, Luis Manzano 13, Julio César Blázquez-Encinar 14, Marta Nataya Solís-Marquínez 15, Marcos Guzmán García 16, Julia Lobo-García 17, Victoria Achával-Rodríguez Valente 18, Celia Roig-Martí 19, Marta León-Téllez 20, Pablo Tellería-Gómez 21, María Jesús González-Juárez 22, Ricardo Gómez-Huelgas 23, Alejandro López-Escobar 24,✉; for the SEMI-COVID-19 Network
PMCID: PMC9862219  PMID: 36680737

Abstract

The significant impact of COVID-19 worldwide has made it necessary to develop tools to identify patients at high risk of severe disease and death. This work aims to validate the RIM Score-COVID in the SEMI-COVID-19 Registry. The RIM Score-COVID is a simple nomogram with high predictive capacity for in-hospital death due to COVID-19 designed using clinical and analytical parameters of patients diagnosed in the first wave of the pandemic. The nomogram uses five variables measured on arrival to the emergency department (ED): age, sex, oxygen saturation, C-reactive protein level, and neutrophil-to-platelet ratio. Validation was performed in the Spanish SEMI-COVID-19 Registry, which included consecutive patients hospitalized with confirmed COVID-19 in Spain. The cohort was divided into three time periods: T1 from February 1 to June 10, 2020 (first wave), T2 from June 11 to December 31, 2020 (second wave, pre-vaccination period), and T3 from January 1 to December 5, 2021 (vaccination period). The model’s accuracy in predicting in-hospital COVID-19 mortality was assessed using the area under the receiver operating characteristics curve (AUROC). Clinical and laboratory data from 22,566 patients were analyzed: 15,976 (70.7%) from T1, 4,233 (18.7%) from T2, and 2,357 from T3 (10.4%). AUROC of the RIM Score-COVID in the entire SEMI-COVID-19 Registry was 0.823 (95%CI 0.819–0.827) and was 0.834 (95%CI 0.830–0.839) in T1, 0.792 (95%CI 0.781–0.803) in T2, and 0.799 (95%CI 0.785–0.813) in T3. The RIM Score-COVID is a simple, easy-to-use method for predicting in-hospital COVID-19 mortality that uses parameters measured in most EDs. This tool showed good predictive ability in successive disease waves.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11739-023-03200-3.

Keywords: COVID-19, Neutrophil-to-platelet ratio, Hemogram-derived ratios, Risk factors, Mortality, Score, Spain

Background

The COVID-19 pandemic, a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a huge impact on healthcare systems worldwide and resulted in more than 523 million known infections and well over 6.2 million deaths globally as of May 24, 2022 [1]. The disease’s spectrum ranges from a minor illness that can be treated on an outpatient basis to severe acute respiratory failure that may require admission to the intensive care unit (ICU) or death [2–4].

The early detection of patients with COVID-19 who may have worse outcomes is a priority [5–7]. A highly accurate tool for predicting the clinical course of this disease could be very useful for risk stratification, clinical decision-making, and ultimately for reducing mortality. A number of prognostic models for COVID-19 have been proposed since the beginning of the pandemic. Several studies have established a link between the most severe cases of COVID-19 and blood cell count-derived ratios, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), or neutrophil-to-platelet ratio (NPR) [8–12].

Our group created a prognostic nomogram (Risk of In-hospital Mortality Score in COVID-19 (RIM Score-COVID)) that is highly accurate for predicting in-hospital mortality [13]. The RIM Score-COVID includes five variables commonly measured upon a patient’s arrival at the emergency department (ED): age, sex, baseline oxygen saturation (SpO2), C-reactive protein (CRP) level, and NPR. Applying the nomogram to the validation cohort, the area under the receiver operating characteristics curve (AUROC) was 0.861 (95% CI 0.823–0.900).

The Spanish Society of Internal Medicine (SEMI, for its initials in Spanish) sponsored a nationwide COVID-19 patient registry in which 150 Spanish hospitals participated. Over 24,000 patients over 18 years of age were included. Several studies derived from the SEMI-COVID-19 Registry have reported clinical characteristics with prognostic value [4, 14–16] as well as prognostic scores [17, 18]. However, since the start of the pandemic, multiple factors have changed the course of disease because the clinical management [20], available resources, and treatments indicated have evolved since the beginning of the pandemic [19, 21]. Therefore, the objective of this study was to validate the prognostic utility of the RIM Score-COVID in the SEMI-COVID-19 Registry in three time periods: patients admitted in the first wave, patients admitted after first wave but before the start of vaccination, and patients admitted after the start of vaccination [22].

Methods

The RIM Score-COVID was validated using the SEMI-COVID-19 Registry, which retrospectively compiles data on the index admission of patients ≥ 18 years of age with COVID-19 confirmed microbiologically through a reverse transcription polymerase chain reaction (RT-PCR) or antigen test and with hospital discharge or in-hospital death from January 2020 to December 2021. More in-depth information about the justification, objectives, methodology, and preliminary results of the SEMI-COVID-19 Registry have recently been published [4, 14, 15].

Study population and registry information

Patients from the SEMI-COVID-19 Registry were treated at their attending physician’s discretion, according to local protocols and clinical judgement. Patients included in open-label clinical trials could be included in the registry, provided that all information about treatment was available.

An online electronic data capture system (DCS) was developed, which included a database manager along with procedures for the verification of data and contrasting of information against the original medical record to ensure the best possible quality of data collection. Patient identifiable data were dissociated and pseudonymized.

Data collection

Data were collected retrospectively and included approximately 300 variables grouped under various headings: (1) inclusion criteria, (2) epidemiological data, (3) RT-PCR and serology data, (4) personal medical and medication history, (5) symptoms and physical examination findings at admission, (6) laboratory (blood gasses, metabolic panel, complete blood count, coagulation) and diagnostic imaging tests, (7) additional data at 7 days after admission or at admission to the intensive care unit (ICU), (8) pharmacological treatment during the hospitalization (antiviral drugs, immunomodulators, antibiotics) and ventilatory support, (9) complications during the hospitalization, and (10) progress after discharge and/or 30 days from diagnosis. Variables were obtained from the patient’s electronic medical record [4].

To validate the results obtained with the initial RIM Score-COVID model, the cohort of patients was divided into three groups based on admission date.

The first time period (T1) was February 1 to June 10, 2020 (first wave). The cut-off point of June 10, 2020 was selected for two reasons: first, because it was the date that the last patient was included in the original validation model for the RIM Score-COVID and second, because it is the approximate date of transition between the first and second waves of the COVID-19 pandemic in Spain.

The second time period (T2) was from June 11 to December 31, 2020 (second wave and pre-vaccination period). The second cut-off point of December 31, 2020 was selected for two reasons: first, because vaccination in Spain began soon before on December 26, 2020 and second, because it is the approximate date of transition between the third and fourth waves in Spain.

The third time period (T3) was from January 1 to December 5, 2021. The third cut-off point of December 5, 2021 was selected because it was the end of data inclusion in the SEMI-COVID-19 Registry for this work. T3 is the vaccination period.

RIM Score-COVID

The RIM Score-COVID is a logistic regression model that includes five variables commonly measured upon the patient’s arrival at the ED: age, sex, baseline SpO2, CRP level, and NPR value. The NPR is the ratio of neutrophil count (× 109 cells/L) to platelet count (× 1011 cells/L). The initial nomogram was developed in a cohort of 2,543 patients with COVID-19 requiring hospital admission, of which 1,955 (76.8%) patients were included in the final analysis. The patients were randomly divided into training and validation cohorts; applying the nomogram to the latter cohort, the area under the receiver operating characteristics curve (AUROC) was 0.861 (95% CI 0.823–0.900). The nomogram developed is shown in Fig. 1 [13]. It should be noted that the RIM Score-COVID was developed in a cohort of COVID-19 patients admitted during the first wave of the pandemic, when there was a multitude of hospitalized patients, a shortage of RT-PCR diagnostic tests for SARS-CoV-2, and frequent changes in the diagnostic and treatment protocol proposed by the Spanish Ministry of Health. For several weeks in the first wave, COVID-19 was diagnosed based solely on clinical and radiological criteria.

Fig. 1.

Fig. 1

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Nomograms of the NPR model. SpO2 (%): oxygen saturation; NPR (high: > 3.0) neutrophil-to-platelet ratio; CRP (high: > 112 mg/L): C-reactive protein

Statistical analysis

Data were expressed as medians (interquartile range) for continuous variables or as numbers and percentages for categorical variables. The normality of the distribution was assessed using the Kolmogorov–Smirnov test. The Kruskal–Wallis test was used for comparison of continuous independent variables (Kolmogorov–Smirnov test < 0.05 in all). Pearson's Chi-square test was performed to compare categorical variables between groups. ROC curves and their corresponding 95% AUC confidence intervals (CI) were calculated [23]. The Statistical Package for Social Sciences SPSS version 23.0 (Armonk, NY, USA) was used to perform all statistical analyses. Significance was established as p < 0.05. The Python package "scikit-learn" (1.0.1) was used to generate ROC curves and their corresponding AUC. Confidence intervals were estimated through bootstrapping 1000 tenfold cross-validation resampling, also calculated with scikit-learn 1.0.1.

Ethical aspects

The study was conducted in accordance with ethical principles and was conducted pursuant to good clinical practice standards and the principles of the latest versions of the Declaration of Helsinki (2013) and the Oviedo Convention (1997). This work was approved by the Institutional Research Ethics Committee of Málaga on March 27, 2020 (Ethics Committee code: SEMI-COVID-19 27–03-20), as per the guidelines of the Spanish Agency of Medicines and Medical Products. All patients gave informed consent. All data collected, processed, and analyzed in this work were anonymized and used only for the purposes of this project. TRIPOD statement guidelines were adhered to in the execution and reporting of the study [24].

Results

Data from 24,514 patients included in SEMI-COVID-19 Registry were analyzed, of which 22,566 (92.1%) were included. All patients were over 18 years old and none died in the ED. Patients admitted prior to February 1, 2020 (n = 15); those with platelet counts higher than × 106 cells/mm3 (n = 6); those with total leukocyte counts lower than the sum of total lymphocytes and total neutrophils (n = 481); and patients missing CRP (n = 767), SpO2 (n = 510), total neutrophils (n = 107), total platelets (n = 46), or sex (n = 16) were excluded, as shown in the flowchart in Fig. 2.

Fig. 2.

Fig. 2

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Patient inclusion flowchart. CRP C-reactive protein; SpO2 oxygen saturation

The cohort of patients was divided into time periods according to the aforementioned cut-off points. A total of 15,976 (70.7%) were included in T1, 4,233 (18.7%) in T2, and 2,357 in T3 (10.4%). In total, 4,238 (18.7%) patients died: 3,113 (73.4%) in T1, 702 (16.5%) in T2, and 423 (9.9%) in T3. As to the mortality rate, the proportion of patients who died was highest in T1 (19.4%), followed by T3 (17.9%), and was the lowest in T2 (16.5%) (Table 1).

Table 1.

Patients included in each time period, mortality, and mortality rate

Patients included Mortality (%)
Total 22,566 4238 (18.7%)
T1 15,976 3113 (19.4%)
T2 4233 702 (16.5%)
T3 2357 423 (17.9%)
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T1 first time period from February 1 to June 10, 2020, T2 second time period from June 11 to 31 December 31, 2020, T3 third time period from January 1 to December 5, 2021.

Table 2 shows the demographic data, comorbidities, evaluation of patients in the ED, as well as the outcomes of all patients included in the study. The groups of patients diagnosed in the different time periods were compared and significant differences were found in terms of age, sex, diabetes mellitus, hypertension, and cancer. Regarding the first evaluation in the ED, all parameters studied were significantly different between the time periods, as were the percentage of patients admitted to the ICU and the percentage of deaths (Table 2).

Table 2.

Comparison of demographic, clinical, and biochemical characteristics upon admission and outcomes in three successive periods of the pandemic

Total (n = 22,566) T1 (n = 15,976) T2 (n = 4,233) T3 (n = 2,357) P value a
Demographics
 Age (years) 69 [56–80] 69 [56–79] 70 [57–82] b 68 [56–79]  < 0.001
 Male sex, n (%) 13,005 (57.6) 9,161 (57.3) 2,423 (57.2) 1,421 (60.3) b 0.022
Comorbidities
 Diabetes mellitus, n (%) 4,673 (30.7) 3,160 (19.8) 1,043 (24.7) b 470 (20)  < 0.001
 COPD/Asthma, n (%) 3,050 (13.5) 2,124 (13.3) 591 (14) 335 (14.2) 0.326
 Heart failure, n (%) 1,563 (6.9) 1,104 (6.9) 289 (6.8) 173 (7.3) 0.670
 Hypertension, n (%) 11,760 (52.2) 8,193 (51.3) 2,337 (55.2) b 1,230 (52.2)  < 0.001
 Myocardial infarction, n (%) 1,313 (5.8) 899 (5.6) 270 (6.4) 144 (6.1) 0.151
 Atrial fibrillation, n (%) 2,505 (11.1) 1,752 (11) 504 (11.9) 249 (10.6) 0.157
 Moderate–severe kidney disease, n (%) 1,366 (6.1) 946 (5.9) 286 (6.8) 134 (5.7) 0.097
 Cancer, n (%) 2,220 (9.9) 1,608 (10.1) 418 (9.9) 194 (8.2) b 0.018
Clinical and analytical assessment in ED
 SpO2 < 90%, n (%) 4,990 (22.1) 3,590 (22.5) 766 (18.1) b 634 (26.9) b  < 0.001
 NPR 0.024 [0.017–0.034] 0.024 [0.017–0.034] 0.024 [0.017–0.035] 0.026 [0.018–0.036] b  < 0.001
 NLR 4.9 [3–8.4] 4.9 [3–8.2] 4.8 [2.9–8.4] 5.7 [3.4–9.7] b  < 0.001
 CRP (mg/L) 65 [22.5–131] 62 [20.3–130.4] 65 [23.2–125] 86.9 [42.9–144] b  < 0.001
Outcome
 ICU admission, n (%) 2,150 (9.5) 1,481 (9.3) 451 (10.7) b 218 (9.2) 0.022
 Mortality, n (%) 4,238 (18.8) 3,113 (19.5) 702 (16.6) b 423 (17.9)  < 0.001
RIM Score
 RIM Score NPR Model 0.05 [0.01–0.18] 0.05 [0.01–0.18] 0.06 [0.01–0.19] b 0.06 [0.02–0.19] b 0.003
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Expressed values: Median and [interquartile range]. Percentage is by columns.

a Categorical variables were compared using the Chi-square test and quantitative variables using the Kruskal–Wallis Test (K. Smirnov < 0.05).

b Indicates a significant difference with respect to the first period. Significant differences are shown in bold.

T1 first time period from February 1 to June 10, 2020, T2 second time period from June 11 to 31 December 31, 2020, T3 third time period from January 1 to December 5, 2021; COPD Chronic Obstructive Pulmonary Disease, SpO2 < 90% oxygen saturation less than 90%, NPR neutrophil-to-platelet ratio, NLR neutrophil-to-lymphocyte ratio, CRP C-reactive protein, ICU intensive care unit.

To predict the probability of death based on variables measured upon hospital admission, ROC curves and their corresponding AUC for the NPR model of the RIM Score were calculated for the total number of patients and for each time period. The AUC of the RIM Score-COVID in the Spanish SEMI-COVID-19 Registry was 0.823 (95% CI 0.819–0.827). The AUC for each time period was 0.834 (95% CI 0.830–0.839) for T1, 0.792 (95% CI 0.781–0.803) for T2, and 0.799 (95% CI 0.785–0.813) for T3 (Fig. 3 A–D).

Fig. 3.

Fig. 3

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AUC charts of the NPR RIM Score-COVID in the Spanish SEMI-COVID-19 Registry calculated for the total number of patients included (A) and for each time period (B, C, D). T1 first time period from February 1 to June 10, 2020 (B), T2 second time period from June 11 to 31 December 31, 2020 (C) T3 third time period from January 1 to December 5, 2021 (D); NPR, neutrophil-to-platelet ratio

Discussion

According to our results, the RIM score-COVID (NPR model) is an effective and simple tool for predicting the risk of in-hospital mortality in patients with COVID-19. This nomogram incorporates the NPR, a novel ratio proposed by our group that is able to be calculated using values found in a complete blood count [13]. To our knowledge, this is the first study in which a nomogram designed in the first wave has been validated using data from later periods of the COVID-19 pandemic.

The RIM Score-COVID nomogram uses five accessible, routine, and simple-to-measure parameters commonly obtained in the patient’s first assessment in the ED. An AUC value of 0.861 was obtained in the validation cohort during the nomogram’s development [13]. Values close to 0.8 were reached in the three different time periods, during which the disease was managed differently due to greater knowledge of COVID-19 as the pandemic progressed, the emergence of different strains, and the start of a mass vaccination campaign. This reflects the RIM Score-COVID’s prognostic capacity for in-hospital mortality due to COVID-19 and, therefore, its clinical usefulness.

Several previous studies have published clinical scores that attempt to predict the risk of worse outcomes in patients with COVID-19 [16, 17, 24–28]. However, some of these studies have methodological limitations, including small patient samples, an unrepresentative selection of the control group, or short or incomplete follow-up periods [28].

On the other hand, many of the nomograms and scores published to date are complex, as they include many parameters (some up to 23) and show a lower predictive ability than ours [25–30]. Other scores have demonstrated a predictive ability similar to ours, but were developed with a smaller number of patients, do not include training and validation cohorts [31, 32], use parameters that are not accessible in many hospital EDs [33–35], or use imaging methods that cannot always be reported objectively in real time [35].

Two scores have been developed from the SEMI-COVID-19 Registry. The first was the PRIORITY model, which included age, dependency, cardiovascular disease, chronic kidney disease, dyspnea, tachypnea, confusion, systolic blood pressure, SpO2 ≤ 93%, and a requirement for oxygen. The AUC value of this model was 0.794 (95% CI: 0.775–0.813) in the validation cohort [17]. The other model developed and evaluated was a machine learning-based in-hospital COvid-19 Disease Outcome Predictor (CODOP), developed in a multicontinental retrospective study that included patients in the SEMI-COVID-19 Registry. CODOP uses 12 clinical parameters that are commonly measured at hospital admission and associated with the pathophysiology of COVID-19 (platelets, eosinophils, neutrophils, monocytes, CRP, creatinine, lactate dehydrogenase, sodium, potassium, glucose, and D-dimer) as well as age. CODOP has a high discriminative ability up to 9 days before clinical resolution (AUROC: 0.90–0.96, 95% CI: 0.879–0.970) [18].

A mortality prediction score has recently been published that is based on a cohort of 6,161 patients with COVID-19 on arrival at the ED of 127 Spanish hospitals. This score is similar to the RIM Score-COVID in that it uses the parameters of age, sex, SpO2, and NLR. It also includes two other parameters: dyspnea, which, although dichotomous (yes/no), is a subjective variable, and estimated glomerular filtration rate, which may not be so easy to obtain. However, its predictive capacity is lower than that of the RIM Score-COVID, with an AUC in the validation cohort of 0.845 (0.819–0.870) [36].

The first wave of COVID-19 posed an unprecedented challenge to healthcare systems around the world [37–39]. During those first months, limited resources, the scarcity of diagnostic tests, patients' own fears of going to hospitals, and the lack of knowledge of the disease led to a scenario that—despite the current overload of healthcare systems has fortunately not been repeated with such intensity for the time being [40, 41].

These aspects are reflected when comparing the cohorts of the three time periods: patients admitted in the first wave were older, had a more severe inflammatory state on arrival at the ED, and there were significantly higher percentages of patients admitted and deceased than in the successive waves [40, 42]. However, age, presence of comorbidities, and inflammatory status on arrival at the ED did not differ in deceased patients from the three time periods, with the exception of CRP, which, although elevated in both, was significantly different.

Nevertheless, despite the temporal differences that have led to different hospital care scenarios, the emergence of new SARS-CoV-2 strains, the varying availability of resources, the use of treatments with a higher degree of clinical evidence, and the start of the vaccination campaign, the RIM Score-COVID nomogram has continued to demonstrate prognostic capacity in the three time cohorts, with an AUC in successive waves of 0.79 and 0.80.

Some factors, such as age, hypoxemia, abnormal blood count ratios, and increased acute phase reactants, have been identified as risk factors for mortality and worse prognosis [18, 19, 43]. Early identification of patients at risk for moderate or severe forms of COVID-19 could lead to more forceful clinical behavior in the ED and to reducing admission thresholds using blood count-derived ratios in patients with COVID-19, especially the novel NPR.

Our findings may reflect an underlying inflammatory state that would become evident on the nomogram when weighing and combining complete blood count (CBC) parameters with the other factors identified as relevant. CBC-derived ratios, including the NPR, have been shown to be independent markers of mortality and worse prognosis in COVID-19 patients [11–13].

Our study has some limitations. The research has been performed at different time points during the pandemic with all the implications described previously. However, this could also be considered a strength, as it has allowed for the validation of a simple nomogram in patients with confirmed SARS-CoV-2 infection. The study has been performed on patients in Spain, but given the demographic variations among patients from different regions of Spain, it is reasonable to expect the model to perform similarly in other populations. On the other hand, although patients with COVID-19 who were discharged home from the ED were not included in the study, all patients who required hospital admission were included; therefore, our model should be applied to patients who require hospital admission for COVID-19. Lastly, the data were collected from electronic medical records by attending physicians, so important information may have been missing.

During the different study periods, the treatment protocols for patients with COVID-19 changed based on the scientific evidence available at that time. This has led to changes in the therapeutic approach to patients in the different periods/waves of the disease. We believe this aspect lends greater value to our findings since, without assessing the treatments administered, the information obtained from the patient on arrival at the ED is independent of the therapeutic protocols indicated when predicting the risk of in-hospital death due to COVID-19. This logic can also be extended to the effects of different SARS-CoV-2 strains, since although the RIM Score-COVID was developed when the Alpha variant was predominant, its discriminatory capacity has also been proven with later strains, such as the Delta variant. Further studies are needed to demonstrate its discriminatory capacity in new variants such as Omicron. Finally, the SEMI-COVID-19 Registry was not designed to collect information on vaccination in T3, so these data could not be analyzed. However, Spain is one of the countries where vaccination against SARS-CoV-2 has been very successful, with a high percentage of vaccination coverage in population. Vaccination has been shown to reduce the severity of SARS-CoV-2 infection. However, the progression of COVID-19 infection in patients vaccinated against SARS-CoV-2 is well described and related to the time that has elapsed since full vaccination and host characteristics (high comorbidity and immunosuppression). This suggests that decreased immunity and impaired immune responses after vaccination could help explain the high mortality rate [44].

Conclusion

The RIM Score-COVID is an easy and practical quantitative prediction tool. The nomogram uses objective parameters that are easy to obtain and reproducible in most healthcare facilities that treat COVID-19 patients worldwide. It can be calculated at no added cost and without the need for additional laboratory tests. This tool has been validated in a large cohort of patients hospitalized for COVID-19 in different periods of the pandemic in a large number of Spanish hospitals.

These assessments provide further evidence on this highly accurate tool’s predictive ability of the risk of in-hospital COVID-19 mortality, which showed good prognostic ability in successive waves of the pandemic. Further studies are needed to determine the use of this nomogram to support clinical judgment in other populations and healthcare settings around the world.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 29 kb) (29.6KB, docx)
Supplementary file2 (DOCX 27 kb) (27KB, docx)

Acknowledgements

We gratefully acknowledge all the investigators and staff from the SEMI-COVID-19 Registry who participated in the collection of the patient data (see Appendix 1).

Funding

There are no sources of funding for this manuscript.

Data availability

J-M C-R. and J-M R-R have full access to the data and are the guarantors for the data.

Declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The project was approved by the Institutional Research Ethics Committee of Málaga on 27 March 2020 (Ethics Committee code: SEMI-COVID-19 27–03-20), as per the guidelines of the Spanish Agency of Medicines and Medical Products. All patients gave informed consent.

Informed consent

Only patients who had previously given consent for their medical records to be used for medical research were included in this registry. Data confidentiality and patient anonymity were always maintained, in accordance with Spanish regulations on observational studies.

Footnotes

Awards obtained: the RIM Score-COVID project was winner of the EpidemiXs–COVID Warriors Challenge of the V National Health Hackathon. Madrid, November 2020.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Alejandro López-Escobar, Email: lopezea@vithas.es.

for the SEMI-COVID-19 Network:

José Manuel Ramos Rincón, Carlos Lumbreras Bermejo, Jesús Millán Núñez-Cortés, Juan Miguel Antón Santos, Ricardo Gómez Huelgas, Xavier Corbella, Francesc Formiga Pérez, Narcís Homs, Abelardo Montero, Jose María Mora-Luján, Manuel Rubio-Rivas, Victoria Augustín Bandera, Javier García Alegría, Nicolás Jiménez-García, Jairo Luque del Pino, María Dolores Martín Escalante, Francisco Navarro Romero, Victoria Nuñez Rodriguez, Julián Olalla Sierra, Paloma Agudo de Blas, Coral Arévalo Cañas, Blanca Ayuso, José Bascuñana Morejón, Samara Campos Escudero, María Carnevali Frías, Santiago Cossio Tejido, Borja de Miguel Campo, Carmen Díaz Pedroche, Raquel Diaz Simon, Ana García Reyne, Laura Ibarra Veganzones, Lucia Jorge Huerta, Antonio Lalueza Blanco, Jaime Laureiro Gonzalo, Jaime Lora-Tamayo, Carlos Lumbreras Bermejo, Guillermo Maestro de la Calle, Rodrigo Miranda Godoy, Barbara Otero Perpiña, Diana Paredes Ruiz, Marcos Sánchez Fernández, Javier Tejada Montes, Ana María Álvarez Suárez, Carlos Delgado Vergés, Rosa Fernandez-Madera Martínez, Eva Mª Fonseca Aizpuru, Alejandro Gómez Carrasco, Cristina Helguera Amezua, Juan Francisco López Caleya, Diego López Martínez, María del Mar Martínez López, Aleida Martínez Zapico, Carmen Olabuenaga Iscar, Lucía Pérez Casado, María Luisa Taboada Martínez, Lara María Tamargo Chamorro, Laura Abarca Casas, Álvaro Alejandre de Oña, Rubén Alonso Beato, Leyre Alonso Gonzalo, Jaime Alonso Muñoz, Crhistian Mario Amodeo Oblitas, Cristina Ausín García, Marta Bacete Cebrián, Jesús Baltasar Corral, Maria Barrientos Guerrero, Alejandro D. Bendala Estrada, María Calderón Moreno, Paula Carrascosa Fernández, Raquel Carrillo, Sabela Castañeda Pérez, Eva Cervilla Muñoz, Agustín Diego Chacón Moreno, Maria Carmen Cuenca Carvajal, Sergio de Santos, Andrés Enríquez Gómez, Eduardo Fernández Carracedo, María Mercedes Ferreiro-Mazón Jenaro, Francisco Galeano Valle, Alejandra Garcia, Irene Garcia Fernandez-Bravo, María Eugenia García Leoni, María Gómez Antúnez, Candela González San Narciso, Anthony Alexander Gurjian, Lorena Jiménez Ibáñez, Cristina Lavilla Olleros, Cristina Llamazares Mendo, Sara Luis García, Víctor Mato Jimeno, Clara Millán Nohales, Jesús Millán Núñez-Cortés, Sergio Moragón Ledesma, Antonio Muiño Míguez, Cecilia Muñoz Delgado, Lucía Ordieres Ortega, Susana Pardo Sánchez, Alejandro Parra Virto, María Teresa Pérez Sanz, Blanca Pinilla Llorente, Sandra Piqueras Ruiz, Guillermo Soria Fernández-Llamazares, María Toledano Macías, Neera Toledo Samaniego, Ana Torres do Rego, Maria Victoria Villalba Garcia, Gracia Villarreal, María Zurita Etayo, Rafael Aragon Lara, Inmaculada Cimadevilla Fernandez, Juan Carlos Cira García, Gema Maria García García, Julia Gonzalez Granados, Beatriz Guerrero Sánchez, Francisco Javier Monreal Periáñez, Maria Josefa Pascual Perez, Jose Luis Beato Pérez, Maria Lourdes Sáez Méndez, Nicolás Alcalá Rivera, Anxela Crestelo Vieitez, Esther del Corral Beamonte, Jesús Díez Manglano, Isabel Fiteni Mera, Maria del Mar Garcia Andreu, Martin Gericó Aseguinolaza, Cristina Gallego Lezaun, Claudia Josa Laorden, Raul Martínez Murgui, Marta Teresa Matía Sanz, Mª Mar Ayala-Gutiérrez, Rosa Bernal López, José Bueno Fonseca, Verónica Andrea Buonaiuto, Luis Francisco Caballero Martínez, Lidia Cobos Palacios, Clara Costo Muriel, Francis de Windt, Ana Teresa Fernandez-Truchaud Christophel, Paula García Ocaña, Ricardo Gómez Huelgas, Javier Gorospe García, José Antonio Hurtado Oliver, Sergio Jansen-Chaparro, Maria Dolores López-Carmona, Pablo López Quirantes, Almudena López Sampalo, Elizabeth Lorenzo-Hernández, Juan José Mancebo Sevilla, Jesica Martín Carmona, Luis Miguel Pérez-Belmonte, Iván Pérez de Pedro, Araceli Pineda-Cantero, Carlos Romero Gómez, Michele Ricci, Jaime Sanz Cánovas, Jorge Álvarez Troncoso, Francisco Arnalich Fernández, Francisco Blanco Quintana, Carmen Busca Arenzana, Sergio Carrasco Molina, Aranzazu Castellano Candalija, Germán Daroca Bengoa, Alejandro de Gea Grela, Alicia de Lorenzo Hernández, Alejandro Díez Vidal, Carmen Fernández Capitán, Maria Francisca García Iglesias, Borja González Muñoz, Carmen Rosario Herrero Gil, Juan María Herrero Martínez, Víctor Hontañón, Maria Jesús Jaras Hernández, Carlos Lahoz, Cristina Marcelo Calvo, Juan Carlos Martín Gutiérrez, Monica Martinez Prieto, Elena Martínez Robles, Araceli Menéndez Saldaña, Alberto Moreno Fernández, Jose Maria Mostaza Prieto, Ana Noblejas Mozo, Carlos Manuel Oñoro López, Esmeralda Palmier Peláez, Marina Palomar Pampyn, Maria Angustias Quesada Simón, Juan Carlos Ramos Ramos, Luis Ramos Ruperto, Aquilino Sánchez Purificación, Teresa Sancho Bueso, Raquel Sorriguieta Torre, Clara Itziar Soto Abanedes, Yeray Untoria Tabares, Marta Varas Mayoral, Julia Vásquez Manau, Maria del Carmen Beceiro Abad, Maria Aurora Freire Romero, Sonia Molinos Castro, Emilio Manuel Paez Guillan, María Pazo Nuñez, Paula Maria Pesqueira Fontan, Antonio Pablo Arenas de Larriva, Pilar Calero Espinal, Javier Delgado Lista, Francisco Fuentes-Jiménez, María del Carmen Guerrero Martínez, María Jesús Gómez Vázquez, Jose Jiménez Torres, Laura Limia Pérez, José López-Miranda, Laura Martín Piedra, Marta Millán Orge, Javier Pascual Vinagre, Pablo Pérez-Martinez, María Elena Revelles Vílchez, Angela Rodrigo Martínez, Juan Luis Romero Cabrera, José David Torres-Peña, Marisa Asensio Tomás, David Balaz, David Bonet Tur, Ruth Cañizares Navarro, Paloma Chazarra Pérez, Jesús Corbacho Redondo, Eliana Damonte White, María Escamilla Espínola, Leticia Espinosa Del Barrio, Pedro Jesús Esteve Atiénzar, Carles García Cervera, David Francisco García Núñez, Francisco Garrido Navarro, Vicente Giner Galvañ, Angie Gómez Uranga, Javier Guzmán Martínez, Isidro Hernández Isasi, Lourdes Lajara Villar, Verónica Martínez Sempere, Juan Manuel Núñez Cruz, Sergio Palacios Fernández, Juan Jorge Peris García, Rafael Piñol Pleguezuelos, Andrea Riaño Pérez, José Miguel Seguí Ripoll, Azucena Sempere Mira, Philip Wikman-Jorgensen, Juan Alberto Aguilera Ayllón, Arturo Artero, María del Mar Carmona Martín, María José Fabiá Valls, Maria de Mar Fernández Garcés, Ana Belén Gómez Belda, Ian López Cruz, Manuel Madrazo López, Elisabeth Mateo Sanchis, Jaume Micó Gandia, Laura Piles Roger, Adela Maria Pina Belmonte, Alba Viana García, Ane Andrés Eisenhofer, Ana Arias Milla, Isolina Baños Pérez, Laura Benítez Gutiérrez, Javier Bilbao Garay, Jorge Calderón Parra, Alejandro Callejas Díaz, Erika Camacho Da Silva, MªCruz Carreño Hernández, Raquel Castejón Díaz, María Jesús Citores Sánchez, Carmen Cubero Gozalo, Valentín Cuervas-Mons Martínez, Laura Dorado Doblado, Sara de la Fuente Moral, Alberto Díaz de Santiago, Itziar Diego Yagüe, Ignacio Donate Velasco, Ana María Duca, Pedro Durán del Campo, Gabriela Escudero López, Esther Expósito Palomo, Ana Fernández Cruz, Amy Galán Gómez, Sonia García Prieto, Beatriz García Revilla, Miguel Ángel García Viejo, Javier Gómez Irusta, Patricia González Merino, Edith Vanessa Gutiérrez Abreu, Isabel Gutiérrez Martín, Ángela Gutiérrez Rojas, Andrea Gutiérrez Villanueva, Jesús Herráiz Jiménez, Fátima Ibáñez Estéllez, Pedro Laguna del Estal, Mª Carmen Máinez Sáiz, Carmen de Mendoza Fernández, María Martínez Urbistondo, Fernando Martínez Vera, María Mateos Seirul-lo, Susana Mellor Pita, Patricia A. Mills Sánchez, Esther Montero Hernández, Alberto Mora Vargas, Victor Moreno-Torres Concha, Ignacio Morrás De La Torre, Elena Múñez Rubio, Rosa Muñoz de Benito, Alejandro Muñoz Serrano, Pablo Navarro Palomo, Ilduara Pintos Pascual, Arturo José Ramos Martín-Vegue, Antonio Ramos Martínez, Celia Rodríguez Olleros, Alberto Roldán Montaud, Yolanda Romero Pizarro, Silvia Rosado García, Diana Ruiz de Domingo, David Sánchez Ortiz, Enrique Sánchez Chica, Irene Solano Almena, Elena Suanzes Martin, Yale Tung Chen, Pablo Tutor de Ureta, Ángela Valencia Alijo, Jose Manuel Vázquez Comendador, Juan Antonio Vargas Núñez, Inés Armenteros Yeguas, Javier Azaña Gómez, Julia Barrado Cuchillo, Irene Burruezo López, Noemí Cabello Clotet, Alberto E. Calvo Elías, Elpidio Calvo Manuel, Carmen María Cano de Luque, Cynthia Chocron Benbunan, Laura Dans Vilan, Claudia Dorta Hernández, Ester Emilia Dubon Peralta, Vicente Estrada Pérez, Santiago Fernandez-Castelao, Marcos Oliver Fragiel Saavedra, José Luis García Klepzig, Maria del Rosario Iguarán Bermúdez, Esther Jaén Ferrer, Alejandro Maceín Rodríguez, Alejandro Marcelles de Pedro, Rubén Ángel Martín Sánchez, Manuel Méndez Bailón, Sara Miguel Álvarez, Maria José Nuñez Orantos, Carolina Olmos Mata, Eva Orviz García, David Oteo Mata, Cristina Outon González, Juncal Perez-Somarriba, Pablo Pérez Mateos, Maria Esther Ramos Muñoz, Xabier Rivas Regaira, Laura Mª Rodríguez Gallardo, Iñigo Sagastagoitia Fornie, Alejandro Salinas Botrán, Miguel Suárez Robles, Maddalena Elena Urbano, Andrea María Vellisca González, Miguel Villar Martínez, Daniel Monge Monge, Eva María Ferreira Pasos, Alba Varela García, Luis Sáez Comet, Laura Letona Giménez, Uxua Asín Samper, Gonzalo Acebes Repiso, José Miguel García Bruñén, Mónica Llorente Barrio, María Aranzazu Caudevilla Martínez, Jesús Javier González Igual, Rosa García Fenoll, María Aguilera García, Ester Alonso Monge, Jesús Álvarez Rodríguez, Claudia Alvarez Varela, Miquel Berniz Gòdia, Marta Briega Molina, Marta Bustamante Vega, Jose Curbelo, Alicia de las Heras Moreno, Ignacio Descalzo Godoy, Alexia Constanza Espiño Alvarez, Ignacio Fernández Martín-Caro, Alejandra Franquet López-Mosteiro, Gonzalo Galvez Marquez, María José García Blanco, Yaiza García del Álamo Hernández, Clara García-Rayo Encina, Noemí Gilabert González, Carolina Guillamo Rodríguez, Nicolás Labrador San Martín, Manuel Molina Báez, Carmen Muñoz Delgado, Pedro Parra Caballero, Javier Pérez Serrano, Laura Rabes Rodríguez, Pablo Rodríguez Cortés, Carlos Rodriguez Franco, Emilia Roy-Vallejo, Monica Rueda Vega, Aresio Sancha Lloret, Beatriz Sánchez Moreno, Marta Sanz Alba, Jorge Serrano Ballesteros, Alba Somovilla, Carmen Suarez Fernández, Macarena Vargas Tirado, Almudena Villa Marti, José Francisco Pascual Pareja, Isabel Perales Fraile, Arturo Muñoz Blanco, Rafael del Castillo Cantero, José Luis Valle López, Isabel Rábago Lorite, Rebeca Fuerte Martínez, Inés Suárez García, Llanos Soler Rangel, Alicia Alonso Álvarez, Olaya Alonso Juarros, Ariadna Arévalo López, Carmen Casariego Castiñeira, Ana Cerezales Calviño, Marta Contreras Sánchez, Ramón Fernández Varela, Santiago J. Freire Castro, Ana Padín Trigo, Rafael Prieto Jarel, Fátima Raad Varea, Ignacio Ramil Freán, Laura Ramos Alonso, Francisco Javier Sanmartín Pensado, David Vieito Porto, Carmen Cortés Saavedra, Jennifer Fernández Gómez, Borja González López, María Soledad Hernández Garrido, Ana Isabel López Amorós, Santiago López Gil, Maria de los Reyes Pascual Pérez, Nuria Ramírez Perea, Andrea Torregrosa García, Judit Aranda Lobo, Lucía Feria Casanovas, Jose Loureiro Amigo, Miguel Martín Fernández, Isabel Oriol Bermúdez, Melani Pestaña Fernández, Nicolas Rhyman, Nuria Vázquez Piqueras, José Nicolás Alcalá Pedrajas, Antonia Márquez García, Inés Vargas, Irene Arroyo Jiménez, Marina Cazorla González, Marta Cobos-Siles, Luis Corral-Gudino, Pablo Cubero-Morais, María González Fernández, José Pablo Miramontes González, Marina Prieto Dehesa, Pablo Sanz Espinosa, Sonia Casallo Blanco, Jeffrey Oskar Magallanes Gamboa, Cristina Salazar Mosteiro, Andrea Silva Asiain, Juan Miguel Antón Santos, Ana Belén Barbero Barrera, Blanca Beamonte Vela, Coralia Bueno Muiño, Charo Burón Fernández, Ruth Calderón Hernáiz, Irene Casado López, José Manuel Casas Rojo, Andrés Cortés Troncoso, Pilar Cubo Romano, Francesco Deodati, Alejandro Estrada Santiago, Gonzalo García Casasola Sánchez, Elena García Guijarro, Francisco Javier García Sánchez, Pilar García de la Torre, Mayte de Guzmán García-Monge, Davide Luordo, María Mateos González, José A. Melero Bermejo, Cruz Pastor Valverde, José Luis Pérez Quero, Fernando Roque Rojas, Lorea Roteta García, Elena Sierra Gonzalo, Francisco Javier Teigell Muñoz, Juan Vicente de la Sota, Javier Villanueva Martínez, Miriam García Gómez, Pablo Ramírez Sánchez, Gorka Arroita Gonzalez, Alazne Lartategi Iraurgi, Asier Aranguren Arostegui, Paula Arriola Martínez, Isabel María Portales Fernández, Esther Martinez Becerro, Amalur Iza Jiménez, Cristian Vidal Núñez, María Aparicio López, Eduardo García López, Mª Soledad Azcona Losada, Beatriz Ruiz Estévez, Ana Maria Alguacil Muñoz, Marta Blanco Fernández, Veronica Cano, Ricardo Crespo Moreno, Fernando Cuadra Garcia-Tenorio, Blanca Díaz-Tendero Nájera, Raquel Estévez González, María Paz García Butenegro, Alberto Gato Díez, Verónica Gómez Caverzaschi, Piedad María Gómez Pedraza, Julio González Moraleja, Raúl Hidalgo Carvajal, Patricia Jiménez Aranda, Raquel Labra González, Áxel Legua Caparachini, Pilar Lopez Castañeyra, Agustín Lozano Ancin, Jose Domingo Martin Garcia, Cristina Morata Romero, María Jesús Moya Saiz, Helena Moza Moríñigo, Gemma Muñiz Nicolás, Enriqueta Muñoz Platon, Filomena Oliveri, Elena Ortiz Ortiz, Raúl Perea Rafael, Pilar Redondo Galán, María Antonia Sepulveda Berrocal, Vicente Serrano Romero de Ávila, Pilar Toledano Sierra, Yamilex Urbano Aranda, Jesús Vázquez Clemente, Carmen Yera Bergua, Andrés de la Peña Fernández, Almudena Hernández Milián, María Areses Manrique, Ainara Coduras Erdozain, Ane Labirua-Iturburu Ruiz, Francisco Javier Bejarano Luque, Francisco-Javier Carrasco-Sánchez, Mercedes de-Sousa-Baena, Jaime Díaz Leal, Aurora Espinar Rubio, Maria Franco Huertas, Juan Antonio García Bravo, Andrés Gonzalez Macías, Encarnación Gutiérrez Jiménez, Alicia Hidalgo Jiménez, Constantino Lozano Quintero, Carmen Mancilla Reguera, Francisco Javier Martínez Marcos, Francisco Muñoz Beamud, Maria Pérez-Aguilar, Alícia Pérez Jiménez, Virginia Rodríguez Castaño, Alvaro Sánchez dedel AlcazarRío, Leire Toscano Ruiz, Diana Alegre González, Irene Ariño Pérez de Zabalza, Sergio Arnedo Hernández, Jorge Collado Sáenz, Beatriz Dendariena, Marta Gómez del Mazo, Iratxe Martínez de Narvajas Urra, Sara Martínez Hernández, Estela Menendez Fernández, Jose Luís Peña Somovilla, Elisa Rabadán Pejenaute, Jesús Ballano Rodríguez-Solís, Luis Cabeza Osorio, María del Pilar Fidalgo Montero, Mª Isabel Fuentes Soriano, Erika Esperanza Lozano Rincón, Ana Martín Hermida, Jesús Martínez Carrilero, José Ángel Pestaña Santiago, Manuel Sánchez Robledo, Patricia Sanz Rojas, Nahum Jacobo Torres Yebes, Vanessa Vento, Luis Fernando Abrego Vaca, Ana Andréu Arnanz, Octavio Arce García, Marta Bajo González, Pablo Borque Sanz, Alberto Cozar Llisto, Sonia de Pedro Baena, Beatriz Del Hoyo Cuenda, Martin Fabregate-Fuente, María Alejandra Gamboa Osorio, Isabel García Sánchez, Andrés González García, Oscar Alberto López Cisneros, Luis Manzano, Miguel Martínez-Lacalzada, Borja Merino Ortiz, Jimena Rey-García, Elisa Riera González, Cristina Sánchez Díaz, Grisell Starita Fajardo, Cecilia Suárez Carantoña, Adrian Viteri-Noël, Svetlana Zhilina Zhilina, Gloria María Alonso Claudio, Víctor Barreales Rodríguez, Cristina Carbonell Muñoz, Adela Carpio Pérez, María Victoria Coral Orbes, Daniel Encinas Sánchez, Sandra Inés Revuelta, Miguel Marcos Martín, José Ignacio Martín González, José Ángel Martín Oterino, Leticia Moralejo Alonso, Sonia Peña Balbuena, María Luisa Pérez García, Ana Ramon Prados, Beatriz Rodríguez-Alonso, Ángela Romero Alegría, Maria Sanchez Ledesma, Rosa Juana Tejera Pérez, Julio César Blázquez Encinar, Carmen Martínez Cilleros, Isabel Jiménez Martínez, Teresa García Delange, Raquel Fernández González, Amara Gonzalez Noya, Carlos Hernández Ceron, Isabel Izuzquiza Avanzini, Ana Latorre Diez, Pablo López Mato, Ana María Lorenzo Vizcaya, Daniel Peña Benítez, Milagros María Peña Zemsch, Lucía Pérez Expósito, Marta Pose Bar, Lara Rey González, Laura Rodrigo Lara, Dafne Cabañero, María Calabuig Ballester, Pascual Císcar Fernández, Ricardo Gil Sánchez, Marta Jiménez Escrig, Cristina Marín Amela, Laura Parra Gómez, Carlos Puig Navarro, José Antonio Todolí Parra, Carlota Tuñón de Almeida, María Esther Fraile Villarejo, Victoria Palomar Calvo, Sara Pintos Otero, Beatriz García López, Carlos Aldasoro Frías, Víctor Madrid Romero, Luis Arribas Pérez, Emilia Martínez Velado, Raquel Aranega González, Ramon Boixeda, Javier Fernández Fernández, Carlos Lopera Mármol, Marta Parra Navarro, Ainhoa Rex Guzmán, Aleix Serrallonga Fustier, José López Castro, Manuel Lorenzo López Reboiro, Cristina Sardiña González, Enrique Rodilla Sala, Jose María Pascual Izuel, Zineb Karroud Zamrani, Hortensia Alvarez Diaz, Tamara Dalama Lopez, Estefania Martul Pego, Carmen Mella Pérez, Ana Pazos Ferro, Sabela Sánchez Trigo, Dolores Suarez Sambade, Maria Trigas Ferrin, Maria del Carmen Vázquez Friol, Laura Vilariño Maneiro, Begoña Cortés Rodríguez, María Esther Guisado Espartero, Lorena Montero Rivas, Maria de la Sierra Navas Alcántara, Raimundo Tirado-Miranda, Marta Nataya Solís Marquínez, Víctor Arenas García, Demelsa Blanco Suárez, Natalia García Arenas, Paula Martínez García, David Castrodá Copa, Andrea Álvarez García, Jaime Casal Álvarez, María Jose Menéndez Calderón, Raquel García Noriega, María Caño Rubia, Joaquin Llorente García, Luis Trapiella Martínez, José Ferreiro Celeiro, Diego Eduardo Olivo Aguilar, Irene Maderuelo Riesco, Juan Valdés Bécares, Alba Barragán Mateos, Andrés Astur Treceño García, Joaquín Delgado Casamayor, Diego García Silvera, Andrea Afonso Díaz, Carolina Hernández Carballo, Alicia Tejera, María José Monedero Prieto, María Blanca Monereo Muñoz, José Manuel Del Arco Delgado, Daniel Rodríguez Díaz, Marta Bethencourt Feria, Francisco Javier Herrera Herrera, María de la Luz Padilla Salazar, Rubén Hernández Luis, Eduardo Mauricio Calderón Ledezma, María del Mar López Gámez, Laura Torres Hernández, Sara Castaño Pérez, Selena Gala Aguilera García, Guillermo Castro Gainett, Alba Gómez Hidalgo, Julia Marfil Daza, Marcelino Hayek Peraza, Reyes Aparicio Santos, Máximo Bernabeu-Wittel, Santiago Rodríguez Suárez, María Nieto, Luis Giménez Miranda, Rosa María Gámez Mancera, Fátima Espinosa Torre, Carlos Hernandez Quiles, Concepción Conde Guzmán, Juan Delgado de la Cuesta, Jara Eloisa Ternero Vega, María del Carmen López Ríos, Pablo Díaz Jiménez, Bosco Baron Franco, Carlos Jiménez de Juan, Sonia Gutiérrez Rivero, Julia Lanseros Tenllado, Verónica Alfaro Lara, Aurora González Estrada, Javier Ena, José Enrique Gómez Segado, Ruth Gonzalez Ferrer, Virginia Gracia Lorenzo, Raquel Monsalvo Arroyo, Marcos Guzmán García, Francisco Javier Vicente Hernández, Ángel Luis Martínez González, Beatriz Vicente Montes, Rosario María García Die, Alberto Muela Molinero, Manuel Martín Regidor, Raquel Rodríguez Díez, Bárbara Hernández Sierra, Luis Felipe Díez García, Iris El Attar Acedo, Carmen Mar Sánchez Cano, Virginia Herrero García, Berta Román Bernal, Júlia Calvo Jiménez, Emmanuel Coloma Bazán, Aina Capdevila Reniu, Joan Ribot Grabalosa, Joaquim Fernández Solà, Irene Carbonell De Boulle, Cristina Gabara Xancó, Olga Rodríguez Núñez, Carlos Jorge Ripper, Anyuli Gracia Gutiérrez, Leticia Esther Royo Trallero, Marta Fernández-Ayala Novo, José Javier Napal Lecumberri, Nuria Puente Ruiz, Jose Riancho, Isabel Sampedro García, Pablo Conde Baena, Joaquín Escobar Sevilla, Laura Gallo Padilla, Patricia Gómez Ronquillo, Pablo González Bustos, María Navío Botías, Jessica Ramírez Taboada, Mar Rivero Rodríguez, Víctor Asensi Alvarez, Noelia Morán Suárez, Sara Rodríguez Suárez, Silvia Suárez Díaz, Lucia Suárez Pérez, Maria Folgueras Gómez, Claudia Moran Castaño, Lucía Meijide Rodríguez, Carlos Vázquez, Itxasne Cabezón Estévanez, Carmen Yllera Gutiérrez, Maria Martinez Sela, Sara Fuente Cosío, César Manuel Gallo Álvaro, Julia Lobo García, Antía Pérez Piñeiro, Yolanda Casillas Viera, Lucía Cayuela Rodríguez, Carmen de Juan Alvarez, Gema Flox Benitez, Laura García Escudero, Juan Martin Torres, Patricia Moreira Escriche, Susana Plaza Canteli, MCarmen Romero Pérez, Jorge Andrés Soler, Marián Bennasar Remolar, Alejandro Cardenal Álvarez, Daniela Díaz Carlotti, María José Esteve Gimeno, Sergio Fabra Juana, Paula García López, María Teresa Guinot Soler, Daniela Palomo de la Sota, Guillem Pascual Castellanos, Ignacio Pérez Catalán, Celia Roig Martí, Paula Rubert Monzó, Javier Ruiz Padilla, Nuria Tornador Gaya, Jorge Usó Blasco, MAngeles Martinez Pascual, Leyre Jorquer Vidal, Ana Alberich Conesa, Mari Cruz Almendros Rivas, Miquel Hortos Alsina, José Marchena Romero, Anabel Martin-Urda Diez-Canseco, Francisco Amorós Martínez, Erika Ascuña Vásquez, José Carlos Escribano Stablé, Adriana Hernández Belmonte, Ana Maestre Peiró, Raquel Martínez Goñi, M. Carmen Pacheco Castellanos, Bernardino Soldan Belda, David Vicente Navarro, Ana Suárez Lombraña, Jon Cabrejas Ugartondo, Ana Belén Mancebo Plaza, Arturo Noguerado Asensio, Bethania Pérez Alves, Natalia Vicente López, Marta León Téllez, Francisco Epelde, Isabel Torrente, Pablo Guisado Vasco, Ana Roda Santacruz, Ana Valverde Muñoz, Mª José Esteban Giner, Alejo Erice Calvo-Sotelo, Eva García Sardón, Javier Galán González, Luis Gámez Salazar, Angela Agea Garcia, Itziar Montero Días, Alvaro Santaella Gomez, Marta Correa Matos, Selene Núñez Gaspar, Antonio González Nieto, Raquel Gómez Méndez, Ana Rodríguez Álvarez, Onán Pérez Hernández, Alina Pérez Ramírez, María Candelaria Martín González, Miguel Nicolas Navarrete Lorite, Lourdes González Navarrete, Julio Cesar Alvisa Negrin, José Fernando Armas González, Iballa Jiménez, Paula Ortega Toledo, Esther Martin Ponce, Xjoylin Teresita Egües Torres, Sara Gutiérrez González, Cristina Novoa Fernández, Pablo Tellería Gómez, Oriol Alonso Gisbert, Mercé Blázquez Llistosella, Pere Comas Casanova, Angels Garcia Flores, Anna Garcia Hinojo, Ana Inés Méndez Martínez, Maria del Carmen Nogales Nieves, Agnés Rivera Austrui, Alberto Zamora Cervantes, Vanesa Alende Castro, Ana María Baz Lomba, Ruth Brea Aparicio, Marta Fernández Morales, Jesús Manuel Fernández Villar, María Teresa López Monteagudo, Cristina Pérez García, Lorena Rodríguez Ferreira, Diana Sande Llovo, Maria Begoña Valle Feijoo, Juan Antonio Montes Romero, Jose Luis Serrano Carrillo de Albornoz, Manuel Jesus Soriano Pérez, Encarna Sánchez Martín, Thamar Capel Astrua, Paola Tatiana Garcia Giraldo, Maria Jesús González Juárez, Victoria Marquez Fernandez, Ada Viviana Romero Echevarry, José F. Varona Arche, María Gloria Rojano Rivero, Adrián Montaño Martínez, Reina Valle Bernad, Cristina Limia, Cristina Amado Fernández, Andrea Tejero Fernández, Lucia Paz Fajardo, Tomás de Vega Santos, Antonio López Ruiz, and Hector Meijide Míguez

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Associated Data

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Supplementary Materials

Supplementary file1 (DOCX 29 kb) (29.6KB, docx)
Supplementary file2 (DOCX 27 kb) (27KB, docx)

Data Availability Statement

J-M C-R. and J-M R-R have full access to the data and are the guarantors for the data.

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