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Characteristics and outcomes by ceiling of care of patients hospitalized with COVID-19 during four waves of the pandemic in a metropolitan area: a multi-center cohort study

The aim of this study was to describe clinical characteristics and outcomes of COVID-19 patients and study the impact of ceiling of care in them across waves. Patients with a ceiling of care were mainly older, with more comorbidities at baseline and some features of its clinical profile changes among waves. Patients with a ceiling of care in all waves had poorer outcomes than patients without a ceiling of care. Due to differences at baseline and in outcomes between patients with and without ceiling of care, analysis should be stratified according to therapeutic ceiling of care to avoid bias.