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El manejo cl&#237;nico de estos procesos requiere valorar evolutivamente el intercambio pulmonar de gases&#44; lo que preferentemente se lleva a cabo mediante la gasometr&#237;a arterial&#44; aunque para disminuir la invasividad se suele monitorizar su evoluci&#243;n mediante la oximetr&#237;a&#46; La variable m&#225;s utilizada en la valoraci&#243;n de la gravedad de la hipoxemia y la evoluci&#243;n del paciente es la presi&#243;n parcial de ox&#237;geno &#40;PaO<span class="elsevierStyleInf">2</span>&#41;&#44; as&#237; como su relaci&#243;n con la concentraci&#243;n de gas administrada &#40;fracci&#243;n inspiratoria de ox&#237;geno &#91;FiO<span class="elsevierStyleInf">2</span>&#93;&#41;&#44; variable conocida como PaFi &#40;PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a>&#46; La PaO<span class="elsevierStyleInf">2</span> es importante para conocer el contenido total de ox&#237;geno que desde la sangre arterial &#40;CaO<span class="elsevierStyleInf">2</span>&#41; puede llegar a los tejidos&#44; ya que es determinante tanto en la cantidad de gas unido a la hemoglobina como en el disuelto en el plasma<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a>&#46; La primera es mucho m&#225;s importante &#40;un 95&#37; del CaO<span class="elsevierStyleInf">2</span>&#41; y se expresa mediante el porcentaje de saturaci&#243;n de dicha mol&#233;cula &#40;SaO<span class="elsevierStyleInf">2</span>&#41;&#46; Sin embargo&#44; recientemente se ha reportado en un estudio realizado <span class="elsevierStyleItalic">in silico</span> que el SARS-CoV-2 ser&#237;a capaz de dificultar la uni&#243;n entre hemoglobina y ox&#237;geno mediante algunas de sus prote&#237;nas &#40;por ejemplo&#44; ORF8&#41;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">6&#44;7</span></a> e incluso destruir mol&#233;culas de hemoglobina<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">6&#44;7</span></a>&#46; Un estudio todav&#237;a m&#225;s reciente&#44; realizado sobre hemat&#237;es de pacientes con COVID-19 mediante determinaciones prote&#243;mica y lipid&#243;mica&#44; tambi&#233;n sugiere que pueda existir una menor afinidad entre el ox&#237;geno y la hemoglobina en estos pacientes<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a>&#46; Las consecuencias cl&#237;nicas de estos dos estudios podr&#237;an ser importantes&#44; ya que limitar&#237;an el valor de la PaO<span class="elsevierStyleInf">2</span> y de la PaFi en la evaluaci&#243;n del estado real de oxigenaci&#243;n del paciente con COVID-19<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a>&#46; Dado que existen numerosas ecuaciones validadas que permiten calcular la saturaci&#243;n que corresponde a una determinada presi&#243;n parcial de ox&#237;geno&#44; y teniendo en cuenta los otros factores principales implicados&#44; la diferencia entre dicha variable y la saturaci&#243;n real del paciente permite inferir si la afinidad del gas por la mol&#233;cula de hemoglobina se ha visto afectada o no por el virus&#46; El objetivo del presente estudio fue analizar la concordancia entre la SaO<span class="elsevierStyleInf">2</span> medida y la estimada a partir de la PaO<span class="elsevierStyleInf">2</span>&#44; con el fin de valorar si la infecci&#243;n tiene realmente efectos sobre la afinidad del ox&#237;geno sobre la hemoglobina&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">M&#233;todo</span><p id="par0015" class="elsevierStylePara elsevierViewall">El presente estudio se llev&#243; a cabo analizando todas las muestras de gasometr&#237;a arterial y venosa procedentes de pacientes con COVID-19 &#40;confirmaci&#243;n por reacci&#243;n en cadena de la polimerasa o PCR en frotis nasal o far&#237;ngeo&#41;&#44; obtenidas en el laboratorio central de nuestro centro entre los meses de marzo y abril de 2020&#46; En total fueron 549 muestras de sangre arterial procedentes de 139 pacientes&#44; y adicionalmente 544 muestras venosas extra&#237;das en 215 enfermos&#46; Se descartaron otras gasometr&#237;as&#44; al estar realizadas y procesadas en otros dispositivos asistenciales&#44; con criterios de calibraci&#243;n y mantenimiento instrumental levemente diferentes&#46; Tambi&#233;n se incluyeron las gasometr&#237;as de dos grupos control&#58; el primero formado por pacientes sincr&#243;nicos al primer grupo&#44; con cuadros febriles&#44; pero radiolog&#237;a no sugestiva de afectaci&#243;n por SARS-CoV-2 y PCR negativa para dicho virus &#40;251 muestras arteriales de 73 enfermos y 1&#46;069 muestras venosas correspondientes a 379 pacientes&#41;&#44; y el segundo constituido por sujetos ingresados en los dos meses anteriores a la detecci&#243;n de los primeros casos de infecci&#243;n por SARS-CoV-2 y por cuadros pulmonares no parenquimatosos &#40;2&#46;614 muestras arteriales procedentes de 1&#46;089 enfermos y 3&#46;098 muestras venosas de 1&#46;461 pacientes&#41;&#46; La inclusi&#243;n de muestras arteriales y venosas se debi&#243; al inter&#233;s en analizar la afinidad del ox&#237;geno por la hemoglobina en un amplio rango de presiones arteriales de dicho gas&#46; De acuerdo con el Comit&#233; de &#201;tica de la Investigaci&#243;n Cl&#237;nica &#40;CEIC&#41; de la instituci&#243;n&#44; los pacientes dieron inicialmente su consentimiento verbal para la inclusi&#243;n de sus datos cl&#237;nicos y anal&#237;ticos&#44; con aprobaci&#243;n posterior en el marco de un estudio sobre pacientes graves con COVID-19 &#40;ref&#46; 2020&#47;9458&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">T&#233;cnicas</span><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Gasometr&#237;a arterial y venosa</span>&#58; La primera se realiz&#243; mediante punci&#243;n de la arteria radial y siguiendo las indicaciones de la Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41; para la obtenci&#243;n y preservaci&#243;n de la muestra<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">9</span></a>&#44; mientras que la segunda se obtuvo por venopunci&#243;n&#44; generalmente de la cubital&#44; aunque tambi&#233;n de la cef&#225;lica o la bas&#237;lica&#46;Las gasometr&#237;as mencionadas fueron analizadas en aparatos de medici&#243;n de gases Rapidpoint 405 &#40;Siemens&#44; M&#250;nich&#44; Alemania&#41;&#44; dotados de cooximetr&#237;a para la medida de la saturaci&#243;n de ox&#237;geno&#44; fuera en sangre arterial &#40;SaO<span class="elsevierStyleInf">2</span>&#41; o venosa sist&#233;mica &#40;SvO<span class="elsevierStyleInf">2</span>&#41;&#46; Adem&#225;s&#44; se obtuvieron los restantes par&#225;metros est&#225;ndar de gasometr&#237;a&#46; Los controles de calidad fueron los recomendados por los proveedores&#44; con 3 <span class="elsevierStyleItalic">runs</span> diarios del l&#237;quido de ajustes&#46; Los valores medidos de las variables antes mencionadas se compararon en cada uno de los grupos con los obtenidos por su c&#225;lculo mediante las ecuaciones de Kelman&#44; Severinghaus y Siggaard-Andersen<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">10&#8211;12</span></a>&#44; que los estiman fundamentalmente a partir de la PaO<span class="elsevierStyleInf">2</span> medida&#44; teniendo en cuenta tambi&#233;n las desviaciones de la curva de saturaci&#243;n&#46; Adem&#225;s&#44; se dispon&#237;a del valor de hemoglobina en sangre en el momento de la punci&#243;n&#44; ya que es proporcionado por el mismo medidor de gases &#40;valores normales en nuestro laboratorio&#44; 12&#44;0 a 17&#44;0 g&#47;dL&#41;&#46; Dentro de la anal&#237;tica general de los pacientes con COVID-19 tambi&#233;n se valor&#243; la ferritina en sangre &#40;valores normales en nuestro laboratorio&#44; 30 a 400 ng&#47;mL&#41;&#44; mediante inmunoensayo electroquimioluminiscente &#40;ECLIA&#41; en &#171;<span class="elsevierStyleItalic">sandwich</span>&#187; &#40;analizador Cobas 8000 e801&#44; Roche&#44; Basel&#44; Suiza&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">An&#225;lisis estad&#237;stico</span><p id="par0025" class="elsevierStylePara elsevierViewall">Tras comprobar la normalidad en sus distribuciones&#44; se procedi&#243; a mostrar los valores de las variables como media y desviaci&#243;n est&#225;ndar de esta&#46; Los valores medidos y calculados de la SaO<span class="elsevierStyleInf">2</span> y la SvO<span class="elsevierStyleInf">2</span> para un mismo grupo fueron comparados con an&#225;lisis de la varianza de tipo aleatorio de dos v&#237;as &#40;<span class="elsevierStyleItalic">two-way random ANOVA</span>&#41;&#44; con obtenci&#243;n del CCI como expresi&#243;n de la consistencia&#44; emple&#225;ndose la misma aproximaci&#243;n para las comparaciones entre los tres grupos&#46; La relaci&#243;n entre variables se analiz&#243; con el coeficiente de Pearson y regresi&#243;n lineal&#46; Tambi&#233;n se efectu&#243; un an&#225;lisis de concordancia mediante la representaci&#243;n de Bland-Altman&#44; basado en la media de las diferencias<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">13</span></a>&#46; Dado que a PaO<span class="elsevierStyleInf">2</span> superiores a 100 mmHg podr&#237;a producirse un efecto meseta sobre la SaO<span class="elsevierStyleInf">2</span>&#44; se efectu&#243; un an&#225;lisis <span class="elsevierStyleItalic">post hoc</span> adicional censurando dichos valores&#46; En todas las pruebas se ha considerado como significativo un valor de p &#60; 0&#44;05&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Resultados</span><p id="par0030" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> aparecen las caracter&#237;sticas generales y cl&#237;nicas m&#225;s relevantes de los pacientes&#44; mientras que en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se muestran los valores medios de sus gasometr&#237;as arteriales y venosas para cada uno de los tres grupos&#46; En el grupo con COVID-19&#44; la SaO<span class="elsevierStyleInf">2</span> medida por cooximetr&#237;a fue pr&#225;cticamente superponible a la calculada por las diferentes ecuaciones &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; Los resultados fueron similares en sangre venosa&#46; Por otra parte&#44; las correlaciones entre SaO<span class="elsevierStyleInf">2</span> medida y calculada y entre SvO<span class="elsevierStyleInf">2</span> medida y calculada mostraron asimismo valores muy elevados&#44; con la l&#237;nea de regresi&#243;n muy cercana a la de identidad &#40;<a class="elsevierStyleCrossRef" href="#fig0005">figura 1 del manuscrito y figura A&#40;a&#41; del suplemento <span class="elsevierStyleItalic">on line</span></a>&#41;&#59; resultados corroborados adem&#225;s por el an&#225;lisis de consistencia&#44; en que los valores de los CCI fueron siempre superiores a 0&#44;98 &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; Situaci&#243;n que tambi&#233;n es evidente en la gr&#225;fica de Bland-Altman &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Por otra parte&#44; los pacientes mostraban unos valores medios de presi&#243;n parcial de di&#243;xido de carbono &#40;PCO<span class="elsevierStyleInf">2</span>&#41; y de pH dentro de la normalidad&#44; tanto en sangre arterial como venosa&#46; No se observaron relaciones de inter&#233;s entre variables cl&#237;nicas y las diferencias entre saturaciones medidas y calculadas&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Los resultados no fueron sustancialmente diferentes en ninguno de los dos grupos control&#46; El de pacientes sincr&#243;nicos con PCR negativa para SARS-CoV-2 tampoco mostr&#243; diferencias entre la saturaci&#243;n medida y la calculada con las diferentes ecuaciones&#44; tanto en sangre arterial como venosa&#46; Lo mismo sucedi&#243; con el grupo de pacientes sin patolog&#237;a infecciosa&#44; cuyos an&#225;lisis gasom&#233;tricos fueron efectuados en los meses anteriores a la pandemia&#46; Tambi&#233;n en estos dos casos las correlaciones y CCI fueron altamente significativos&#46; El valor de hemoglobina y la ferritina fueron algo superiores en el grupo con COVID-19&#44; comparado con ambos grupos control&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">En el an&#225;lisis <span class="elsevierStyleItalic">post hoc</span>&#44; con exclusi&#243;n de las gasometr&#237;as con valores de PaO<span class="elsevierStyleInf">2</span> superiores a 100 mm Hg&#44; tampoco se objetivaron diferencias entre la SaO<span class="elsevierStyleInf">2</span> medida y los valores calculados para esta variable con cualquiera de las tres ecuaciones y para ninguno de los tres grupos del estudio &#40;<a class="elsevierStyleCrossRef" href="#sec0050">tablas A y B&#44; y figura A del suplemento <span class="elsevierStyleItalic">on line</span></a>&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discusi&#243;n</span><p id="par0045" class="elsevierStylePara elsevierViewall">El resultado principal del presente estudio es la demostraci&#243;n de que la infecci&#243;n activa por SARS-CoV-2 no modifica de forma sustancial la relaci&#243;n entre PaO<span class="elsevierStyleInf">2</span> y SaO<span class="elsevierStyleInf">2</span>&#46; Esto es especialmente relevante para el manejo cl&#237;nico de los pacientes con afectaci&#243;n pulmonar debida a COVID-19&#46; Adem&#225;s&#44; tampoco se observ&#243; afectaci&#243;n de la afinidad del ox&#237;geno por la hemoglobina en sangre venosa&#44; ni una reducci&#243;n de dicha mol&#233;cula secundaria a la infecci&#243;n&#46;Un estudio reciente&#44; realizado <span class="elsevierStyleItalic">in silico</span>&#44; suger&#237;a que diversas prote&#237;nas de superficie del virus &#40;como ORF8 y quiz&#225;s alguna otra glicoprote&#237;na&#41; ser&#237;an capaces de dificultar la uni&#243;n entre el hierro de la mol&#233;cula de hemoglobina y el ox&#237;geno<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">6&#44;14</span></a>&#44; dificultando as&#237; el transporte del gas a los tejidos&#44; aunque se mantuviera una PaO<span class="elsevierStyleInf">2</span> adecuada&#46; Esto tendr&#237;a adem&#225;s como consecuencia que esta &#250;ltima variable solo tendr&#237;a un valor relativo en el manejo de los pacientes&#44; al no reflejar su estado real de oxigenaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">7&#44;14</span></a>&#46; M&#225;s recientemente a&#250;n&#44; y utilizando t&#233;cnicas &#243;micas&#44; otro grupo ha descrito alteraciones proteicas y lip&#237;dicas que afectan a la membrana de los hemat&#237;es&#44; y que tambi&#233;n podr&#237;an condicionar una menor afinidad del ox&#237;geno por la hemoglobina para una determinada presi&#243;n parcial del gas<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a>&#46; En circunstancias normales&#44; se sabe que dicha presi&#243;n permite predecir con aceptable aproximaci&#243;n la saturaci&#243;n de la hemoglobina&#44; ya que ambas variables mantienen una relaci&#243;n conocida&#44; en forma de &#171;<span class="elsevierStyleItalic">S</span>&#187; it&#225;lica&#46; A valores altos o muy bajos de presi&#243;n&#44; los cambios de saturaci&#243;n son relativamente peque&#241;os&#59; sin embargo&#44; cuando la primera desciende por debajo de 60 mm Hg se producen descensos dram&#225;ticos de la segunda<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">5&#44;15</span></a>&#46; Ciertamente hay factores que pueden modificar la relaci&#243;n entre ambas variables&#44; desplazando la curva hacia la izquierda o la derecha&#46; Los m&#225;s importantes son la temperatura&#44; la PaCO<span class="elsevierStyleInf">2</span>&#44; el pH y la concentraci&#243;n del 2-3-difosfoglicerato<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a>&#44; as&#237; como la presencia de hemoglobinas an&#243;malas&#44; que ser&#237;a el caso sugerido para la infecci&#243;n por SARS-CoV-2&#46; En circunstancias cl&#237;nicas&#44; estos desplazamientos no son tenidos habitualmente en cuenta&#44; pero s&#237; que se utilizan para el c&#225;lculo de la saturaci&#243;n cuando esta no se ha podido determinar directamente&#46; Esto ya no es frecuente&#44; debido a que la mayor&#237;a de los medidores de gases actuales incorporan la cooximetr&#237;a&#46; Sin embargo&#44; esta t&#233;cnica no se hallaba disponible hasta hace relativamente pocos a&#241;os&#44; por lo que se desarrollaron diversas ecuaciones de predicci&#243;n de la saturaci&#243;n &#40;siendo las de Kelman&#44; Severinghaus y Siggaard-Andersen&#44; las que ofrecen mejores concordancias con la saturaci&#243;n medida&#41;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">10&#8211;12&#44;16</span></a>&#46; Para el presente estudio&#44; estas mismas ecuaciones han permitido predecir la saturaci&#243;n que corresponder&#237;a a una determinada presi&#243;n de ox&#237;geno y a los otros factores mencionados&#44; tanto en sangre arterial como venosa y en una muestra amplia tanto de pacientes como de extracciones sangu&#237;neas&#46; Nuestros resultados indican que utilizando cualquiera de las principales ecuaciones no existen diferencias relevantes cl&#237;nicamente entre la saturaci&#243;n medida por cooximetr&#237;a y las calculadas&#44; desmintiendo contundentemente y en situaci&#243;n cl&#237;nica real&#44; la hip&#243;tesis de una alteraci&#243;n relevante de la afinidad del ox&#237;geno por la hemoglobina&#44; como consecuencia de la infecci&#243;n por SARS-CoV-2&#46; Muy recientemente&#44; un grupo brit&#225;nico tambi&#233;n ha sugerido que dicha hip&#243;tesis pudiera ser falsa en un peque&#241;o estudio piloto con 14 muestras de gasometr&#237;a arterial procedentes de pacientes con COVID-19<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a>&#46; En este sentido&#44; sus resultados utilizando una metodolog&#237;a diferente y basada en el c&#225;lculo de la P<span class="elsevierStyleInf">50</span>&#44; son coincidentes con los nuestros&#46; Sin embargo&#44; la situaci&#243;n real respecto de la afinidad del ox&#237;geno por la hemoglobina en estos enfermos sigue siendo debatida<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">18&#44;19</span></a>&#46; Los presentes resultados mueven tambi&#233;n a una reflexi&#243;n adicional&#44; consistente en recordar el enorme espacio que existe entre las aproximaciones <span class="elsevierStyleItalic">in s&#237;lico</span> o <span class="elsevierStyleItalic">in vitro</span> y las circunstancias observables en la cl&#237;nica humana&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">El trabajo <span class="elsevierStyleItalic">in s&#237;lico</span> antes mencionado tambi&#233;n suger&#237;a que otras prote&#237;nas virales&#44; como orf1ab&#44; ORF3a y ORF10&#44; desnaturalizar&#237;an la estructura de la mol&#233;cula de hemoglobina liberando el hierro&#44; con lo que los grupos hemo preexistentes pasar&#237;an a ser simples porfirinas&#44; sin capacidad de transportar ox&#237;geno<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a>&#46; Esto tendr&#237;a impacto en el CaO<span class="elsevierStyleInf">2</span>&#44; ya que este depende predominantemente del gas unido a la hemoglobina&#44; con disminuci&#243;n subsiguiente del aporte a los tejidos<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a>&#46; El presente estudio tampoco sustenta dicha hip&#243;tesis&#44; ya que ha permitido comprobar que los valores sangu&#237;neos de hemoglobina en los enfermos con COVID-19 eran incluso algo superiores a los de los grupos control&#46; Sin embargo&#44; algunos trabajos han reportado descensos de la hemoglobina en este tipo de enfermos<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">20&#8211;22</span></a>&#46; En general&#44; dichos estudios no han incluido grupos control con enfermedad grave&#44; en los que las extracciones de sangre y los descensos de hemoglobina son muy frecuentes&#46; Por otra parte&#44; y como en el presente trabajo&#44; otros autores han reportado incrementos en la ferritina s&#233;rica en pacientes con COVID-19<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">23</span></a>&#44; lo que se ha relacionado con un eventual papel de esta mol&#233;cula para tamponar el hierro liberado por la hemoglobina<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a>&#46; El hierro es esencial para la replicaci&#243;n viral&#44; y quiz&#225;s por ello numerosos virus son capaces de interferir en la homeostasis de este metal<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">24</span></a>&#46; Sin embargo&#44; todav&#237;a no se conoce si este podr&#237;a ser tambi&#233;n el caso del SARS-CoV-2&#46; Por otra parte&#44; los macr&#243;fagos juegan un papel importante en la regulaci&#243;n de la homeostasis del hierro&#44; ya que previenen la liberaci&#243;n de mol&#233;culas de hemoglobina por parte de los hemat&#237;es<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a>&#46; Sin embargo&#44; un exceso de grupos hemo tambi&#233;n puede ayudar a activar el sistema de inmunidad innata&#44; desencadenando la orientaci&#243;n proinflamatoria de los macr&#243;fagos<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">26&#44;27</span></a>&#44; lo que parece ser un desencadenante clave de la tormenta inflamatoria propia de la COVID-19<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a>&#46;</p><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Limitaciones del estudio</span><p id="par0055" class="elsevierStylePara elsevierViewall">Ciertamente el grupo control de pacientes con PCR negativa para SARS-CoV-2 puede contener alg&#250;n sujeto con COVID-19&#44; ya que la sensibilidad de esta prueba no es del 100&#37;&#44; y adem&#225;s algunos enfermos podr&#237;an estar en una fase con escasa poblaci&#243;n viral&#46; Esta fue la raz&#243;n de a&#241;adir un segundo grupo control&#44; formado por pacientes cuya estancia hospitalaria fue previa a la observaci&#243;n de casos COVID-19 en nuestro medio&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Por otra parte&#44; es posible que alguna muestra solicitada y consignada como arterial se correspondiera finalmente con una muestra venosa&#46; Aunque dicha posibilidad se minimiz&#243; en la medida de lo posible puede haber ocurrido de forma ocasional&#46; No obstante&#44; tambi&#233;n en estos casos la similitud entre saturaci&#243;n medida y calculada ser&#237;a &#250;til para el objetivo del estudio&#44; distorsionando adem&#225;s m&#237;nimamente los valores globales de las muestras clasificadas como arteriales o venosas&#46; Por otra parte&#44; debemos reconocer un cierto grado menor de incertidumbre respecto al desplazamiento real de la curva de saturaci&#243;n de la hemoglobina&#44; al no disponer de algunos factores menores que pueden influirla&#46; Sin embargo&#44; los m&#225;s relevantes s&#237; se han utilizado en las ecuaciones&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Llama la atenci&#243;n que los pacientes con COVID-19 del presente estudio mostraban una hemoglobina algo superior a la de los otros dos grupos&#44; en contra de lo reportado en parte de la literatura &#40;fundamentalmente en pacientes graves o con comorbilidades&#41;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">1&#44;21&#8211;23</span></a>&#44; y sugerido por uno de los dos art&#237;culos que analizan los mecanismos para la desnaturalizaci&#243;n de la mol&#233;cula<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a>&#44; sino al contrario&#46; Esto adem&#225;s motiv&#243; que en el primer grupo se evidenciara un contenido de ox&#237;geno en sangre algo superior&#46; Pensamos que el mantenimiento de la cifra de hemoglobina en los pacientes con COVID-19 fue debido a que durante la pandemia se fue muy estricto en minimizar las extracciones de sangre&#44; reduci&#233;ndose incluso las puramente asistenciales y tom&#225;ndose una &#250;nica muestra para estudios&#44; que se almacen&#243; en el Biobanco&#46; Por otra parte&#44; nuestra serie incluye pacientes con niveles moderados de gravedad&#46;Finalmente&#44; hubiera sido deseable disponer de la determinaci&#243;n de la P50 &#40;PaO<span class="elsevierStyleInf">2</span> a la que corresponde una SaO<span class="elsevierStyleInf">2</span> del 50&#37;&#41;&#44; como complemento de las ya mencionadas ecuaciones de predicci&#243;n de la SaO<span class="elsevierStyleInf">2</span>&#46; Sin embargo&#44; las especiales y dram&#225;ticas circunstancias de la pandemia por COVID-19 no permitieron dicha aproximaci&#243;n&#46; No obstante&#44; las ecuaciones utilizadas permiten una aproximaci&#243;n suficientemente exacta a la relaci&#243;n entre PaO<span class="elsevierStyleInf">2</span> y SaO<span class="elsevierStyleInf">2</span><span class="elsevierStyleSup">165</span>&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; el presente estudio demuestra de forma fehaciente&#44; y en situaci&#243;n cl&#237;nica real&#44; que el virus SARS-CoV-2 no parece afectar de forma relevante la afinidad entre el ox&#237;geno y la mol&#233;cula de hemoglobina&#44; ni tampoco desnaturalizar el grupo hemo&#46; Por tanto&#44; el uso de la PaO<span class="elsevierStyleInf">2</span> para valorar el estado de oxigenaci&#243;n sigue siendo v&#225;lido tambi&#233;n en pacientes con COVID-19&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Financiaci&#243;n</span><p id="par0080" class="elsevierStylePara elsevierViewall">Financiado por una beca no restringida de Boehringer-Ingelheim y por Fundaci&#243;n Catalana de Neumolog&#237;a &#40;FUCAP&#41;&#46;</p></span></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La afectaci&#243;n pulmonar por COVID-19 se asocia frecuentemente con alteraciones en la oxigenaci&#243;n&#46; La presi&#243;n parcial arterial de ox&#237;geno &#40;PaO<span class="elsevierStyleInf">2</span>&#41; es la variable m&#225;s utilizada cl&#237;nicamente para valorar dicha oxigenaci&#243;n&#44; ya que influye decisivamente en el ox&#237;geno transportado por la hemoglobina &#40;expresado por porcentaje de saturaci&#243;n&#44; SaO<span class="elsevierStyleInf">2</span>&#41;&#46; Sin embargo&#44; dos estudios recientes realizados respectivamente <span class="elsevierStyleItalic">in silico</span> y mediante t&#233;cnicas &#243;micas en hemat&#237;es de pacientes han sugerido que SARS-CoV-2 podr&#237;a disminuir la afinidad del ox&#237;geno por la hemoglobina &#40;lo que implicar&#237;a que la PaO<span class="elsevierStyleInf">2</span> sobrevalorar&#237;a la SaO<span class="elsevierStyleInf">2</span> real&#41;&#44; e incluso reducir&#237;a la cantidad de esta mol&#233;cula transportadora&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Evaluar dicha hip&#243;tesis en muestras gasom&#233;tricas de pacientes con COVID-19&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron las gasometr&#237;as de todos los pacientes con COVID-19 realizadas en nuestro laboratorio&#44; as&#237; como las de dos grupos control&#58; pacientes sincr&#243;nicos con PCR negativa &#40;GCS&#41; y grupo hist&#243;rico &#40;GCH&#41;&#46; Se compararon por separado las SaO<span class="elsevierStyleInf">2</span> y saturaciones venosas &#40;SvO<span class="elsevierStyleInf">2</span>&#41;&#44; medidas por cooximetr&#237;a &#40;COX&#41; con las calculadas mediante las ecuaciones de Kelman &#40;K&#41;&#44; Severinghaus &#40;SV&#41; y Siggaard-Andersen &#40;SA&#41; en cada grupo&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Las cifras de SaO<span class="elsevierStyleInf">2</span> y SvO<span class="elsevierStyleInf">2</span> medidas y calculadas fueron pr&#225;cticamente superponibles en todos los grupos&#46; As&#237;&#44; los coeficientes de correlaci&#243;n intraclase &#40;<span class="elsevierStyleSmallCaps">CC</span>I&#41; en COVID-19 para SaO<span class="elsevierStyleInf">2</span> fueron 0&#44;993 en COX-K y 0&#44;992 en COX-SV y COX-SA&#59; siendo 0&#44;995 para SvO<span class="elsevierStyleInf">2</span> tanto en COX-K como en COX-SV y COX-SA&#46; La hemoglobina y la ferritina resultaron algo superiores en el grupo COVID-19 respecto de GCS y GCH &#40;hemoglobina&#44; p &#60; 0&#44;001 en ambos&#59; ferritina&#44; p &#60; 0&#44;05 para GCS y p &#60; 0&#44;001 para GCH&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En condiciones cl&#237;nicas&#44; el SARS-CoV-2 no influye de forma apreciable en la afinidad del ox&#237;geno por la hemoglobina&#44; ni tampoco en los niveles de esta &#250;ltima&#46; Por tanto&#44; la PaO<span class="elsevierStyleInf">2</span> es un buen marcador de oxigenaci&#243;n sangu&#237;nea tambi&#233;n en COVID-19&#46;</p></span>"
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        "resumen" => "<span id="abst0035" class="elsevierStyleSection elsevierViewall"><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Pulmonary involvement in COVID-19 is frequently associated with alterations in oxygenation&#46; The arterial partial pressure of oxygen &#40;PaO<span class="elsevierStyleInf">2</span>&#41; is the most clinically used variable to assess such oxygenation&#44; since it decisively influences the oxygen transported by hemoglobin &#40;expressed by its percentage of saturation&#44; SaO<span class="elsevierStyleInf">2</span>&#41;&#46; However&#44; two recent studies conducted respectively <span class="elsevierStyleItalic">in silico</span> and using omic techniques in red blood cells of COVID-19 patients have suggested that SARS-CoV-2 could decrease the affinity of oxygen for the hemoglobin &#40;which would imply that PaO<span class="elsevierStyleInf">2</span> would overestimate SaO<span class="elsevierStyleInf">2</span>&#41;&#44; and also reduce the amount of this carrier molecule&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Objective</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">To evaluate this hypothesis in blood samples from COVID-19 patients&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Methods</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Blood gases of all COVID-19 patients performed in our laboratory in two months were included&#44; as well as those from two control groups&#58; synchronous patients with negative PCR for SARS-CoV-2 &#40;SCG&#41; and a historical group &#40;HCG&#41;&#46; Both SaO<span class="elsevierStyleInf">2</span> and venous saturations &#40;SvO<span class="elsevierStyleInf">2</span>&#41; measured by cooximetry &#40;COX&#41; were compared separately with those calculated using the Kelman &#40;K&#41;&#44; Severinghaus &#40;SV&#41; and Siggaard-Andersen &#40;SA&#41; equations in each group&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Results</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Measured and calculated SaO<span class="elsevierStyleInf">2</span> and SvO<span class="elsevierStyleInf">2</span> were practically equivalent in all groups&#46; Intraclass correlation coefficients &#40;ICC&#41; for SaO<span class="elsevierStyleInf">2</span> in COVID-19 were 0&#46;993 for COX-K and 0&#46;992 for both COX-SV and COX-SA&#59; being 0&#46;995 for SvO<span class="elsevierStyleInf">2</span> for either COX-K&#44; COX-SV or COX-SA&#46; Hemoglobin and ferritin were slightly higher in COVID-19 compared to SCG and HCG &#40;hemoglobin&#44; p &#60; 0&#46;001 for both&#59; ferritin&#44; p &#60; 0&#46;05 for SCG and p &#60; 0&#46;001 for HCG&#41;&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusion</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Under clinical conditions SARS-CoV-2 does not have an appreciable influence on the affinity of oxygen for the hemoglobin&#44; nor on the levels of this carrier molecule&#46; Therefore&#44; PaO<span class="elsevierStyleInf">2</span> is a good marker of blood oxygenation also in COVID-19&#46;</p></span>"
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                  \t\t\t\t">66 &#177; 17&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">64 &#177; 13&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>G&#233;nero femenino &#40;&#37;&#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">43&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">49&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>Tabaquismo activo &#40;&#37;&#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">8&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&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>Ex fumador &#40;&#37;&#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">28&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">24&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>Enolismo &#62; 100 g&#47;d &#40;&#37;&#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">6&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">5&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>&#205;ndice masa corporal &#40;kg&#47;m<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">2</span></a>&#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">22&#44;3 &#177; 3&#44;5&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">23&#44;3 &#177; 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">Presentaci&#243;n cl&#237;nica</span></span></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>Fiebre &#62; 38&#176; C &#40;&#37;&#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">65&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">61&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>Tos &#40;&#37;&#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">74&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">73&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>Disnea &#40;&#37;&#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">72&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">76&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>Astenia &#40;&#37;&#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">46&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">42&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>Anorexia &#40;&#37;&#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">16&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">18&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>Taquicardia &#62; 100 lat&#46;&#47;min &#40;&#37;&#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">27&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">23&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>Taquipnea &#62; 20 resp&#46;&#47;min &#40;&#37;&#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">34&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">30&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>Sin afectaci&#243;n radiol&#243;gica &#40;&#37;&#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">11&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">13&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>Afectaci&#243;n Rx unilateral &#40;&#37;&#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">23&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&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>Afectaci&#243;n Rx bilateral &#40;&#37;&#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">66&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">67&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>SDRA &#40;&#37;&#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">31&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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></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">Fallo multiorg&#225;nico &#40;&#37;&#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">24&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">22&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">Mortalidad en el ingreso &#40;&#37;&#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">21&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">19&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="elsevierStyleItalic">Comorbilidades relevantes &#40;&#37;&#41;</span>&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">79&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">68&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>HTA &#40;&#37;&#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">62&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">57&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>Dislipemia &#40;&#37;&#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">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">50&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
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;41 &#177; 0&#44;08&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">7&#44;42 &#177; 0&#44;08&#42;&#42;&#42;&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">Bic&#46; Est&#46; &#40;mmol&#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
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44;4 &#177; 5&#44;2&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">25&#44;8 &#177; 7&#44;0&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">24&#44;6 &#177; 4&#44;0<span class="elsevierStyleSup">&#42;&#42;&#42;&#43;</span>&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">EB &#40;mmol&#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
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;7 &#177; 4&#44;5&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&#44;3 &#177; 4&#44;8&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&#44;7 &#177; 3&#44;9<span class="elsevierStyleSup">&#42;&#42;&#42;&#43;&#43;</span>&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">Hb &#40;g&#47;dl&#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">12&#44;4 &#177; 2&#44;3&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">11&#44;8 &#177; 2&#44;4&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">13&#44;3 &#177; 1&#44;8<span class="elsevierStyleSup">&#42;&#42;&#42;&#43;&#43;&#43;</span>&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">Ferritina &#40;ng&#47;ml&#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">553 &#177; 690 &#40;NR<span class="elsevierStyleSup">1</span>&#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">725 &#177; 687 &#40;NR<span class="elsevierStyleSup">2</span>&#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">1&#46;280 &#177; 1&#46;628<span class="elsevierStyleSup">&#42;&#42;&#42;&#43;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2763505.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">b&#41; Sangre venosa</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Grupo control hist&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Grupo control sincr&#243;nico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Pacientes con COVID-19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#61; 1&#46;461&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#61; 379&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#61; 215&nbsp;\t\t\t\t\t\t\n
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                  \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">Edad &#40;a&#241;os&#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">65 &#177; 23&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">64 &#177; 22&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">67 &#177; 18&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">G&#233;nero &#40;femenino&#44; &#37;&#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">46&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">46&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">49&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">N&#250;mero de gasometr&#237;as &#40;n&#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">3&#46;098&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">1&#46;069&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">544&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">PvO<span class="elsevierStyleInf">2</span> &#40;mmHg&#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">34 &#177; 9&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">34 &#177; 9&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">34 &#177; 9&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">PvCO<span class="elsevierStyleInf">2</span> &#40;mmHg&#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">45&#44;7 &#177; 10&#44;0&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">45&#44;8 &#177; 10&#44;7&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">44&#44;8 &#177; 9&#44;2<span class="elsevierStyleSup">&#42;&#43;</span>&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">CvO<span class="elsevierStyleInf">2</span> &#40;ml&#47;dl&#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">10&#44;3 &#177; 5&#44;4&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&#44;8 &#177; 5&#44;1&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">11&#44;2 &#177; 5&#44;2<span class="elsevierStyleSup">&#42;&#43;&#43;</span>&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">pH&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">7&#44;37 &#177; 0&#44;07&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">7&#44;36 &#177; 0&#44;08&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">7&#44;38 &#177; 0&#44;06<span class="elsevierStyleSup">&#42;&#42;&#42;&#43;&#43;&#43;</span>&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">Bic&#46; Est&#46; &#40;mmol&#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
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#44;0 &#177; 4&#44;3&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">23&#44;8 &#177; 5&#44;2&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">24&#44;4 &#177; 4&#44;0<span class="elsevierStyleSup">&#42;&#43;&#43;</span>&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">EB &#40;mmol&#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
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3 &#177; 4&#44;0&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&#44;2 &#177; 4&#46;2&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">1&#44;0 &#177; 4&#44;1<span class="elsevierStyleSup">&#42;&#42;&#42;&#43;&#43;&#43;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab2763507.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Datos relativos a las gasometr&#237;as arterial y venosa en los diferentes grupos de pacientes <span class="elsevierStyleBold">a&#41; Sangre arterial</span></p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
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        "mostrarFloat" => true
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
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        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">SaO<span class="elsevierStyleInf">2</span>&#58; saturaci&#243;n de ox&#237;geno en sangre arterial&#59; SvO<span class="elsevierStyleInf">2&#58;</span> saturaci&#243;n de ox&#237;geno en sangre venosa&#59; CCI&#58; coeficiente de correlaci&#243;n intraclase&#46;</p>"
          "tablatextoimagen" => array:2 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\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" scope="col"><span class="elsevierStyleBold">a&#41; Sangre arterial</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo control hist&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo control sincr&#243;nico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pacientes con COVID-19&nbsp;\t\t\t\t\t\t\n
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                  \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">SaO<span class="elsevierStyleInf">2</span> medida &#40;&#37;&#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">94&#44;4 &#177; 4&#44;9&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">94&#44;8 &#177; 4&#44;1&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">95&#44;0 &#177; 3&#44;9&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">SaO<span class="elsevierStyleInf">2</span> Kelman &#40;&#37;&#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">94&#44;5 &#177; 5&#44;0&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">94&#44;9 &#177; 4&#44;2&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">95&#44;0 &#177; 3&#44;8&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="elsevierStyleItalic">CCI vs&#46; SaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">medida</span>&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&#44;989 &#91;0&#44;988-990&#93;&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&#44;991 &#91;0&#44;988-0&#44;993&#93;&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&#44;993 &#91;0&#44;991-0&#44;994&#93;&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">SaO<span class="elsevierStyleInf">2</span> Severinghaus &#40;&#37;&#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">94&#44;5 &#177; 5&#44;1&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">95&#44;0 &#177; 4&#44;1&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">95&#44;0 &#177; 4&#44;0&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="elsevierStyleItalic">CCI vs&#46; SaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">medida</span>&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&#44;987 &#91;0&#44;986-0&#44;988&#93;&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&#44;990 &#91;0&#44;987-0&#44;993&#93;&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&#44;992 &#91;0&#44;991-0&#44;993&#93;&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">SaO<span class="elsevierStyleInf">2</span> Siggaard-Andersen &#40;&#37;&#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">94&#44;4 &#177; 5&#44;0&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">94&#44;8 &#177; 4&#44;1&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">94&#44;8 &#177; 3&#44;9&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="elsevierStyleItalic">CCI vs&#46; SaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">medida</span>&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&#44;987 &#91;0&#44;986-0&#44;988&#93;&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&#44;991 &#91;0&#44;988-0&#44;993&#93;&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&#44;992 &#91;0&#44;990-0&#44;994&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab2763508.png"
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            1 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">b&#41; Sangre venosa</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo control hist&#243;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grupo control sincr&#243;nico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pacientes con COVID-19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><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">SvO<span class="elsevierStyleInf">2</span> medida &#40;&#37;&#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&#44;3 &#177; 17&#44;9&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&#44;1 &#177; 18&#44;0&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">61&#44;6 &#177; 18&#44;8&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">SvO<span class="elsevierStyleInf">2</span> Kelman &#40;&#37;&#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&#44;0 &#177; 17&#44;4&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">59&#44;5 &#177; 17&#44;3&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">61&#44;1 &#177; 18&#44;2&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="elsevierStyleItalic">CCI vs&#46; SvO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">medida</span>&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&#44;991 &#91;0&#44;990-0&#44;991&#93;&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&#44;990 &#91;0&#44;988-0&#44;991&#93;&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&#44;995 &#91;0&#44;994-0&#44;996&#93;&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
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